At 48 hours

Happily sleeping with no sedatives!

The top line shows her heart rate - happily in her normal 130s
without the pacemaker!  Fourth line is her breathing rate, now
ranging between 40 and 60 (from low twenties on the ventilator)

At 48 hours Muriel was put on the "CPAP" mode of the ventilator.  She is still intubated, but basically breathing on her own.  When she takes a breath, the machine gives a slight pressure assistance.  Her breathing rate has climbed to as high as 60 (from low twenties), but the breaths are shallower so the overall volume is probably similar.  Her oxygen saturation and other gases are all staying in normal range, so she is basically doing what her body needs.  She also lost the pacemaker today!

Ventilator in CPAP mode

The CPAP mode continued for 2 hours, then they switched back to the ventilator.  This gave a chance to check her blood gases and evaluate how well she tolerated breathing on her own.  She of course passed with flying colors.  After two hours on the ventilator she is now back to CPAP for another two hours, and the plan for the night crew is to take her to a four on - four off schedule and re-evaluate during doctor rounds in the morning.  If all is well extubation may happen tomorrow afternoon!

Muriel gets her first echo since surgery

Earlier this morning Muriel had her first echocardiogram since surgery.  The skilled technician captured pictures of her heart by shooting from below her belly (see picture), which I found fascinating.  Megan and I have seen to many echos at this point I thought I might be able to pick out the patch over the tricuspid valve, or perhaps see the lack of reverse flow now that the patch is in place.  The techs are instructed not to comment on the echo while it is being taken, though, so I couldn't ask my normal barrage of questions.  And alas, I really wasn't able to recognize anything new!

Mommy hanging out

Most of the day we spent hanging around her room talking to the nurses and doctors that came through.  We had a visit from "Papa" (Megan's dad), though I forgot to take a pic...  Overall, other than the pacemaker being shutoff, not a lot of changes today.  The next few days may prove to be much more active.

Closing shot of a happy little girl