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Powered by LifeTypeThe doctors started talking about discharge last Friday and that continued on Monday. They decided to turn off the continuous morphine and moving more of her medicines to her NG tube.
I was pretty skeptical that she was going to tolerate only on occasional morphine and I expected her to vomit more with the increased meds through her NG tube, but as of Tuesday, she has been doing about the same as the previous days, so that is good. She has continued to play and also vomit a little.
We've had some full days since our last post, so I'll try to catch you all up.
On Friday night, Jon and the girls went to Camp Maranatha for the annual father-daughter retreat and the boys went to Boston to stay in the apartment.
We went to Target to get some maternity shirts for Heather and the girls thought the mannequins' positions were pretty funny and so mimiced them.
Grace has been steadily improving.
She is not throwing up as much, she's had a few messy diapers that look more normal than she's had in months, or even ever.
She had an ultrasound which she slept right through.
Her drain has not been putting out much, so they wanted to check the fluid level. This is the first time I've watched her ultrasound, so I can't compare. And it's really hard to tell what's what, but I did recognize the kidneys.
I started to write that I hadn't heard any results yet, but the radiology doctor just came in and said there is still evidence of VOD, but the fluid level is down.
Yesterday, she was interested in eating, notably when she had to be fasting for the ultrasound. When she was allowed to eat, she had some fruit snacks and trail mix, but it came back up. The nurse thought it was mostly because of mucus that she had to get out, but I'm not so sure.
She had fun playing with the safe in our room, with her babydoll accomplice.
Today we woke up early to error 12 from the feed pump. It makes it continuous high-pitched beep until someone comes to turn it off.
She threw up very soon after waking up, and I think we need to do a wake up button push every morning. (She didn't need it at all in the night, so she is improving.)
But she's been happily playing since. She says and signs "later" when I ask if she wants to eat. She tolerated playing in the room while I folded laundry and got dressed, but we went for a walk as soon as possible and have been in the playroom for quite a while now.
Grace had a great day today, despite staying up until after midnight (I went to sleep, but I asked the nurse in the morning, and she stayed up reading her new book and trying to not let the nurses check her oxygen levels since that would involve taking away her light...)
We have lots of good news to report.
Grace has been improving the last couple of days. Her abdomen measured 53.5 cm, the smallest it has been in weeks. They have changed her cyclosporin from IV to NG (nasogastric) which is a step towards getting ready to be discharged. The dosage for cyclosporin is changed based on regular lab draws, and the medicine absorbed changes based on the method of administration, so I imagine that is why they are changing this one to NG first. All meds will need to be changed to NG before we can leave.
Our family will be in Boston next weekend (after the father-daughter retreat at Maranatha) and we are wondering if there is anyone who would be willing to spend some time at the hospital so our whole family (minus Grace) can go out to Boda Borg and the same sushi buffet that some of us went to last week.
I think we could do dinner on Saturday night around 6:30 or Sunday around 5:30.
We are going to Boda Borg on Sunday afternoon from 12:30PM to 5:30PM or so.
From Jon "[Yesterday's ultrasound] didn't report too much that we didn't already know. There was a little fluid in her abdomen on that side, so I wasn't expecting much, but a fair bit came out last night, I think 100 mls in the last three drains. The fluid near her lungs is almost gone. Her stomach measurement is down a little, but the accuracy doesn't seem to be great. They are about to measure again once she pees from the lasix. They've turned her oxygen down to 1/4L.
They are going to start food through her today.
So, lots of good news."
Her stomach measurement this morning was even less. The nurse has turned off the oxygen. While she was awake, it was perfect. Now she is asleep and it is down to 96, which is still good. We had a start and stop and start again with the feeds because Grace threw up her ursodial. But so far, as she's asleep, it's been fine.
The diaper change and measurement and weight were a lot of movement for her, so there was a lot of coughing and some vomit.
