The goal of this weekend is to keep Hana steady and stable for her Berlin Heart surgery Monday morning. We met with the surgeon yesterday – he is also the one who will do Hana’s heart transplant. Whenever a doctor has to talk to you about a procedure they have to tell you about all the possible risks – so it was a little terrifying yesterday to hear about the Berlin Heart. One thing the surgeon is concerned about is the fever that Hana had yesterday. If she has a fever they can not do the surgery. They want her to be fever free for 48 hours. If she has a bacterial infection they can not do the surgery.
Yesterday they stopped all of Hana’s sedative drips because she seemed overly sedated and her heart rate was getting way too low. She still had a clonidine patch that was starting to kick in. Eventually they took that off too and Hana was not getting any sedation but was still very, very sleepy and still. The problem with this is Hana will eventually wake up and need sedation but also that she will start to go through withdraw again and that could cause her to have a fever which could delay her Berlin Heart surgery. So, the dance right now is upping Hana’s sedation as she starts to withdraw but not so much that her heart rate drops too low.
They also think the ketamine Hana was on before was causing delirium which was agitating her which caused them to increase her other sedatives.
I feel like I know a lot more this time around in the CVICU. I also feel more confident in asking questions. But I think I need to be even more aggressive. These are smart people with medical degrees and lots of training at some of the best places in the country. When they don’t discuss something in rounds I often assume it’s because the answer is so obvious that it’s not mentioned, but this is not always the case. I’ve started pressing them more, especially the fellow who needs to be more aggressive. I see things he doesn’t, I think he needs to pay more attention to how Hana looks instead of just going by the numbers.