Post-Op Day 2

Last night brought an interesting turn of events.  Around 10:30 pm, Jake appeared to emerge from his sedated state and attempted to sit up.  This sent the nurse and mom into a full sprint to his bedside to calm him down and administer more medicine.  The doctors do not want Jake emerging from his slumber nor moving around so this was a bit alarming.  Before long, Jake was back to sleeping soundly.   

The weekends change things at the hospital and it was certainly evident, as the rounds seemed to begin much later.  Neurosurgery popped by for a split second and then it was Plastics turn. We discussed with the team Jake's recent activity along with some bleeding but were assured everything looked normal and Jake was doing well. They reminded us about the swelling and did indicate we would have to evaluate his eye swelling before they will release the eye sutures.  

Jake did give us some surprises today.  After grimacing and turning to his side, we gave him some more pain medication.  Then the fun started. Jake decided to resist all of his pain medication and started to lift his head up, tried to sit up and thrashed a bit in his bed.   Of course, he timed it perfectly while his nurse was on break.   We helped calm him down and spoke to him to get him to stop the urge to sit up.   Now remember, none of his doctors want him in an awake state while he is intubated and his eyes are sewn shut.  After we whispered to him and held his arms and touched his face we were able to relax Jake but we definitely think he heard us and was in a more lucid state.  After they authorized a larger dose of pain meds, Jake resumed his peaceful sleep.  It was a little unsettling because his movement causes bleeding and then Jake actually was making choking noises and vomited.  This was scary because he has the tube in and so the nurses needed to suction all of that out and clean out his line to prevent aspiration and the fluids creeping into his lungs.   While Jake slept, the nurses had to clean out his line connected to his stomach, which the process makes him cough.  Then, they listen with the stethoscope to his stomach to see if he is breathing clear.  We had to repeat this process several times until Jake was relieved and got a clear sign.   

We reviewed all of this activity with the PICU doctors during their rounds and they laid out a plan for greater pain meds if need be and ordered an x-ray to make sure his tube didn't move during all of the activity.  

The swelling has continued throughout the day and all of his features look pumped up with air.  It is hard to process but just when we think he has reached peak swelling he finds a way to get bigger.

The rest of the afternoon, Jake returned to his peaceful sedated sleep and we avoided any other activity.  We did find out that on Monday after extubation in an OR, Jake would come back to the PICU for at least a day to ensure his breathing without the tube is on track.   

After an uneventful afternoon, we did find out that the x-ray showed that the tube had to be repositioned.  Jake was given some more medicine and a paralyzing agent to keep him still while they repositioned his breathing tube.   A frustrating but necessary task and the medicines helped Jake remain still while the Respiratory Therapist and Nurse got the job done.   

Jake is now resting peacefully after being cleaned and repositioned for the night.  Let's hope his physical feats are over for the time being so we can proceed towards Monday.