She asked me to hold her, but then changed her mind, so I am sitting by the crib holding her hand.
In addition to the drain being installed yesterday, yesterday was moving day. They have all patients move every month to allow for the room to be completely cleaned. From the few examples I've seen, that generally means moving to a nicer room, since they can pick the day when the move happens, and so we moved one day early to ensure getting a nicer room. The new room is at least 50% bigger, and the bed is double the size, and has a huge window sill due to an interesting architecture design that is hard to describe in person, so we'll have to get a picture of it. If they hadn't done anything with the design, the window would have been facing a wall or maybe a tiny portion of the garden. But, instead the installed a floor to ceiling mirror diagonally, and then a left-facing window, with a window sill that is probably 6 feet long, and 7 or 8 feet tall. The result is that there is another "room" that I think with some pillows or blankets, might make for a nice little nook to hang out in behind the bed, so we'll have to try that out. It probably won't work for Grace, due to all of her connections to the pumps, but I expect the siblings will enjoy it.
The last couple of days have been tough, but today is looking up. At 2:00 this morning, Jon called me to say that her breathing was worse and they were considering bringing her up to the ICU. I called my sister, she prayed for us. 45 minutes later, Jon texted to say that they had increased her oxygen and her breathing was better, so she was not going up to the ICU.
In the morning, Jon discovered that they had actually turned up the wrong oxygen supply, and she was getting the same amount that she had been. So that means that God helped her breathe last night despite the nurse's mistake.
Jon also had a good last rounds conversation with the doctor that he'd been having trouble communicating with. He had some good conversations with nurses about beeping and things, and despite being up partly in the night with the ICU investigation, he got a good amount of sleep. So that is an answer to prayer also.
This afternoon, they put in a drain to her abdomen, and have gotten out a significant amount of fluid so far (I think over 100ccs.) She has been sleeping a lot, so it's hard to know how that's affected her, except that it seems like sleeping peacefully is probably a good thing and that she's more comfortable.
Today is also the day of official engraftment! Her ANC was up to 700 today. Yesterday, there was one reading that was 480, but because they took another reading that was over 500 it still counted, so today is the third day.
Please continue to pray for wisdom about her liver, as we're still not sure what's going on with that.
I've had a lovely time at home, including many conversations, a game of Wingspan, and a beautiful hymn sing. I'll be bringing Faith back down with me in the morning.
Grammy is staying with Grace tonight, Jon is sleeping at the apartment. Grammy helped him pack up the old room and set up the new room. Every 30 days, they need to do a whole thorough room cleaning, so we needed to switch rooms. It is bigger than our old room.
The last several days have been back and forth. I’ve started several posts in my head, and then they end up changing. The weekend doctors cancelled the stool studies, then the attending on Monday re-ordered them. Jon had some very frustrating conversations with the doctor, but an encouraging one with the social worker. Also, conversations with nurses and clinical assistants about ratios of pee and poop in potties and diapers. But before they actually put her on precautions, Grace got some time in the morning in the playroom with PT, who was happy with her strength for squatting and getting up and down and reaching.
I also forgot to post this picture of her walking with her shopping cart, from a couple of days ago.
Once again, it was good for me to visit home. This time, I brought Joy back with me. We left later than I meant to, for various reasons (one being the second batch of Victory tshirts came in!) so we had a bit more traffic in Boston than I have yet driven in. It was stressful for Joy, I think, but I am getting used to it.
Grace was so happy to see Joy! They have a secret handshake that in the past Grace has sometimes rather reluctantly done. But this time, she volunteered all the pieces, including the last one, and that made Joy happy, too.
Grace had a great day today. She went out for a walk, wasn't even too upset when Heather left for Hillsboro, waved at everyone as we walked down the hallway. (She was especially adorable today because she brought a toy vacuum cleaner instead of her normal shopping cart, which is useful for stability as well as bringing things everywhere). Various staff members thanked her for cleaning up the hallway)