Saturday, November 26, 2011

Thanksgiving in ICS

It has been a tad stressful the last few days! Annabelle's throat had been hurting really badly and Oxycodone was barely cutting it. By Thanksgiving eve she wasn't able to swallow her meds anymore. I tried pushing them through her NG tube but as soon as anything hit her stomach, she immediately vomited it up. She was so miserable she asked me if she could just go to the hospital to get some medicine through her line, so we took off for the hospital around 9 pm. When we checked into the ER she had a fever. Since she had labs drawn earlier that day I knew her ANC was zero so that automatically bought us a room in ICS. They gave her 2 fluid boluses in the ER and when we got up to ICS around 1 am her blood pressure had dropped. The resident ordered another fluid bolus but this time they drew up big 50ml syringes and pushed it through her line by hand as fast as they could. (Normally they just 999 the pump and have it push the fluid as quickly as it can.) This whole time Annabelle was pretty out of it. After the 3rd bolus they felt OK with where she was at and let her sleep. Of course she woke screaming and needing morphine a couple of times so I had gotten about 3 hours of sleep when things got really wild!

Around 6:30 am her heart rate monitor suddenly jumped to 231 beats/minute. The alarms started sounding and people came running in but it quickly went back down. They checked her blood pressure and it was quite low again so they started the 4th fluid bolus in 10 hours. She hadn't peed this entire time and her face was getting pretty swollen. They couldn't get her to really wake up and her pressure was still low so they called a rapid response code to her room. Within minutes her room was filled with doctors and nurses assessing the situation while the fellow gave out verbal updates. It all happened so quickly I didn't really know how to act! One of the resident docs that we love got the page and saw Annabelle's name and she was the first one to arrive. In the middle of all the commotion she looked over and whispered to me "are YOU ok?" I guess I didn't realize how serious the situation was. After things settled down she came over and gave me a hug, still in my pajamas with greasy hair and all! That's when it started to sink in a bit. Annabelle was not doing so hot. The PICU attending doctor gave his advice and after going back and forth they decided to leave her up here.

She eventually woke up and started looking alive again around 9:30. She watched some of the Thanksgiving Day Parade on TV and thought that was pretty great! However, in the afternoon she started dropping pressures again. They ordered yet another fluid bolus and another PICU consult. She recovered more quickly after that one and they decided to still keep her up in ICS. Right after that we found out that one of her blood cultures taken in the ER had come back positive. It takes a while for them to find what the actual bacteria is though, so they loaded her up with more antibiotics to wait it out. That night she only had to get 1 fluid bolus to keep her pressure up, so it seemed she was on the up and up! After getting a blood transfusion yesterday she hasn't required any extra fluid! We found out the results of her positive culture this morning. She had Staphylococcus Coagulase Negative in her blood. It is a bacteria that is commonly on your skin and most of the time when it comes back positive they question whether the blood sample was tainted and whether it is actually IN the blood. Because of everything else that was going on with her little body, Dr Spraker said she believes it really was in Annabelle's blood stream. Super.

Now that we have a reason for everything that was going on, she is down to 3 antibiotics and her pressure is stable. When she is able to take meds orally or through her NG tube we should be able to get out of here. Her throat still hurts and she is back to not even swallowing her own saliva, but hopefully her counts will come up in the next couple days and she'll feel a lot better! Until then, we'll be hanging out here.


Connie said...

Oh my goodness. How scary for both of you. I can't even imagine all of the chaos and fear that a rapid response call would bring.

We pray for Annabelle every night. I hope her counts come up very fast so that things can start to be better for you guys. We love neutrophils!

Trapper and Suzy said...

Wow. I don't understand a whole lot of what you're saying, but we are praying our butts off for Annabelle! We think of you guys often, so if there's anything you need, please call me. Love y'all!

Shannon said...

Wow is right. I'm sorry you had such a wild Thanksgiving! I'm thankful she's doing better! Lots of prayers coming your way. Love you!

The Page Family said...

You amaze me! You have so much strength in you! You are doing great! I cried as I read what you are all going through. We are told we are not given more then we can handle. You must be so strong to be given so much! Our thoughts and prayers are with you always!

Blaine & Tessa said...

We love you and pray for better days to come (at least smoother days). We were glad to read that things looked up toward the end of your post.
Love ya!