Shannon had a good, stable night. She has continued to have a good cough reflex, in fact it is more consistent and stronger. She hasn't done anything else but she is still on fentanyl and versed for pain and sedation, plus the pentabarbital effects are probably still on board. We just need to give her more time. Her ICP have definitely peaked and are staying down (highest was 19 overnight) suggesting that the brain swelling is starting to subside. They probably turn down the fentanyl and versed for at least another 24 hours to make sure the ICPs stay down. Another good sign is her diabetes insipidus has resolved--she is maintaining her sodium levels without the vasopressin (medication to treat the DI). Her EEG is constantly active. I don't know how to read EEGs but there is definitely more activity when Shannon is simulated--even just when her arm is rubbed--which is pretty exciting to see.
Her pneumonia is getting better--her white blood cell count is down and she's doing better on the ventilator. They have taken her off one antibiotic based on the preliminary lung cultures. There are going to start her tube feedings back slowly to try to get some nutrition. If she can't tolerate it, they will likely start TPN (nutrition in her IV) tomorrow. She has been weaning down off the levophed (BP medication) which was being used to maintain adequate blood flow to her brain. Hopefully she can be weaned off it completely today.
We are anticipating another slow stable day and are praying for more small signs of waking up. The PICU attending that took care of her over the weekend stopped by and was encouraged by her progress and simple said, "Time is on our side." The waiting continues painfully slowly but she appears to be out of the acute dangerous time period--now we need to faithfully and patiently wait.