Thursday, March 3, 2011

Day 6: February 24, 2010

Hearing the resident report “Day 6 post-op” at rounds this morning was quite the wake-up call......what? I thought we were only supposed to be in the PICU for 2-3 days?  What happened to our original post-op plan?


William had another restful night, with only a few wakings.  Around 8:15am, the white coats approached our little corner of the PICU.  Dr. Savard frankly said, “Okay, we’re getting this tube out, he’s fine.”   At that point, William was the slightest bit awake, certainly not fully alert and his eyes still closed...just as they had been for the past 24 hours.

I was told to leave the room (of course, it was so early in the morning, that I was there alone still)...

gulp...

About 15 minutes later, a resident came to the hall to tell me William was doing well and I could return.

I came rushing in to find William being sat up, a little oxygen mask on him and with TWO less tubes: the intubation tube and the NG.  Woohoo!



 Within a minute, William started vomiting.  They deep suctioned him and he vomited again...and again...not pretty.  It was obvious his NG had been clogged for quite some time...he was full of gunk.

After about 25 minutes off the vent completely, they decided to start C-PAP support.  William was really straining to breathe, he had all the signs of breathing difficulty (flaring his chest and nostrils) and his heart rate was too high.

Once all settled with the C-PAP head gear, complete with a padded head piece, William was exhausted from all that labored breathing...and once again, he slept hard!


William was so exhausted, he slept through most chest PT sessions, that were done every hour.  He had a lot of chest congestion that desperately needed to be broken up and suctioned out.  Now without the trachea tube in place, the deep suctioning process was even more traumatic.



Whenever William began to wake up a bit, he was distressed. The hope was to discontinue C-PAP later that day so William could begin clear liquids (it has been 6 days since he ate anything).




If you remember the original expectations for William's surgery, he was going to be kept sedated and intubated for 2-3 days post-surgically and then transferred back to Sloan to begin therapy and for his final stretch of recuperation.  By day 6 now and just being extubated, we were all suffering from home-sickness.  Fred made plans to return home and spend some quality time with Nicholas, who we all desperately missed.  But first, he gave our little trooper one more kiss...




Although we never weighed William through the PICU time, his edema was certainly at its peak around this point.  He was H-U-G-E...







After 5 hours on C-PAP, William was still struggling to breathe.


William's coming back....



By this point, William's IV pain med had been discontinued a day and a half previously.  He was only receiving fentanyl through this epidural.  As the day went on, he was showing more signs of discomfort and started on Toradol.
His discomfort is obvious...

When Dr LaQuaglia came in the early evening, he said the plan was for William to be transferred back to Sloan the following day (Thursday).

William’s evening nurse, Mo was wonderful. With careful planning of all lines and tubes, she transferred William into Mommy’s arms, first time since last Friday. I have to say, it was incredibly overwhelming to be holding him and maintaining everything in its position....



but boy, did that hour with him feel so good!

  

(can we say there's one exhausted Momma!)


Now that he was extubated, William was introduced to the PICU speciality...the percussion bed.
Percussion Bed this is William...William, meet the Percussion Bed.

William says, "oooo, I LOVE it!



This night was also noteworthy in that William began running a low-grade fever, around 100.5.  With the elevated temperature came elevated heart rate and respirations...which in the PICU means lots of monitor alarmings....not a restful night.

1 comment:

Lexi said...

Kristie, you capture these moments so incredibly; I am so glad it's been over a year now, though! The video with you and William playing with his pacifier is so tender, and heartwarming; you're an incredible mother! I knew it before, but it's so apparent in these little glimpses. I love you all. William's story and your unconditional love is so inspiring!