Another Snag

Katie's potassium levels are currently too high to put her under anesthesia. We had labs on 10/28 and Dr. M. called us the next day to say that we needed to try to hydrate her and also to add more kayexalate to her bowel flush solution and redraw the labs on 10/30. So we did that, and it did come down but not far enough. So on Friday Dr. M asked that we do 2 flushes per day with the increased kayexelate. So in order to facilitate that and not take Katie from her Halloween activities we pulled her out of school early that day.

She and I are both off for pre-op labs tomorrow, we expect to spend most of the day at the hospital We both have to have labs drawn, give urine samples, and have histories and physicals again. I may or may not be meeting with someone from anesthesia. It's been very frustrating trying to figure out this day because no one can tell us exactly what will happen and there's no time schedule. The recheck for the potassium has been ordered to be included with the labs already being drawn tomorrow, hopefully that won't get messed up.

If we can't get the potassium down this way, we may have to try some dialysis. So Katie and I talked to a very nice lady at our church today about local dialysis centers, and she's going to call some of her camp friends who have been through it. Ultimately if we can't get it down, we would have to postpone the surgery until enough dialysis gets done that it comes down.

I also spoke to the anesthesiologist for Katie on Friday evening. That was a bit funny, we were at our church's trunk or treat event at the time. She gave us some new info and some revised from what we knew before info:

We will need to stop one of Katie's blood pressure meds a few days before the surgery and Dr. M will discuss this with us on Monday evening or Tuesday 11/3 or 4.

She will give Katie some oral Valium upon arrival to the PACU , she will place the first peripheral IV in the PACU while she's awake as we did for the cystoscopy, then will give her Versed through that first IV.

Katie and I will both report to the Peds PACU (I was planning to ask tomorrow where I should report.)

Katie and I will be taken from the PACU to our respective ORs at the same time because there is so much they want to get done on Katie before the actual surgery starts including: a central line, an arterial blood pressure monitor which can later be used for blood draws, a couple of other peripheral IVs, and a Foley catheter for her bladder. The volume of IVs is for a couple of reasons. The central line is much more stable so it will last longer. Peripheral IVs are rarely good for more than a few days at a time, when someone is going to need the care Katie is going to need a central line is preferred. The other lines will be in place to assure access when it is needed, so should one or two of the lines fail for some reason she can still get her the medicine she needs. The peripheral lines will be pulled as they fail and as long as there is still a functioning line they won't be replaced they will have served their purpose.

She will not be using an epidural for pain control but instead a PCA that will dispense Dilaudid a very good narcotic pain control medication.

So... that's where we are. Any questions, ask away.