Miss Charlotte is doing well here in the PICU. So well, in fact, she has decided to never, ever leave. (OK, that's an exaggeration).
For the past 36 hours Charlotte has been dropping her heart rate, an event called bradycardia, which is frowned upon in the medical field. Charlotte's resting heart rate, as you may remember, has always been pretty high-- a side effect, most likely, from the PDA damage. Most six month olds would typically have a heart rate around 90-100 beats per minute. Charlotte is usually around 150. Not alarming, as every kid is different.
However, for the past day and a half, Charlotte has been dropping her heart rate to well below 100-- mostly to the 70's and 80's but a few times down into the 50's and 60's. All the major "problems" that doctors worry about have been ruled out: She's not septic, she's doesn't have a blood clot, she doesn't have a brain bleed, she's keeping her oxygen sat's up, etc. There doesn't seem to be any symptom to go along with these drops in heart rate.
Last night a CT scan of her head was done, to rule out an acute brain bleed, and it came back "normal for a micropreemie." Meaning, nothing happening right now, but there was "significant loss of brain mass" and "increased cerebral spinal fluid to compensate for brain loss due to a prior incidence." Prior incidence being born way to early. The beautiful part of being a preemie is that nothing is definite. Brain loss like this could mean severe impairment, or it could mean nothing. The CT only shows structure, it cannot comment on function.
The main thing is that she is not critically ill, and we're just not sure how serious these bradys actually are. Typically they are something that indicate something else is going wrong, but we're now entering the "less likely" field of explanations (ie Seizures). So it could very well be that Charlotte has just "re-set" to a new normal, and these bradys are just her new resting heart rate. Or that she just really, really, really loved that sedation and its taking a long time to leave her system.
Someday, though, we're gonna break outta this place. Maybe next week?
Geez--Miss Charlotte!!! You sure are making everyone work hard for their money! Amanda--I love your updates because even when you are blunt, dry and to the point, some of your humor shows through. You totally get it and learned how to not let all of this make you crazy!! And you also are showing others that sometimes there IS no answer to what is happening--and that's OK (frustrating, but ok). Taking it day by day is the only way to go. Oh, and we all know how much Miss Charlotte LOVES her sedation. Thank the Lord she is so stubborn--a good quality for a preemie to have. Hope she continues to cruise along and is back home soon!!
ReplyDeleteDear Charlotte, I think it is time for you to give your parents a much needed break. I promise you that being home is fun and big brothers are quite entertaining.
ReplyDeleteLove,
Eloise
PS My mom says she agrees with everything that Sharon said above and that your mom is an amazing person and she feels honored to know her (virtually).