Cassie's Journey

Cassie had a brief trip to the OR this morning to redress the residual limb in her left leg. The plastics team was enthralled with the progress her left leg has made, and passed on this good news to Cassie.

Cassie also made good progress offloading fluid from her chest. She was able to sit up on the side of the bed with support from PT / OT for 10+ minutes. While sitting up both therapists ran her through some arm and leg exercises. She very much enjoyed this increased mobility. After she laid back down, the nurses continued to do mobility exercises with her arms and legs. The medical staff is making an emphasis to increase her mobility over the coming days.

Cassie was able to tolerate room air for 90 minutes today before she became acidotic. As a reminder, acidotic is when she is unable to expel enough CO2 in her breathing which causes her blood to increase in acidity which throws off her blood pressure among other items. The respiratory team is evaluating if she will go back on room air later tonight.

Cassie’s test for pneumonia came back negative. She is still struggling to breathe on room air due to the mucus build up in her lungs. At this time the medical staff believe her difficulties breathing are because of the fluid buildup around her heart and lungs. However her blood pressure keeps dropping as the medical staff have attempted to offload this fluid through dialysis. They will continue to try and slowly offload fluid to help strengthen her breathing capabilities.

Cassie is continuing to work with the PT / OT teams to help regain some strength in her arms and legs.

Cassie had a restful evening. She is still dealing with a large quantity of mucus in her lung system that is making it difficult for her to breathe. The medical staff are still awaiting results from the bronchoscopy performed yesterday. This morning the respiratory team helped breakup some of the mucus before putting her back on “room air”. Cassie was able to tolerate “room air” for 2 hours today before the medical staff wanted her to rest prior to her surgery.

This afternoon Cassie had a second surgery to address the amputation on her left leg. The plastics team helped shape the residual limb to be best fit for future prosthetic use. While they were in the OR the medical staff also closed two remaining wounds on her left thigh from Cassie’s fasciotomy. She also had two more wounds closed in her groin. These prior wounds served as the arterial access point for her use of ECMO pre and post transplant. The medical staff viewed the surgery as a success due to the length of residual limb remaining below the knee with healthy tissue able to surround the end. The left leg will continue to remain open as she will revisit the OR numerous times in the future to finalize the shaping of the residual limb through skin grafts.

At this time there is still no medical action required on her right foot as the medical staff will continue to wait until Cassie can verbalize what she is feeling to the team. Cassie has returned back to her room from the OR trip and is settling in for a well deserved rest.

Happy Mother’s Day to all of the loving Mother’s that inspire and develop the next generation.

We had the opportunity to spend the day with our beloved Cassie and reflect on how thankful we are to have her as our rock.

Cassie had a restful night where she remained on ventilation to allow her recovering chest to relax. The ICU team performed many tests today to rule out any possible pathology causing her episode of low blood pressure last evening. She had a Bronchoscopy performed today to collect lung mucus and test for potential infection causing her extra difficulty with breathing.

While she is still awaiting results they continue to test her breathing ability on room air.

The family is extremely thankful for the continued outreach, support and prayers for Cassie as she fights to make strides everyday.

Cassie got some good rest last night. This morning she was able to tolerate more time sitting up on the side of the bed with the support of Physical and Occupational therapists. She was able to sit up for about 5 minutes before her dizziness returned. She has continued to be off the ionotrophic agent that would support her heart functionality. She was on “room air” for 7.5 hours today. However at the end of her time on “room air” her blood turned very acidic. This is caused from her inability to expel carbon dioxide as she breathes out. This caused her blood pressure to decrease significantly at the end of the day and made her get very drowsy. In order to return back to normal levels she was placed back on the ventilator temporarily and had to use some blood pressers to return her blood pressure to an acceptable level. The medical staff got everything back to normal levels and are settling her in for the night. The family continues to share all the thoughts and prayers that are passed along through this page to Cassie.

Cassie had yet another busy day in her recovery. Cassie didn’t get a lot of rest last night and woke up very tired. She was on “room air” for about an hour this morning but it was paused so she could get a permanent central line placed into her right shoulder. This central line will still allow the medical staff to give her medication directly into her blood stream while maintaining comfort and preventing infection.

Cassie was not able to tolerate sitting up on the side of her bed as she got extremely dizzy after a few minutes. They continued to work on moving her hands while she laid back down. Cassie has been off the ionotrophic agent that supports the functionality of her heart for over 36 hours, and the lab test showed that her transplanted heart is functioning extremely well on its own. The goal is for Cassie to get more time on room air this weekend and continue her PT / OT sessions.

Cassie has continued to make tremendous progress in her breathing ability without the ventilator. Today she was able to tolerate 7 hours of room air without the support of a ventilator. She beat her record of 4 hours from yesterday. While on the room air she had a physical therapy and occupational therapy session where they were able to sit her up on the side of the bed. While sitting up she was able to move her legs and arms with assistance from the staff. She has not been in pain today after the amputation yesterday as the medical staff continue to monitor the pain levels.

Cassie had an amputation performed on her lower left leg. Earlier this week the doctors confirmed that there was no recovery in most of her lower left leg, and her left foot was completely dead. The doctors performed the first operation of a below the knee amputation. While this is not ideal, the amputation was an important step to her recovery. Cassie will still be able to live a very functional life with the use of a prosthetic and get back to doing some of her favorite activities like pickleball, tennis, hiking, and strolls around the neighborhood. The doctors are continuing to closely monitor her right foot which was also affected by the loss of blood flow. She still has the ability to wiggle her toes in the right foot, but there is concern for future functionality once she is able to walk. No procedures on the right foot need to be taken at this time as the medical staff will let her body recover more before deciding the next course of action.

Cassie has continued to progress in a number of other areas in her recovery. She was able to be on “room air” for 4 hours and was able to tolerate the speaking valve for 15 minutes. While she is still not strong enough to be able to speak, they will continue to increase her time on “room air” with the use of the speaking vent to build up the strength of her diaphragm so she can speak to the family. Please pass along your thoughts and prayers to Cassie today as she will need them to strengthen her spirits.

Cassie has continued to progress in her recovery. She was tilted twice today for 35 minutes each time. She also was able to tolerate room air for 3 straight hours today. As she continues to be able to breathe this room air without the use of the vent, the speech team will evaluate her for a speaking valve in the coming days. She also met with the PT / OT teams today and they were able to work on her grip strength and sit her up on the edge of the bed. The family would like to thank everyone for the constant outreach, prayers, and meals.

Cassie has continued to progress well in her recovery, making progress in her fluid offload, reducing her reliance on blood pressers, and reducing her reliance on the ionotropic medicine as well. She was able to match her tolerance of “room air” of up to an hour today, as well as continuing her “tilting” for longer than she has before.

Cassie took her 12th trip to the OR today where the doctors reassessed the fasciotomy wounds in her left leg. The doctors confirmed that there was no infection and that she maintains muscle reactivity in the back of her calf. The doctors are continuing to evaluate next steps for her left leg and right foot. Both of these extremities were affected by a lack of blood flow while she was on the ECMO machine.