Things have been really hectic and to top it off I forgot my password for blogger...
Mali was very very sick. We got home 2 weeks ago after a 3 week stint in hospital. She had a complicated pneumonia with empyemas which required 2 weeks in ICU on a ventilator and 2 surgeries. It has been a scary time to say the least. I will give a brief recap, more so that I can show her one day.
Saturday 24th May - Dave woke me up at about 11am to tell me Mali was really tired and was having a nap on the lounge. This was far to early for her to nap so I got up and checked her. She was running a really high fever so I gave her some panadol. After 30 minutes her temp was still 39.5C so I ran out and got some nurofen for her. I managed to get the temp down to 38.2 piggybacking the two. I thought it might just be a virus and was willing to give it 3 days to run its course. She continued about the same for 3 days but by the Monday night she was miserable.
Tuesday 27th May - Mali woke up at 2am and was inconsolable. I put her in the bath for a bit and then we hopped into her bed but she was falling asleep sitting up and then would cry every 10 minutes. We left at 7:30am for the doctors, I honestly thought she might have tonsillitis or something, I was very wrong. The doctor took one look at her, listened to her chest and told me she had increased sounds on the right and none on the left and I needed to take her straight to Gosford hospital. So off we went.
Once in the ER at gosford she declined quickly with RR of about 60 and SpO2 or about 88. They put a canular in and did a portable x-ray and put her on some oxygen. They then moved us to the resus bay so they could monitor her more closely. Her Xray showed her lower and middle left lung were whited out (pneumonia) and one of the doctors thought there was signs of an occlusion (fluid around the lung). They then did an Ultrasound of her lung but found no fluid but that the lung was completely collapsed. They started her on 3 antibiotics (fluclox, cephotaxine, cyclomyocin) and we spent the night in the High Observation room.
Wednesday 28th May - Mali seemed a lot better in the morning and we were moved to a normal room. She was up walking around and playing. Her canular occluded at about 2 0r 3 pm. The resident attempted to put in a new one (in three different places, poor baby) but could not get one. We then had to wait for the anethitist to come put one in. He got one in her foot first try but we had already missed 2 doses of antibiotics. She had a really rough night but her SpO2 stats stayed okay at 94 room air.
Thursday 29th May - Sent for another X-ray which showed the entire lung was now whited out. Sent straight away for another U/S. As soon as they started this one I could see all the fluid....I was given the option of heading to Westmead or John Hunter. I chose Westmead (good thing too as we would have ended up there anyway) and we waited until about 7pm for an ambulance transport. Poor Mali was so scared on the way down there but was so brave. They had booked us a bed on the ward but as soon as we got there they had ICU registrar Jo and ICU nurse practitioner, Brad come and evaluate her as they felt she was too unwell to go to the ward. They decided she needed surgery to place an intercostal chest drain straight away and that she should stay on the ventilator until the next morning. I think this night was the hardest. I lost it but was trying not to cry for her. We walked with her to surgery and as they wheeled her away she yelled out 'Bye Mummy' and my heart broke. Her surgery was over very quickly (about 30 minutes) and they brought her back to ICU. Seeing her with all the tubes was so scary and I was in tears so they sent us to bed for the night.
Friday 30th May - Mali was very sedated still and on the ventilator. They placed a central line in as she would be on antibiotics for awhile. They also had to reposition the vent tube to in her nose and put in an arterial line. The X-ray that day looked the same or a bit worse and they decided to keep her on the vent until at least the next day.
Saturday 31st May - Respiratory team decides to use Urokinase to flush the drain which would help dissolve any puss in there. Still ventilated and expected to be until sunday or monday.
Sunday 1st June - Urokinase started. Still ventilated and continues to spike 39.6 temps.
Monday2nd June - The temps still spiking, not talking about taking her off the vent anytime soon. She has started desaturating when they do physio. X-ray looking a little worse.
Tuesday 3rd June - Test comes back positive for pnumococcus antigen. Antibiotics reduced to just the Cephotaxine.
Wednesday 4th June - Sent for a CT scan to see what is in the lung cavity. Shows a large abscess which may be multiple pockets or one big one. 2 surgery options suggested. Either a radiologist goes in and aspirates the abscess and hopefully the rest will drain out or keyhole surgery to actually remove the puss and abscess. Thankfully the ICU consultant (David) and the surgeon both wanted to do the keyhole surgery which would have the greatest chance of working. Surgery planned for the next day.
Thursday 5th June - Sent to surgery at 8:30am. Takes about 3 hours. Surgeon says it went really well and there was alot of stuff to remove. Once her removed the web of fibrin over the lung it inflated. He was pleased they decided to do that surgery. She now had two chest drains which were a fair bit larger than the original. One in the original site and one lower down. She also had a small incision on her back where to camera was put in. Due to the surgery all her vent settings were put back up and they decided to leave them for a couple of days to give her lung a chance to recover a bit.
Friday 6th June - Xray looked about the same. Still high temperatures but it was assumed this was from stirring up the toxins into her system. Infectious diseases decided to place her on Flagil and Vancomyocin to cover anaerobic bacteria and penicillin resistant pnumoccoccus strains.
Saturday 7th June - Vent setting stayed the same but temperatures did drop a little
Sunday 8th June - Vent settings lowered a little. Temperatures seemed to be subsiding.
Monday 9th June - Upper chest drain removed and the began to wean the morphine and switched from midazolam to valium
Tuesday 10th June - Mali was finally extubated. She did really well and I was able to hold her for the first time.
Wednesday 11th June - Lower chest drain removed and arterial line taken out for transfer to ward. Now on oral morphine. Finally started talking a little bit and moving arms to catch bubbles.
Thursday 12th June - Still very sleepy but talking a bit more. Refuses to walk and screams in pain. Acting more like herself.
Friday 13th and Saturday 14th June - Continues to improve. Only one temperature of 38C and did vomit once on Saturday.
Sunday 15th June - Switched to oral antibiotics only (E-myocin and Augmentin Duo) and discuss sending home on Monday
Monday 16th June - Finally discharged. Still not walking but acting like herself now.
She did start walking on the thursday afterwards but she is still abit wobbly on her feet. We have a follow up appointment on the 17th July and if she is not walking normally we will organise physio for her.
Thankfully I was able to stay with her the entire time and a central coast charity, Kids in Need, paid for my accommodation in the parents hostel.
Im so thankful to have her home and that she is ok. We did have alot of fun family drama in there too but it pales in comparison to her health. My mum broke her shoulder an we are currently not speaking to Dave's family...Hopefully that will be sorted out soon.
