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Wednesday, December 03, 2008

Fentanyl Questions

Dr. Musa says that Zoe's uneasiness is a reaction to her vent, which wasn't at a good setting. She says that airflow problems caused Zoe to be uneasy, and that adjusting the vent will make her happier.

Beth, Zoe's nurse, had told the doctors on rounds that she saw baby's lips smacking, the discomfort, the hand movements that she thought was withdrawal.

Dr. Musa disagreed.

My big sis sent me this. I instant messaged Jen. Jen just messaged me to say that Zoe was extremely uncomfortable and crying. Jen was working hard to calm her down. Finally, Jen got her to rest...with morphine.

That's what you use to start weaning someone from a powerful opioid. So perhaps it is Dr. Musa's new vent setting - or perhaps its withdrawal. We'll have to wait to find out.

5 comments:

  1. Anonymous6:44 PM

    To Zoe's family:

    I followed the link to the study proposal, but it had no conclusion. The conclusion can be found here:

    http://www.ncbi.nlm.nih.gov/pubmed/18411237?dopt=Abstract

    CONCLUSIONS: We conclude that administration of low-dose naloxone (0.25 microg/kg per hour) does not decrease fentanyl requirements in critically ill, mechanically ventilated children.


    Apparently, the hypothesis was NOT borne out.

    I have had some brief experience with Fentanyl. I developed shingles. After going through several oral medications and many sleepless nights, my doctor put me on Fentanyl patches so that I could at least get enough pain relief to get some sleep. After the initial phase, they did not make me sleepy or groggy. When the shingles pain had resolved after several weeks, I discontinued the patches. There was a period of withdrawal, and it was uncomfortable. There would have been no reason to go through the withdrawal if I had still been in pain. The point I'm trying to make is that your sweet little girl apparently needs pain relief in the form of medication to keep her comfortable. If given at the appropriate dosage, it doesn't have to keep her groggy. When the pain from all the recent medical services rendered to her is done, then she could go through the withdrawal without undoing all the good that was supposed to come from her recent surgery and treatment.

    I've been praying for Zoe and her loved ones since I became aware of her situation last week. When I saw your struggle with the pain medication situation today, I felt compelled to write.

    I understand that you are screening these comments before they get published on your blog. Please consider not publishing the above part of this one. The part below is more appropriate for public viewing.

    I pray that God keeps Zoe and her loved ones in love and healing energy and guides all who are making decisions on Zoe's behalf to do what is best for her.

    Hugs to you all,
    Violet

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  2. How frustrating.... What an outpouring of love all over Zoe her Mommy must be. So comforting to hear her voice and feel her touch... Better than any medicine. Keep it up, Mommy. Keep it up, Daddy.

    Ginny

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  3. Either way here, and God knows, I will be praying for Zoe to come through with minimal discomfort, unless of course, God takes all discomfort away. Praying for wisdom and His strength for you, moment by moment. It may take a little more time but I know God will hold you up as you wait. Zoe is worth all the time that it takes to bring her through.

    Laurie in Ca.

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  4. huntsouth8:24 PM

    All that I can see in your detailed care of Zoe, is a mirror image of God's intensely detailed care for us, every moment of our lives. When I arrived at church this evening, I found that Zoe's name and some information about her was on our weekly prayer sheet. I gave an update and our pastor noted that Zoe means "life". We are all praying for all of you and for wisdom as you go through each day--and night. love, the Hunts

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  5. May the Lord give you wisdom and guide your every step. In studying so many of God's chosen people in the Bible, it is evident that He fails to give the ending of the story so many times. We walk by faith. Day by day. Hour by hour. Minute by minute...constantly asking, "Now what God? What should I do/not do and where should I go/not go?"

    This blog is evidence that you are asking God every minute...now what? This type of faith is extremely genuine, infectious, and inspiring.

    I remember the Ecclesiastes....a time for everything. (angie paraphrase):

    a time to trust the physicians
    a time to yell at the physicians
    a time to trust the field of medicine
    a time to question the field of medicine
    a time to ponder stats
    a time to reject stats
    a time to surrender on bended knee
    a time to stand and fight like a bear
    a time to want to be alone
    a time to want to be with friends
    a time to wait upon nurses
    a time to summons the nurses

    ReplyDelete

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