Lost Tooth

So sometime today she lost her tooth.  No really it's lost...we can't find it anywhere.  We changed her bedding, searched her mouth, washed her hair etc...no tooth!  We guess maybe she swallowed it?!?!  Do you still think the tooth fairy will come?

She has not been on BP med since 12:15 in the afternoon.  She did great all day until now.  It is low again, just like it has been for the last 2 night (3 nights now).  It has been mentioned that perhaps this is just her normal.  Everyone's pulse and BP and temp go lower while sleeping, so maybe this is just what she does.

They are trying to hold off on the BP meds as long as possible.

At 4:30 this afternoon they did a one hour spontaneous breathing trial.  So the tube was still in her mouth/throat, but the ventilator was not giving her breaths of air.  She kept her o2 up and took breaths and her heartrate didn't soar out of control.  So she did great.  It seemed a little labored (harder to breathe) but she was breathing through a straw after all.

They were willing to extibate (pull out breathing tube) or leave it in until tomorrow.  We decided to leave it in and let her get a good nights sleep.

Feeds have not been restarted.  THey don't want to start them until she has been extibated for 2 hours in case they have to reintubate.

Her snot and her lung cultures both grew out pseudemonas (which she has had before).  Blood has not grown anything.  Apparently pseudemonas is hard to get rid of.  Once you have had it...you will probably get it again.

She is sleeping for the night.  The Dr. is worried about her BP.  But once again is saying this might be her norm.  Tomorrow she is going to stick a resident on tracking down her old PICU charts to see what her night time BP was.  They are trying to hold off giving her BP meds.

The Dr. is saying that if this her normal this might actually explain why she doesn't urinate during the night.  Because she is not getting good blood flow to the kidneys so she is not urinating.  I said if so would we need to follow up with this at home.  She said no, her body knows how to compensate.  I asked how dangerous this was and she thought it was okay IF this is what she normally does.  If this is abnormal then yes we need to treat it.

She wants us to track her BP during the night at home for a bit to know what her normal is.