Friday

Okay, here we go again with the ups and downs.  First, the ups.  They have her blood-work, as far as her electrolytes are concerned, pretty much leveled out.  She looks/acts/feels a lot better now.

Now, the docs seem to think that the nausea/diarrehea issue might have been caused by the feeds that she was put on upon discharge.  She was on something called "Peptamen" while she was in the hospital and she was doing good--no nausea, even when given her meds.  She was still having loose stools but it was beginning to get some better.  It was suggested that we could add some fiber to the feeds to help firm the stools.  However, upon being discharged, they changed her feeds from Peptamen to something called "Jevity 1.5."  The reason being that the Jevity has more calories (of which Rachell really really needs) plus it already contained some added fiber.  Makes sense.  However, she was on the Jevity 1.5 before her heart transplant and her stomach/system couldn't tolerate it.  It was thought though that at the time it was b/c of her poor heart function and not enough blood making it to the gut, thereby causing the nausea.  Well, they swtiched her back to the Jevity 1.5 on the day she was being discharged without seeing whether or not it would have an effect on her stomach/system.  Well, as we found out, it did.  Apparently her stomach/system can't handle the Jevity 1.5, thus, the reason for them switching back to the Peptamen.

Since she has been switched back to the Peptamen, she has been doing well and seems to be tolerating her feeds okay, even at a higher rate.  She did get a little nauseated this morning but that may have been due to one of the meds, which they may either completely do away with or have us add something to it. 

Now, for the down.  One of the docs is really concerned about Rachel's vocal-cord issue and has asked that the swallow-study be done again to see if she has made any improvements with her swallowing.  The doc has said that he isn't comfortable in discharging her from the hospital until the vocal-cord/swallowing issue is taken care of.  He explained that an open airway, which is what is happening in Rachel's case, only presents more of the same problems that brought her back to the hospital.  The thinking is that if she were to get nauseated and got sick, with her airway still opened, she could aspirate into her lungs, thereby causing an infection and she would be right back in the hospital.

So, a swallow-study is supposedly scheduled for sometime today--what time we don't know--and hopefully we will begin to get some answers.  So please pray that Rachel is able to pass her swallow study test, that her vocal cords have improved enough, so that she doesn't have to undergo another surgery/procedure.