February 2nd, 2010

Kierson has made substantial progress over the past two days. She has stopped having major oxygen desaturations and heart rate drops. However, she continues to have minor desaturations that the nurses prevent from worsening by simply turning up her oxygen concentration. She is now getting nebulizer treatments every 3 hours that seem to be helping prevent bronchospasms that may have been the problem all along. Her tracheal aspirate culture came back yesterday showing signs of bacterial growth, specifically Proteus. She was initially put on 3 broadspectrum antibiotics (amikacin, vancomycin, zosyn) but now is down to 2 antibiotics (ampicillin and amikacin) since we now know what we're fighting. We're glad it's not the pseudomonas that is 'going around'.

Our neonatologist stated that if she continues to do well, he'll consider extubating Kierson tomorrow. Doesn't mean that it will happen tomorrow, but he is going to consider it. He doesn't want her intubated any longer than necessary as it causes blunting of her neurologic development. He thinks that she may need to go back on steroids to help her lungs get past the inflammation related to the recent infection but will evaluate this in a few days once we're past the infection. However, despite the benefits of the steroids helping her lungs out, their use comes with the trade-off of also causing blunting of her neurologic development.

It's been a miserable past 4 days. We are emotionally exhausted from the critical condition that Kierson has been in. We are very much relieved (...but still very tired...) that she is showing some stability. We know that we aren't out of the woods just yet.

We are very grateful to my fellow residents have taken my shifts in the ED so that I can be up in the NICU with Kierson and Deitre. Thank you all for your continued prayers for Kierson, her docs, nurses and respiratory therapists, and for us.

Here's a pic of Kierson's older sister, Emmerson, showing her recent interest in tools (...soft, chewable tools...). A girl after my own heart...