Ruby had a good start to her day,
since the output has been down they have been able to take out her left chest tube!
That was an exciting start. They also switched her to a different ventilator over night to help manage the leak. Her feeds are up to 30mls per hour and she is tolerating them well. Still lots of air in her tummy, but she is slowly getting it through, and we did a bowel irrigation to help her out and plan to do another this evening.
She has been having a hard time this afternoon because they've switched her to oral doses of morphine, taking her off of fentanyl... Trache care (changing the gauze around it) was not a fun time on less sedation and it took her a long time to calm down. We are hoping that this method of weaning will pan out, but she is not off to a great start with it, so they may have to try a different method. We are going to do some iv doses of morphine for trach care over the next few days to see if that helps.
On a more positive note, the ivabradine seems to be slowing her heart rate better, so she's been sitting in a good spot even though she has periods where she is pretty upset.
With being upset throughout the day her oxygen settings have been a bit up and down, but her saturations haven't plummeted, just been a bit low.
It's hard to tell if she is having withdrawal or pain/discomfort or a combination of the two, since she can't really tell us how she's feeling. She just gets upset and writhes or grimaces a lot. She's rated at a 4 once the scoring system for withdrawal but it's so hard to know if the scoring is correct in babies.
I know the more sedation they remove the more upset she'll be, and it's incredibly hard to watch and not be able to comfort her very well. But I guess this is progress (?) to be talking about weaning her off these things... Just hoping it won't set her back in any way and that she can be more comfortable as we move forward.
