Post-Op Day 3

Jake is starting to show his strength and what a fighter he is.  As you can imagine, he is exhibiting the signs that he is sick and tired of the tube in his throat and is starting to fight more against it.  In the early am, we were informed that Jake was meeting all of his feeding and water goals through his feeding tube but that didn't last very long.   Jake appears to be dealing with a lot more fluid and is struggling to cough and battle it while intubated.   This morning's monumental session saw Jake fight vigorously in his bed before relieving himself of his entire stomach's contents.   After being cleaned and relaxed, Jake resumed his deep slumber with some help of his drug cocktail mixed with pain and anxiety relief.  

During morning rounds, we discussed his escalated agitation with the breathing tube as well as his vomiting.    The plan was set to remove his feeding regimen since after midnight Jake was going to have to switch back IV anyway to prepare for Monday's extubation.  

The PICU doctors also ordered lasik to dry Jake's body of massive fluids as another preparatory maneuver.  It appeared that Jake outside of the increased agitation and vomiting would still be on track to remove the breathing tube and eye sutures Monday.   

When the Plastic Surgery team rounded, we discussed their point of view on Jake's condition.  They removed Jake's bandage around his head that was covering his incision site which they had reopened his zig-zag scar from his previous head surgery which travels from ear to ear.    The incision site looks great and they were quite pleased with how everything looked.  

Jake continued to struggle with his breathing tube throughout the day and the build up of congestion in his throat and stomach.  It appears its a sign that he is ready for the next step in his recovery.   Making strides towards that as they removed his catheter and Jake has now reached the target for body fluid level.   Essentially he is drying out as they need him to.   

His appearance looks better today and we think he is draining and appearing less swollen.   

Tonight, Jakey appeared to be more aware and was battling hard with his tube trying to roll out of his bed and throw his head up.   Took a while to calm him down and the resident ordered a slight increase in his medicine.   Jake has finally surrendered to the increased dose and hopefully can rest before the big day tomorrow.