I was hoping that I would never have to write these words again, but I guess not.  Emma had another episode this morning.  It was not too bad, but she is still a bit worked up over it.  I spent a long time just holding her trying to get her to calm down.  I called her cardiologist and he instructed me to turn up her oxygen even more and to wait and see if she acts like she has totally gotten over it.  If she is still working extra hard later today I will probably call him back and see if he can see her today.  I am sort of waiting to see how she does after her nap.  She is just now settling down for a nap and when she wakes up should give me a good idea of really how she is doing.  In the past there have been times where naps just prolonged it and she woke up still working hard.  If that happens I will want to head to Little Rock as I will began to expect another episode coming.  If she seems peaceful and content in her breathing once she has slept it off I will feel pretty good about just leaving her here.

One thing I am considering as a possiblity of making things worse, maybe not causing the episodes, but who knows? is that she has been consistently throwing up her 7:00am feed.  I was beginning to suspect this had to do with one of her medications that she only receives then.  Ironically it is her reflux medicine.  I am going to try giving it to her at another time tomorrow to see if that makes a difference.  The thing I realized this morning is that she also gets one dose each of her diuretics at that feed.  I don’t think they are upsetting her stomach unless it is interacting with the reflux med because she also gets them later in the evening with no problems.  But when she throws up she may very well be losing most of her dose of the diuretics which help to get the fluid out of her lungs.  Maybe her lungs have been building up more fluid?  I will work on this problem, but the most urgent thing is that she actually returns to normal today.  Please pray.