June 26, 2010 – One More Night in Pediatrics

Katelynn slept through last night relatively well, despite the regular vital sign checks and a dose of IV antibiotics at 2:00 AM.  I became best friends once again with the sleeper chair, which is basically an armchair that folds out flat.  Thankfully the rigid arms saved me a couple of times last night from rolling straight onto the ground, and I must reluctantly admit, it was more comfortable than I remember.  At 5:45 AM, Katelynn’s nurse gently woke me up with a reminder that we would no longer be able to give my daughter any more clear liquids after 6:00 AM to prepare for her morning MRI.  Feeling more refreshed than expected, I washed up quickly and mixed a few ounces of unflavored Pedialyte mixed with some apple juice for Katelynn.  She was already waking up, so I was very glad I did not have to disturb her much-needed rest.

 A couple hours later, the day shift nurse came by to tell us that we would be transported downstairs for the MRI.  Sometimes I wish I was not so familiar with this hospital, but having spent the better part of four months practically living out of this facility two years ago has allowed me to imbed most of the layout of the first and second floors into my long-term memory.  I probably could have brought Katelynn down myself, and if we do this enough, I may just consider moonlighting as an Imaging Technician.

 After a bit of a wait for the anesthesiologist to arrive, we were ready for the scan.  It was quite amusing to listen to the assisting nurse explain to me how he once had forgotten to remove his cell phone before entering the MRI room and ended up with all of his stored names and numbers erased by the tremendously powerful magnet.  It just would happen that I brought along my backpack, which contained my laptop, digital camera and digital video camera that conveniently stores recordings on a forty gigabyte hard drive.  Listening to the nurse’s story, I reached for my cell phone in the right pocket of my shorts and slowly began inching away from the caution sign hanging in the doorway that boldly proclaimed, “Warning – magnet is always on!” 

 The anesthesiologist came through the door roughly fifteen minutes later, with the aroma of a freshly toasted onion bagel attached either to his breath or scrubs.  He certainly must have tried to eat on the run between his last procedure and this one, but I was just glad to know the scan would be complete soon, meaning we would be able to move closer towards bringing Katelynn home.  I expressed some concerns regarding Katelynn’s seemingly long lasting post-surgical lethargy yeserday, but the nurse explained and the doctor affirmed that today’s use of the short-term sedative, Propofol (http://en.wikipedia.org/wiki/Propofol), would be metabolized by Katleynn within an hour or so after its administration.  Ironically, Propofol has gained notoriety as the drug implicated in the overdose death of Michael Jackson, which occurred exactly one year and a day ago.  Nonetheless, Katelynn’s past MRI scan a couple months ago involved the use of the same drug, so we knew what to expect.  It was not even ten seconds after the doctor depressed the syringe connected to Katelynn’s IV line before I felt her going limp in my arms with her eyes rolling backwards.  Thirty minutes and we would be done.

 Thankfully, my parents and one of my sisters have been instrumental in keeping Adam and Daria busy during the course of the past two days.  This allowed Jenn-Jen to join me at the hospital as the MRI concluded right on time.  We followed the anesthesiologist and assisting nurse as they wheeled Katelynn in her hospital-grade crib towards the same recovery room we sat In yesterday after the surgery.  An hour later, our daughter regained consciousness and we were brought back up to her room on the sixth floor.

The rest of the day seemed very promising, especially because we noticed Katelynn was showing more alertness and an improved appetite.  My sister came by the hospital around noon with Adam to pay a quick visit to Katelynn and drop off a thoughtful care package.  Katelynn was still looking a bit tired, but it was very reassuring to see her interactions with everyone today.  Eventually, we were even able to have her removed from the IV fluids that have been connected since her surgery, and this allowed us to comfortably bring her to the pediatric play room a few doors down.  After lunch, Jenn-Jen and I spent some precious moments with Katelynn, coloring with markers and encouraging her to pretend to feed us play food.  On today’s menu was a sausage, jalapeno and what appears to be a Serrano chile, but it was probably the best play food I have enjoyed in a very long time.  During the course of our play time, our daughter would periodically lift up her left hand, which had her IV line and fingers taped onto an arm board, and try to use it to no avail.  Instead of getting frustrated, Katelynn’s good-natured personality shown through and she used the dangling IV connector to tap on the table just for the fun of it.

 Later in the afternoon, we learned that Dr. Ciricillo’s colleague, Dr. Zusman, would come by during her rounds to assess Katelynn’s MRI results and provide a timeline of when we would expect discharge.  She recommended we stay one more night if we felt that Katelynn was not showing signs that she was back to her “normal” self.  Jenn-Jen and I conferred and agreed that Katelynn was certainly looking and acting much better than yesterday, but her need for several naps during the day made us lean towards the side of caution.  We decided it would be best to stay put and avoid any unnecessary returns to the hospital.

 Dr. Zusman did come by a couple hours later after consulting with Radiology over Katelynn’s scans.  She said that the left lateral ventricle does look a little smaller and there was not much change in the size of the fourth.  This news was a little disappointing, as both Jenn-Jen and I had expected more immediate results.  Perhaps we were a over-ambitious, because Dr. Zusman explained the actual change may be a more gradual process.  Of course, we already knew that Katelynn would require another MRI in half a year to determine the effects of yesterday’s surgery.

 My parents came by in the evening with dinner and our spunky little Daria in tow.  I really think the twins missed each other and it warmed our hearts to hear Katelynn say “hi” to her sister.  Daria had spent a very busy day with my parents, and the plan was for Jenn-Jen to bring her home for the night.  One cause of potential concern actually arose while I was outside the hospital, reattaching Daria’s car seat to our vehicle.  Jenn-Jen noticed during the interaction between our girls, Daria had made Katelynn laugh, but there seemed to be some paralysis on the right side of Katelynn’s face.  Neither of us noticed this earlier and the rest of Katelynn’s extremities on her right side did not seem to be affected either.  I brought up the issue to the night nurse and will have to follow up with Dr. Zusman upon her return tomorrow morning to get her opinion.

 As the night is now wrapping up for Katelynn and me, I am hopeful for a quiet, uneventful night.  Katelynn’s nasal passages seemed a bit congested earlier today and has not improved much tonight.  I hope this does not affect her sleep, but since I put her down in her crib an hour and twenty minutes ago at 9:00 PM, she has stirred several times and almost sounds as if she has a cold.  At least she is not connected to the IV pump and there is no need for antibiotics tonight.

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