Oh ECMO

Day 1 (10/11/13)
Makenna responded really well to ECMO right from the beginning.  Her color looks so much better and her blood pressure and blood gases improved dramatically as well.  The machine is allowing her body to rest and get stronger, which is a good thing, but it also indicates just how sick our sweet baby really is.

Day 2: (10/12/13)
On day two of ECMO I was able to touch her for the first time.  Babies are stimulated by touch and while most babies can handle this stimulation, Makenna's body needs to use it's energy to get better.  As a result we can only touch her in certain ways, for example we are allowed to rest our hand against her leg.  We can't stroke or "pet" her and definitely can't hold her.  Her nurse are also only allowed to touch her as little as possible.  Every 4 hours they have a "hands-on time" where they will suction her nose, change her diaper, check her temperature, switch her position, etc..  This is like her workout and then she spends the next 4 hours sleeping, they won't touch her again until the next hands-on time unless it is necessary.     

Day 3: (10/13/13)
On day 3 of ECMO the ECMO techs noticed that Makenna had several large clots in her tube.  The clots looked like stringy octopi and were collecting blood platelets quickly.  The doctors had never seen clots develop like this before and sent them to pathology to be checked.  They also needed to remove the clots from the lines.  To do this they needed to remove her from ECMO completely for 5 minutes, clean out the lines, and then put her back on ECMO.  While she was off ECMO she used the ventilator to breathe.  This was scary because for the last 3 days the ECMO was doing 100% of the breathing for her and we weren't sure if the ventilator would provide enough support (wasn't enough 3 days ago).  Thankfully she handled being on the ventilator like a pro for the whole 5 minutes!

 

 

Day 4:  (10/14/13)
On day 4 you could really see edema start to form.  She is sedated and needs rest so she spends a lot of time laying on her back, which causes fluid to collect.  They have been giving her medicine to help eliminate the excess fluids and have been turning her on her side to help move the fluid around.  Also because she handled being off ECMO for 5 minutes the day before they decided to lower her ECMO flow from 300 to 275.  It is a small change, but a change in the right direction!

Day 5: (10/15/13)
Makenna handled lowering the ECMO setting well yesterday, so today they lowered it again to 250---again she handled it well again!  Also on this day we had another special milestone!  I was able to change her diaper for the first time!  Other than pumping milk (that she can't drink yet), this was the first real "mommy" thing I got to do---so it was extra special. 

While I was changing her diaper she opened her eyes and looked at me for the first time.  Until this point I have never seen her eyes open in person (only in a picture taken by Rex the day she was born) and she had never seen me before either.  It was definitely an extra special day I will remember forever!!  :-)

 
Day 6 (10/16/13):
Today they turned her ECMO setting down again from 250 to 200!  To come off ECMO she needs to be around 150, so she is very close!  Tomorrow Dr. Kays will be getting back in town and he will decide if she is ready to come off ECMO completely.  If she is, he will also decide when she will be ready for surgery.