Friday 5 October 2012

Sick Little Man Back to the ICU

I certainly wasn't anticipating writing a post from a room in the PICU while Braeden is being 'milked' for yet another blood gas level.  Mr.B has decided that my/our lives aren't exciting enough apparently!

He had been a bit fussy for a few days but Monday night after he went down for the night he started to retch.  Michael and I vented him, got him settled and not even 1/2 hr later he was at it again.  This carried on for another four hours before deciding to take him into Emerge.  He was retching so much and so frequently by this point that I had to hold him in my arms while Mike drove.

When we arrived at Emerge it was blissfully quiet and we got in right away, we even by-passed nursing and got seen by the Dr right away.  Of course when the Dr walked into B's room he was happy, kicking and laughing...figures.  I explained that he was sick (I swear), needless to say, he was sick enough though to put on a good show for the Dr.  I (and the Dr) figured it was just a tummy bug and given his Fundo surgery he was/is unable to vomit so retching it is.  Onward with the anti-nausea and I thought we'd head home, nope.  Drug didn't work so onto an IV to put the drug in intravenously...5 pokes and an hour later he had an IV (and I needed Ativan).  Abdominal xray - clear, blood work - unremarkable...Braeden, retching his little heart out.  Shift change and new Dr and she asked about history of UTI's (urinary tract infections) or any other infections...light bulb!!  So of course I was annoyed that I'd not thought of it but in all fairness these symptoms were new.  His urine dip was nasty to say the least so upstairs we were sent after only 8 short hours in Emerge.

We arrived upstairs to a wonderful welcoming committee and some of our favourite nurses (Mr.B's girlfriends really as they just flirt back and forth!) were on shift.  The thought was it was a nasty UTI and we'd get the antibiotics started and head home in a few days.  He had a good night on Tues and when I came in Weds morning I noticed he had an increased work of breathing.  He had a chest xray done and it was fairly normal (for Braeden) so the Dr wasn't too concerned.  Throughout the day though he was working harder and harder and got lethargic and fussy.  By 3pm I was getting concerned and as the next few hours proved he was getting a lot worse.  He started getting blue around the mouth and wasn't even aware that I was with him, he was just completely lethargic and moaning/whimpering.  They activated the STEP team (nurses from the ICU) to be on hand for extra help and they came up to assess him.  They were trying to formulate a plan of action for him when he started to really struggle so they called the ICU Dr up for assessment and he was in B's room for all of a minute when he said, "take him down" (meaning downstairs to the ICU).

Down we came and got another welcoming committee and this time they were all coming to see how big he'd gotten since his last ICU stay in May.  They started him on high flow O2 (which forces air into his nose) and that seemed to make the difference.  Dr.Volmero did warn me that it would get worse before it got better.  The assumption was that it was the start of Bronchiolitis which is viral which also means there are no drugs to make it better. 

He had a good night on Weds night and when I talked to the nurse at 3am Thurs morning she was joking that he was doing so well they didn't know why he was down there.  I warned her not to say that in front of him as he'd take it as a challenge!  I'm not sure what happened in the next three hours but by 6am I got a call from his nurse saying they had to change him to Bi-Pap (Non-Invasive Ventilation).  When I got in Thurs morning he was annoyed at the mask but tolerating it well.



I was with him for the next 13 hours and he seemed to progress well which was reassuring.  By last night he was actually having small playful periods and was even handing out little smiles.  It was nice to see our B back again!  I had a chat with the Dr and there was still no real consensus on the cause of illness to whether it was Bronchiolitis, Pneumonia or a partial lung collapse.  The good news was that he was progressing nicely!

I called his nurse at 3am this morning (just seems to be my time to call) and all was well, he'd had a good night and had some good resting periods.  When I got here this morning he had a new mask on (still bi-pap) because they noticed he was working harder.  The new mask didn't seem to make much difference in it's deliverance so onto yet another one.

He has been getting progressively worse today and is struggling again to breathe even with the Bi-Pap assistance.   He has gone from being completely miserable (which is so heartbreaking to watch) to lethargic again.  He is also starting to swell up now as well which is more than a little concerning to me given his history of blood clots.  The answers I've gotten so far are "hurry up and wait it out". 

My biggest fear now is that they will have to intubate him (which makes me want to throw up).  I am trying (with great difficulty) to hold it together today for B's sake but it is so very hard to sit by and watch him suffer through this.

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