Everything is still good but, after a soothing early morning, we have had trouble keeping Wren calm. He is okay for a while after waking, particularly if he gets what he wants (Thomas on TV, nursing, a lollipop, a popsicle or a syringe of water to pay with) but after about 30-45 minutes he gets tired and agitated and wants to get up. His pressures spike, lines get occluded, we all rush into overdrive to soothe-disentangle-adjust-distract him and if we don't manage with that - to medicate him.
Josh has gone to sit with him now. He says his plan is to watch his fantasy football roster lose on the little g-phone screen. Wren is sleeping after a dose of Ativan and some Torodol.
Morning Rounds
We had morning rounds with Dr Fletcher (?) attending and Dr Colvin (ICU Fellow) as well as the usual team. The summary was that "he is doing well."
Discussion focused on the LAPs and what to do about them. Also, his overnight X-ray showed some pulmonary edema, described as "some fluff on the right side." The nurse assured me that they are not very concerned at this point. They decided to do a volume challenge - increasing Lasix (not Epi!) and trying to get off more fluid.
Part of the discussion was explaining to residents about the relationship between diastolic pressures and the LAPs. I didn't follow it all but it seems that if the Diastolic is up as well as the LAPS there is less concern at loss of coronary perfusion pressure - all over my head! Anyway, Wren's were going in the right direction.
His chest tube is still putting out a lot - 150 mls in 24 hours - so that is staying in a while. It is now more less bloody but still bright.
His IVs are Torodol, Zantac, Lasix and PRNs are morphine, versed, tylenol, benedryl and Chloryl hydrate. Lasix is now 6 hourly.
Platelets 183
Albumen 3.4
INR 1.2
Milestones
After morning rounds Wren had his Foley catheter removed (traumatic all that tape) and left foot IV which was occluded (lots more tape).
He nursed a few more times. At a lollipop. Ate some cheerios (about 8) and spoke a lot. He is still glum and wants to get up and go home.
The LAP line is still in, at least until tomorrow.
Feedback!
Thank you all for the emails and comments. Since there is no internet connection at the hospital I don't have much time to respond individually. We are not encouraging visits until Wren is a bit happier but please let me know if you ARE in the hospital. We are in the CVICU and I'd be happy to meet for a short while. We just grab breaks from time to time and I sometimes sleep a bit in the parent day room or the sleep lounge.
3 comments:
Are you in the "new" CVICU??
When we were there ... there was never a change to sleep or take a nap in the "family room"...
not a chance...
Just checking in on you guys. Glad things seem to be going well. Good job soothing your boy! All your pictures look so familiar, I can picture exactly where you are! I hope you guys are up to the third floor as soon as possible!
Hang in there, you and Wren are making much progress! You are all a great team. So glad that Wren can nurse. I remember how quickly Evan woke up after surgery and how all those alarm bells would raise he!l when he was unhappy (which was often) and the mad attempts to soothe (he was only a newborn, of course). Love to picture Wren eating a popsicle and squirting a syringe. Hoping that those moments soon vastly outnumber any frustration as lines and such are removed! Glad the cannula is gone!
We're checking often for updates.
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