Vent Clinic

Today was vent clinic day so that means Autumn always acts up. She does awesome until vent clinic days then something seems to happen like a major desat or allergies, etc. I was prepared to go in showing Dr. G how well Autumn is doing with her vent settings at night and for him to be so impressed that he lowers her setting down even more. Well, she was fine this morning (a little tired acting) but as soon as we get to vent clinic she start coughing, needing to be suctioned constantly, and having low 90 sats. I'm pretty sure it's just allergies (I was miserable sneezy ALL day yesterday) but they did do a trach aspirate and started her on Tobi nebs for 2 weeks, off 2 weeks, and then on for 2 more weeks. This will also help with the trach stoma secretions we have been dealing with off and on since before Christmas. She just does not do well when we leave the house except to go shopping...she does AWESOME on shopping days for some reason. ;) The weather has been rainy around here off and on so that could be a reason for all of her sudden issues as well with the coughing and sneezing. Anyways, besides that Dr. G was very excited to hear about all of her progress. She did lose about 3 ounces...weighs 20.5 lbs and grew 1/2 an inch so she's 30 inches long. Just 12 lbs and 8 inches smaller than Gage who is 6 1/2...haha I'd say poor guy but he has no issues with his size. ;) They want us to up her formula by 3 oz. a day to hopefully help get some weight gain. Her blood gas levels were good which shocked me since right before she drew Autumn's blood she coughed, gagged, turned blue, and went into the 50's. Typical Autumn ;) So, we did not get to move any vent setting since they moved them less than 3 months ago...Dr. G just kept saying how excited he was to see her progress and things are looking good.



I have seen really good improvements with Autumn this year. I think now that we have gotten her feeds fixed to minimize her gagging episodes during the day it has made all the difference. Everytime she does have a gagging episode she turns blue and loses some oxygen to the brain so the past few months she just hasn't seemed herself and falling back in developmental areas. Now she goes 4 days or so without vomiting and rarely gags unless she's got a cough (like today). She seems more focused on things and we are making some progress on feeding again...SLOW progress but it's progress. This is our year that we are really focusing on major goals...got my charts made and just have to get Autumn to cooperate in my plans. ;) Hard part is that she closes her eyes when she does not want to cooperate so it becomes difficult to teach her anything. I'm understanding now that some things are behavioral and not that she can't do it but that she's stubborn and just does not want to...I have NO idea where she gets that from?? Our biggest success this year is that she has tolerated her non-modified speaking valve for 45 minutes...it went from only 2-5 minutes to 45 minutes. She can make "ah" noises with it on and we can hear her cry. It's awesome! I'm very excited to see what 2011 will bring and praying this will be our first year to go surgery free for an entire year...hope I did not just jinx us. ;)

Oh, and Layla did tear her ACL and will be having surgery on Thursday. We opted for the major surgery (more expensive one) because of her weight...90 lbs..and feel it will give her the best chance to help her knee get back to its old self so she can be a puppy again. It's a super long recovery process...she will be on kennel rest for at least 6-8 weeks and fully healed by 3-6 months. She's walking with a slight limp and we have been keeping her activity level very low. She does not even know the pain she will be feeling in 2 days. ;( Her momma will make sure she is taken care of well and I will baby her as much as possible. ;)

I forgot to add that Autumn had her renal ultrasound last week and follow-up with her urologist. Everything looked great and still no cathing for us...at least for 6 more months. ;)