The Plan

Audra got her first dose of Depakote on Wednesday night. It is given twice a day so she got another dose when she woke up yesterday morning.  The neurologist said it takes about 3 days to see results and if she doesn't show any effect from it by the 7th day then they will increase the dose.  I went upstairs to work yesterday but I heard that she was a sleepy girl all day and took a few naps.  And she slept beautifully the past two nights (all night long...the first time in 2 weeks!).  I am hoping the Depakote has helped her sleep so well and not the fact that she was exhausted from being off the wall crazy for a few days and only slept 3 hours Tuesday night.

 

It's hard to believe that this sweet angel is needing

Clonidine, Risperdal, Ativan and Depakote

plus the occasional Benedryl to keep her calm.

She hasn't had any more vomiting since Wednesday morning.  Phew!!  I was really worried that we would fall into the same trap we did last admission with all the vomiting that required a PICC line and IV nutrition.

The kidney doctors (nephrology) came to see Audra.  They have been managing her clonidine patch for the hypertension she was found to have last admission.  Their plan is to continue to same dose of the patch and watch her blood pressures.  And we can check a few screening labs since they will be doing blood work for other reasons. 

Yesterday the dentist came by the see Audra around 5pm but she was sleeping so he said he would come back.  He came back at 9pm, just as I was settling in to go to sleep.  Turns out the timing was perfect because with her nighttime meds on board Audra didn't mind him gently looking around in her mouth.  He found that she has 2 more adult teeth coming in on the inside of her mouth without the baby teeth being loose.  In November her dentist had to extract 5 teeth for this same reason.  It seems she has a very small mouth, without enough room for her adult teeth as well as delayed dentition meaning she retains her baby teeth longer than usual and her adult teeth are coming in later than normal.  Now...the dentist doesn't think this is the root cause of Audra's recent behavioral changes (and I agree) but it is absolutely uncomfortable and annoying to her most likely.  Luckily Audra has an appointment with her dentist next week. 

After her impromptu dental exam Audra was able to fall right back to sleep only to be awoken again at 10pm to have her blood drawn.  She tolerated it very well but unfortunately they only got one of the vials filled, and it wasn't the most important one...the one to check for a pheochromocytoma.  So she will have more bloodwork drawn today. 

The little princess has already woken up and gone back to sleep this morning.  Hopefully we don't have her overmedicated now.  I'm waiting on the doctors to come in with today's plan...