Friday, November 22, 2013

Still Sick, But Doing Better

Cute art project that Child Life did for him.
The turkey body is his footprint. Love my
kiddo's chubby foot!
It's funny how time is so fluid.  It crawls at a snail's pace and then races along.  So please forgive me if I'm not too exact on how things happened yesterday.  It was a bit crazy.

All afternoon, he kept creeping up in his oxygen needs.  I mentioned that the Trach Ninja had been in and not impressed.  I think that was about 3:30 or so.  About 4:00, he looked worse still.  Just before 5:00, he dropped again.  I was standing bedside and his nurse asked if I wanted to bag him.  No, she wasn't asking if I wanted to bag him versus her bagging him, but if I thought he needed it.  But guess what, I'm pretty darn good at bagging him.  So I asked her to hand it to me and plug it into the oxygen. 

And it started.  She also called respiratory in, telling them what we were doing.  So we bagged, and tried the vent, and bagged again.  Also involved were phone calls to the PICU, and yeah, the attending had been "attending" a whole lot more the whole afternoon.  In fact, he stepped away because he had a care conference for one of Aaron's little friends, but was in and out of that to come check on us. (Funny part was, even though nothing was said because of HIPPA, her mom and I each knew who the "other" patient was that he was so involved with.) 

PICU wanted to increase some vent settings to see if it helped.  Nope, not happening.  All in all, he was probably being bagged for close to an hour or more, and yep, he landed in the PICU.  We got down here right about 6:00 p.m.  They put him on the hospital vent which lets us give him much more oxygen and he settled right down. 

He's been peaceful ever since.  Well, except when we suction out his nose.  Don't get that one.  Doesn't every three year old love to have their boogers sucked out? 

The PICU has increased some of his ventilator settings to open his lungs and let us use a little less oxygen.  If you look back to his September fun, he really, really struggled the first few days.  Like needing 100% oxygen and having a hard time keeping 80% in his blood.  (We usually sit in the mid-high 90% without any extra oxygen.)  I came back from dinner last night and he was only using 60% to stay above 90%. 

Right now, he's down much, much lower.  I think the next step is to reduce his ventilator settings back to his home settings.  His labs have all come back now, and the only thing that showed up was rhinovirus.  His white blood count, which measures how hard the body is fighting against illness, was very low.  So we're not worried about a bacterial component (and hoping one doesn't show up later). 

It's just support that he needs.  While his vital signs are so much better (and yep, "vital" means exactly that, absolutely necessary, essential to life) he's still pretty sick.  His fever seems to be gone.  He still been a bit warm a few times, up to 38.3 (100.9) a couple of times today, but it's resolved on it's own without medication.  He's also still really, really goopy, with tons of stuff coming out of his nose and his trach.  And he's not playing or smiling a whole lot yet either.  Yep, sick.

However, it's almost 1:00 p.m. and they still haven't rounded on him.  I like being low priority in the PICU.  He's been high priority before, he's been very unstable.  I've seen three attendings at his bedside at 2:00 a.m. before.  Yeah, I like where we're sitting now much better. 

“I took a deep breath and listened to the old brag of my heart.
 I am, I am, I am.”
― Sylvia Plath

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