Rachana was relaxed most of the day as she was on sedatives. She did wake up a few times but was calm and seemed to be less confused and able to visually communicate. The cough from last night has reduced quite a bit. Overall a good stable day but her ventilator settings have gone up to 60% O2 and 12 Peep.
The doctors have decided to go ahead with Tracheostomy i.e put tube in her neck surgically as a replacement for the tubes going in her mouth. This will probably happen in a day or two. They had been avoiding this option with the hopes of resolving the breathing issues in about 2 weeks, but in 4 days we’ll hit the 3 week mark and the tube in the mouth is not designed to be there for that long, brings other infection risks the longer it stays, and it’s also quite literally a pain in the neck! The tracheostomy way of supporting her will probably bring some relief to Rachana as she won’t be bothered by the pipes. The advantage with tracheostomy is that the ventilator can be switched on or off based on her needs, which was not an option with the tubes in the mouth. They will also remove the feeding tube from the mouth and make another incision on the side of her stomach to attach a feeding tube directly into her stomach. These are serious procedures but I believe after more than two weeks of having these tubes in the mouth, Rachana needs a break. This will also perhaps bring some mental relief to her, as she is bothered by the pipes, and that will help her recover faster.
This evening the doctors also found the source of her fevers. After an ultrasound of her heart they found a bacterial vegetation growth near one of the valves of the heart. This condition is called Mitral Valve Endocarditis. The theory is that the staph infection that caused the pneumonia left some remnants in the blood that got attached to a heart valve. The staph infection came from the port in her chest which had a direct line to the heart. The cure is basically a set of antibiotics for about 6 weeks and they hope to get the fever under control quickly. They did this same ultrasound initially but didn’t find anything. In the last 2 days they have essentially repeated all the tests and that gave us a lucky break. It’s also good that they caught it early because this could have caused some heart issues and also spread to other parts of the body.
We’re hoping the next few days will bring changes and perhaps be the beginning of a turn around.