Saturday, April 27, 2013

Hospital Life...Day 33

Today is Day 33.  If you missed yesterday's post, you can read that HERE.

For the first time in a while, there is really not a whole lot to report.  Pain control is really our number one priority right now.  We want, above all, to keep Peyton comfortable.  Since switching methods of pain control, we've had some rough patches.  One of the issues that persists is that her respiratory rate - the number of times she is breathing in a minute - has been on the low side.  She can get a dose of Morphine every three hours on top of the continuous dose administered through the Fentanyl patch.  However, Morphine can suppress the respiratory rate.  If she's already only breathing 8-10 times a minute, is it wise to give her something that could potentially cause it to be even lower?  Probably not.  That said, her pain wasn't quite controlled, so it's really a fine line to walk.

Through the night, her respirations were pretty slow.  The nurse had counted to about 20-25 between breaths at one point.  The residents came in to assess Peyton.  They decided at that point to withhold additional narcotics {the Morphine} for the rest of the night and see how she was in the morning.  They felt badly doing that because she might possibly need it for pain control.  However, as I said it's a really fine line.

This morning, the nurse had to wait until the resident came by before Peyton could get anything additional.  She was finally able to have her dose of Ativan.  She was pretty sleepy through the morning and into the afternoon, so we weren't sure what to do about the Morphine since her respirations always run lower when she is sleeping.  We held off on the Morphine and she didn't actually get any until late this afternoon.  Maybe the Fentanyl patch is finally kicking in??  I hope so!

It's been a quiet day.  I'm pretty tired.  The past couple of nights have been interrupted nights of sleep for me with doctors coming in to check on her respirations.  I attempted a nap this afternoon, but a resident was called in to take a look at her to figure out what to do about the Morphine.  We weren't sure - do we give it to her as a precaution and risk her respiration rate to go lower, or do we wait until she wakes up and risk her being in more pain than she needs to be in and having to play catch up on pain control?  We decided to wait.

Peyton rested much of today, thankfully.  I am always grateful when she is able to rest because she has spent so much of her time in pain.  Praying that tonight is a good night and that we have a similar day tomorrow.  As for her leg, no change there.

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