Fevers, Sprints and Dressing Changes

Owen had another decent day.  He had a restful nights sleep and only had his nurse call me once at 3am because he wanted me.  He gets febrile about every 10 hours, we surround him in cool packs and give him IV Tylenol and he is fine again.  He is still getting IV antibiotics and we'll know tomorrow exactly what grows on his mucus culture.  His blood cultures all came back clean so far. 

 

We talked in rounds about extubation but are giving him a little more time.  He is sprinting off the vent in 3-4 hour increments and does fine.  Tomorrow we may switch to CPAP support and see how he does before extubating him.   He should have the breathing tube removed by the end of the week in a perfect scenario.

 

We are still wanting to chip away at the Epi and start him on Milrinone but are limited by his blood pressure being low. 

 

We stopped the Dilaudid drip because he really didn't need it.  He has orders for Morphine and Ativan as needed.  He was totally fine all day on no sedation or pain meds.  He is gagging on his tube a lot and coughing up a ton of secretions.  We just gave him a dose of both meds tonight so we could change all his dressings (PICC line, Central Line and Arterial line).  It stings and burns so I want him comfortable.

 

As far as anticoagulation therapy.. he is still on Plavix and Asprin.  We are switching him from Heparin back to Coumadin for the long term.  In order to do that, we have to bridge him with Lovenox injections again.  He got his first shot today and did great.  I'm sure the nurse did a much better job than I did in October when I had to do them twice daily. 

 

He is still on TPN and Lipids as well as Pedialyte in the Gtube.  He is gagging on the breathing tube and hacking up secretions so I am too afraid to start real food in his tube because I don't want him vomiting.  Maybe after we get him extubated.  Nutrition is SO important right now and he is just skin and bones.

 

Anytime I ask him how he's doing he gives me a thumbs up.  Just before I took his photo I asked him to give me a thumbs up and this is what we got. :)  He was just getting over a little hacking/suctioning spell so I don't blame him one bit.  This whole situation sucks pretty bad and he is so brave and goes with the flow. 

Rustyn used some of his airline miles to get Kam, Logan and Carson home by Fri night.  They were going to drive home with Rustyn tomorrow but Logan in the car for 12 hours would just be torturous!  So we get one more day together so I hope extubation happens.  Thinking happy thoughts.

I spent the morning at the hotel with Kam and Logan.  We went and got out toes painted so I could do something with Kam before she leaves.  I am going to miss my husband and babies.. but we will be together again very soon.  What did we do before Facetime??

Everything is moving in the right direction.. but in the CVICU... we know one step forward equals two steps back.  Fifteen more minutes and I can give Owen his evening Lovenox injection and settle into my closet to sleep. I'm actually starting to like my little bed on the unit and knowing I am close to Owen helps me really rest.  Praying for Owen's next miracle.