Lessons in freaking out

You'll have to excuse me not updating yesterday, it was a bit of an anxiety-producing day. A pleural effusion (fluid in Rowan's chest) showed up on the chest x-ray yesterday and I didn't want to put a "We're freakin' out!" post up without a good reason. Yes, there is a little bit of fluid now. No, this does not mean the surgery didn't work or that he will need the chest tube put back in. I missed morning rounds yesterday, so I didn't get the doctor update until later in the morning and all I knew was "he did have an effusion on his x-ray" from his nurse. I talked to the fellow and she basically said "It's there, but it's just a smidge. We are going to treat it aggressively." My response: "So it's not time to freak out yet, then?" Well, today the little effusion is still there, but not worse. I was there for rounds this morning and they showed me his x-ray. It really is just a smidge(even with the x-ray being twice his actual size). And they said if it was going to be a problem like before, it would be more serious already and we wouldn't be going down on his vent settings like we are continuing to do! His blood gas levels continue to do well with lower settings and every day he is getting closer to getting that tube out. I think we will throw a party when he has spent more of his life breathing on his own than through the machine. (That will likely be about 7 weeks after he gets extubated.) So priority #1 is getting him there.

The other biggy for him is food. He did really well on his lower rate for two days straight, but did throw up early this morning. So the new plan is slightly lower feeds and leave it alone until he gets extubated. Hopefully, this will be a pretty short wait.

He was getting agitated overnight (maybe cuz he needed to throw up...) and one of his sedation meds is higher than before, but this is perfectly fine with us. We do love to stare at him and for him to be staring back at us, but he will be much better at that once we get him breathing on his own.

We have learned a lot from this little one. Primarily, a lot of patience. But I also know that the way I talk to patients is drastically different than it was before all this (I did a couple half-days in Tulsa in our clinic the week before last). I mentioned the change to a med student that was with me and she asked "Does that mean you're more caring or less?" My response: Yes. More than anything, I think I am much more comfortable being on the doctor side than I was two months ago. I am open with them in saying what is important and what isn't regarding their health. So I am more caring about the things that really affect them and less caring about the things they just don't know are not that big of a deal. Without a medical degree, the average person just isn't going to know that certain things are OK. I know that m'Lady has learned an incredible amount of medicine in the last two months and I do have a medical degree, but even with that it is still difficult to know at times how much we need to freak out. For now, we do like everyone else and just freak out more than is necessary until we're told otherwise. We're getting better at controlling that, but it is a tough change.

I would say it would be nice to have children that weren't so good at teaching us things, but who am I kidding? I would hate to have a boring kid. Luckily, I don't think I am going to have that problem with either of the ones I have now.