Endurance

December 9, 2022 9:00am

Slow and steady is how we are proceeding with Zeke. His edema is having all sorts of effects on his body, circulation, respiratory and blood pressures. It’s hard to watch Zeke’s little body trying to adapt to his latest surgery and circulation. His top half is quite puffy and seems to be getting bigger. This is sad and disheartening but I have to remind myself it’s part of the process, his body must figure this all out and adapt. He started chest physio today as part of the process to begin extubation. Because he has been immobile for 3 weeks on his back his lower lungs are quite diminished and needing help

to secrete fluid. The physiotherapists came twice and will assess if Zeke needs more sessions in a day. For now the goal is to help his body move more and secrete fluid from his chest and lower lungs.

Dr Grey and the fellows have set a 24 hour wean schedule for the different medications Zeke is on. This means every 24 hours they are slowly coming down on a dosage of one medication. This is a safe way to wean off opioids and inotropic meds. There will be withdrawal symptoms on his central nervous system that include tremors, increased muscle tension, agitation, anxiety, insomnia, hallucinations, irritability, gastrointestinal symptoms such as vomiting and diarrhea, fever, perspiration, tachycardia, and hypertension. The slow wean is an attempt to try and avoid Zeke experiencing a majority of these withdrawal symptoms but it is likely he will experience some.

His lasix is constantly being titrated to ensure that he does not have too big of a fluid dump that has a negative affect on his pressures but that he is diuresing enough to offload fluid. It’s a fine balance that is sometimes frustrating.

A picc line has been ordered and we are waiting to go the lab for it be inserted in his arm. This will offer a bit more permanency and get Zeke on track to have the central line removed from his neck. There is still concern because his arms are so edematous that they will not find a vein to insert the line in.

All of this is a lot to process and walk through but I’m reminded that God has given us grace to handle today’s concerns. Here is how you can pray for Zeke, he needs to offload fluid and do so safely. Pray his body starts to adapt

to his newest physiological change and his oxygen saturation levels stabilize. Pray for the picc line to be inserted with no complications and for the withdrawal symptoms from opioids and inotropics to be at best minimal. I know that God is able and I trust that he hears us when we pray. Thank you for continuing to pray for Zeke.

Psalm 42:5 “Why are you cast down, O my soul, and why are you in turmoil within me?Hope in God; for I shall again praise him, my salvation”