Hail

I only saw Penelope for 10 minutes today because I was home with Lucy. It took me longer than expected to get back because of the crazy weather. Jeremy said there was golf ball sized hail at our house after I left. Anyway! When I got back I stopped in to see Penelope. She was sleeping peacefully and snoring around her breathing tube. She was started on another round of diuretics today. Her edema is caused by her liver not excreting bile properly because shes been on iv nutrition for so long. They are giving her some meds to help with it in addition to the diuretic. Now that she is not getting IV nutrition it will self correct, but they want to help her so she doesn't have to work so hard. They did not make any feeding or vent changes today. I did notice that her breathing is much better tonight. She is taking 20-30 breaths/min where she was taking 60-70 before. So shes breathing at much more relaxed rate which is great to see. She is also requiring less supplemental oxygen. So the PICC line is scheduled to come out tomorrow, and then they will start focusing on weaning the vent before extubation. Slow and steady wins the race.

Vitamins

Penelope is no longer getting any nutrition through her PICC line. They are running clear fluids through it to keep the line open while they make sure she is tolerating the 'full feeds'. It should be removed sometime in the next 24-48 hours. Instead of going up on volume for feeds, they increased the fortifier calories. She went from 24 to 27 calories per ounce (unfortified breast milk is about 20 calories per ounce). She was also started on a liquid multivitamin today, which she wasn't a fan of! She's her fathers daughter! She kept trying to spit it back up into the feeding tube and they kept giving it back. Her weight remained steady today which was expected from the diuretics she had a few days ago.  All in all she had a good day.

As for the contact isolation, I only have to put on the gown and gloves if I am going to touch her. I was glad to find that out because Lucy insisted on coming with me this morning. She sat quietly in the recliner and watched Mickey Mouse Clubhouse on my android tablet for the hour that we were there.  The nurses were amused that her answer to every question was 'no', even when the question was 'how old are you?'. When the doctor asked for a high five she said "no way!". I was thankful that none of her new and more colorful vocabulary came out! She chose to yell "MONKEY BUTT!" repeatedly while we were at Village Inn for lunch yesterday. She's turning out to be quiet the character.

Contact Isolation

It certainly was odd to be in Bay 2 this morning. We have nurse practitioners instead of residents on our team. Her feeds were increased to 21Q3, so she at full feeds. They will take out her PICC line tomorrow night. Her weight is 3lbs 4.3 oz, so I was pretty close on my guess. She was pretty annoyed with all the noise overnight, but seems to have adjusted to it this evening. I was pretty annoyed that our new doctor put her on contact isolation. For the last 3 weeks her breathing tube has been growing a benign bacteria, and none of the doctors have been concerned about it. Suddenly today's doctor makes a big deal out of the fact that she hasn't been on isolation. So now we have to wear gowns,and gloves just to enter her room...even though her new room is made of curtains. It will be this way until she is extubated. The Bay 1 team had planned on doing it early this week. I don't get the feeling he's on board with that. This is going to be a long rotation.

Jeremy has to work all weekend so my mom brought Lucy down today. My mom went home today. Our plan was for me to take Lucy home Sunday night, and I would come back early Monday morning so that I wouldn't miss rounds. Now that Penny is isolated Lucy can't go in. So I guess I will probably head home with Lucy tomorrow and come back Sunday when Jeremy gets off work.