Once Again, "Impressive"

At one point last spring when Lynnea was in the hospital during her really long stay, the cardiology team had made a comment about her being "unusual and impressive," and I wrote about this in one of my blog posts. Well, yet again, the word "impressive" is being thrown around, and I have come to understand that when doctors use the word "impressive" they are really using it as a euphemism for bad things. Yesterday during evening rounds, Chuck (Dr. Shepherd, one of the Cardiology Fellows) told me that on the preliminary C-T scan results he "hadn't noticed anything impressive about Lynnea's aorta" meaning that it might not be as bad as Dr. Gruenstein had thought. This morning during rounds, the doctors all decided that Lynnea had bought herself another night in the PICU because of "how impressive she was after extubation yesterday." Yes, last night they took Lynnea off the ventilator around 5pm, and it didn't go very well (but, in some ways, we've kind of come to expect stuff like this from her -- Lynnea doesn't like to do things the easy way). She had a very difficult time breathing on her own, and nearly had to be re-intubated; fortunately, after a few different nebulizer treatments, some IV steroids, and giving her a helium/oxygen blend through a high-flow nasal cannula, she managed to avoid being put back on the ventilator. She had us all a bit worried during this time; I've been around long enough to know that when they start moving extra items in the room (like rocking chairs) out into the hallway, and begin bringing extra carts (like the emergency intubation cart, and the crash cart) into the room, things are not going well. Because of this little incident, there was really no chance of going home today, but since she has done pretty well today (she was taken off the helium/oxygen blend this morning, and we've managed to wean her high-flow steadily throughout the day) there is some talk of possibly going home tomorrow, and at the very least, if they decide not to send us home tomorrow she should be able to move out of the PICU to the general floor. She will be a topic of discussion at the weekly cardiology conference tomorrow morning to decide whether or not she needs any surgery in the near future.