Saturday, May 12, 2007
Surgeries, Pnuemonia, and life in the PICU
Braden was not responding to our normal ways of calming him, so daddy took him to the pediatrician yesterday when he was not doing well. After a phone consult with the pulmonologist and Braden's lack of good response to oxygen, we got him directly admitted into the PICU, by-passing the ER. They had to work quickly on him, as his body started shutting down. After over 10 sticks and no luck getting an IV, they did bedside surgery to put in a central line. Braden had practically no blood pressure, and had to be put on a ventilator, as his body was too fatigued to work on it's own. He was practically blue head to toe by the time I joined them in the PICU, and there was no good news. He had no urinary kidney output, his potassium levels were off, and was not responding to initial doses of fluids.
Braden's blood counts were extremely escalated, his heart rate was really high, his temperature was remaining above 106, and he was not stable by any means. After a few hours of placement on a heating/cooling bed to control his temperature, he had come down to 102. All chest x-rays did not show anything amiss, until after the central line was put in near the right clavicle. Another x-ray showed the central line had flipped the wrong way, and so they took him into surgery to correct it. While there, they were unable to fix it, lost the line, and had to put in a second clavicle central line in the left side for IV access. They also gave him a femoral arterial line near the groin for a second point of IV access.
Another x-ray post-op showed his right lung was 30 percent collapsed due to problems with the central line. At this point it was about 6pm on Friday evening... but his oxygenation was coming under control, his kidneys began to function, and some progress had been made on his temp and heart rate. They did an EEG to ensure he was not in a state of continuous seizure activity, and that a lot of the time, he actually is having normal brain activity - which means his meds are probably working (praise God!!).
Once a second post-op x-ray was done, it showed that although Braden was maintaining proper oxygen levels, his lung had collapsed to 65 percent. The surgeon came bedside to do another surgical procedure to put in a chest tube. The chest tube pulls out the extra air outside the lung that was forcing it to collapse - correcting correct pressure in the lung. The lung has since re-inflated, but it has not been without some consequence. The pulmonary specialist believes there may be a few trouble spots due to the collapse, but we will keep monitoring it. (They have done at least 5 x-rays since we have been here) and continue to take films every 4 or 5 hours. The latest x-ray shows that he probably has a severe form of pnuemonia, but it takes time to show up on films, so we can't say for sure - but it is suspected.
We finally got his temp and heart rate stable around 11:30 last night, and had a pretty good night. They have started to give him some formula (small, small amounts) today, and we probably won't change much today to keep him stable. Tomorrow we may see how he will do off the heating/cooling blanket, and they may even consider taking him off the ventilator, but Braden is driving this train, and it's all up to him and his levels of progress.
We will try to post each day we are here - but no promises. I have attached a pic with arrows pointing to the various function of the tubes. Please keep our awesome little fighter in your prayers - he has really been through it in a rough way the past two days. Thanks for stopping by,
Kodi, Brad, Braden