Quick Medical Update
Things have been really hectic and changing so rapidly. Sarah has asked me (Loretta) to give a quick update until she can get on the computer tomorrow, hopefully.
Ellie is in the Pediatric ICU since last night around 8 PM. Yesterday, the procedures to remove her Broviac and the placement of a new Central Line were completed successfully. Following that, as she was coming out of the anesthesia, she went into Septic Shock and ultimately went into cardiac arrest.
The pulling of the Broviac 'released' or somehow caused the bacterial infectious condition to explode (septic shock). She was moving in the direction of sepsis since Monday night when the fevers began. The placement of the new line caused the additional complication of internal bleeding in the pleural cavity. This fluid in the cavity pressed on her lungs causing inability to breathe and eventually contributed to the shifting of her esophagus and heart in the chest cavity. This all culminated in cardiac arrest and extreme difficulty intubating her(placing a tube in her airway). They worked on her for approximately 4 hours before they could transport her to ICU. During that time her heart stopped for 3 minutes, but resuscitation was eventually achieved. She is on "significantly excessive" amounts of blood pressure medication. She was placed in a drug induced coma and put on a ventilator (breathing machine). They are keeping her body temperature around 94-95F to prevent cardiac arrest, decrease metabolic demands, and studies have shown this improves neurological outcomes. John stayed the night with Ellie in ICU and he reported the medical team worked all night to try to keep her stable - her tissues are full of fluid, her blood pressure was difficult to stabilize. She appeared swollen all over especially her head, neck, chest, and hands. The fluid in the pleural cavity is not draining from the chest tube well and the lungs now show fluid build-up. The doctor told John the swelling will get worse before better, and the kidney and liver function will get worse before they get better. If Ellie does not adequately deal with all of this fluid they will have to put her on dialysis to assist. They reported being mostly pleased with her urine output and bladder function. The doctor concluded, "she is not out of the woods yet, but is doing okay".
Mid-morning, the doctors suspected a clot in the right side of the chest cavity which seemed to be impeding the draining of the fluid from her chest. They initially planned to have the surgeons come in around noon and try to flush the drain and remove the clot or administer drugs to bust the clot up. They were also planning a CT Scan of the head around 2 PM and another x-ray of her chest. By mid-day, the decision by the medical staff was to cancel all tests and procedures and let Ellie rest. They stated somewhere during the early morning hours to the present she had begun to show signs of stabilizing and they did not want this jeopardized by any procedures that could aggravate the sepsis further or cause cardiac arrest again. They felt the fluid drainage from the chest cavity was adequate enough to allow delay of the investigation of the clot until tomorrow. A chest x-ray was done, but no CT Scan of her head.
Around 5 PM Ellie began to show signs of consciousness as they had stopped the paralytic drugs in preparation for helping her to start breathing on her own. The swelling in her face and neck appeared to be lessening. John was able to communicate with her!!! He asked her if she could squeeze his finger - she squeezed with both hands! John reported that Ellie was beginning to have "little sessions of movement" when someone would come in to do something to her -- clean her mouth, mess with one of the 9 tubes coming or going in her body, etc. She definitely doesn't like any of that! We still have the clot in her chest to deal with tomorrow, however they are more comfortable with her brain functioning in light of these new responses from her.
As the day has passed Ellie appears to be progresing. So much so that tonight and through the morning hours they will begin to wean her off some of the blood pressure meds and the ventilator as well. Her Aunt Melanie will be with her tonight so that John and Sarah can get some much needed rest - they will be only two minutes away.
Sarah wants you to know that while she has really wanted to get on and "blog" she has been unable for one reason or another. She asked that this medical update be given with the hope that she will be able to get on tomorrow and share her heart with you all. She says she appreciates and feels the prayer and love of everyone and is strengthened by you all. She asked me to read the comments to her tonight over the phone before she went to sleep.