Obviously, his EEG equipment was taken off, so now he looks more "normal" but with gooped up hair. As they began taking the "probes" off, the lady rubbed off the goop starting on the left side of his head. Well, Finnegan didn't like it very much, so the right side of his head is a bit more "gooped up" than the left. The neurologist was happy with Finnegan's activity today. He had been moving his left arm and legs, looking around, and moving his lips. His intensivist (ICU doctor) and us are worried that he is not moving his right arm/hand very much or even really at all; however, when his fingers on his right hand are pinched, he winces and moves his other limbs about. That was the arm that one of the ER nurses tried to get an IV in, and said "oh, I'm sorry that's going to be a big bruise!" We're hoping that the arm is just sore from that horrible stick and that he'll be flailing it about in no time. His neurologist is not terribly concerned with this now considering the other stuff he was doing today, but it is something to obviously watch.
Finnegan also got an EKG today. The results showed that there was no infection near his heart (yay!). They are still giving him a medication to help protect his heart just in case. He was also put on a medication to help his albumin (protein found in the blood) levels and lasiks to help flush out the excess fluid in the blood. His low albumin level is probably one of the reasons he is still puffy.
Finnegan has also been intermitently given medication to regulate his blood pressure. Otherwise he is on a couple antibiotics consistently to kill the bacteria and protect his heart. They have also been switching out his fluids to account for several different changes in labs.
He actually took a big step forward and they started him on TPN (the IV nutrition he got when he was in the NICU) and a very low amount of formula that is being slowly fed through a feeding tube in his nose. This is similar to the "gut priming" they did in the NICU to prepare Finn's belly for digesting food again. He's only getting about 2ml of formula/hour, but as he tolerates each bit, they will decrease the TPN and increase the formula.
The doctors from the Infectious Disease (ID) unit also came by to see little dude today. They finally determined and confirmed that the meningitis Finn has is pneumococcal. If you want a more basic understanding of the disease, this website is very helpful in explaining things in less medical-jargony terms. http://www.meningitis.org/disease-info/types-causes/pneumococcal They came to check his ears for any sign of infection because ear infections are usually where pneumococcal meningitis stems from/develops. Turns out, both of Finn's ears showed signs of infection. His left ear was red and inflamed and his right was also inflamed with fluid. While the antibiotics can cause inflamation in the ear, it is most likely that he had an ear ache all along and we never knew about it. The doctor from ID said that some babies just have a higher pain threshold, so it's possible that it was only slightly annoying Finn and not really hurting him. Based on everything he went through in the NICU and from what we know about our stubborn boy, that's probably true!
Finn's Godmother Lonnie came to see him today. While I only got to spend about 15 minutes with her and Finnegan, Finn couldn't take his eyes off of her. She was by his side calming him down when the "mean old doctors" came in to pinch his fingers and toes. His face would scrunch up and as she talked to him, his face would relax and his eyes would just stay fixed on her. Finnegan has one awesome Godmommy, and man does he ever lover her! :) Before she left, Lonnie gave me a necklace that has been passed around the family. Each person that had the necklace during a troubling time had good outcomes. After Lonnie left, Finn's doctors came in to say they wanted to put him back on the sedatives since he was showing signs of pain and discomfort.
Ian left shortly thereafter to spend the night at home since he had been at the hospital for almost 2 days straight. The nurse started Finn back on his sedatives very soon after Ian left. Finn started falling back asleep but then popped both eyes open and kept scrunching up his face. Meanwhile his blood pressure and heart rate went up rather high, and he was breathing faster than the vent. The nurse kept checking him over asking, "What are you trying to tell us, buddy?" I never want to have that feeling again. I just wanted to pick him up and hold him. I just wanted to tell him that everything would be alright and that all of this will go away. I wanted to cradle his little head to make him feel safe. Instead, I had to stand there stroking his head and arm, hoping that it was enough to make him feel bThe nurse went to get the doctor to see their interpretation. I started singing a lame version of rock-a-bye baby to try to soothe him. He coughed (which is silent since he is intubated) and flailed his arm around. When I started hold his hand, he found my pinkie and gripped it tightly. By the time the doctor came a couple minutes later, he had calmed down a little. His eyes were starting to close more and his face relaxed. When I knew he was asleep, I went into the bathroom in his room and sobbed. I felt so useless. He is just a helpless little baby, and he has already been through so much. He woke up with horrible facial expressions several times before the drugs finally helped him sleep. The nurses explained that the antibiotics are probably doing their jobs and his body is in less shock, so he is probably feeling a bit more; not to mention he had been off of any pain killer or sedative for over 24 hours to assess his neural state.
After everything seemed to calm down, one of his former nurse practicioners from the NICU came down to see Finn and see what the heck happened. She said the neos and other people she told were in shock that the mighty (recall that they all said he had no clue he was wimpy little white boy) Finn had been admitted to the PICU! Our little peanut is one popular dude!
Just a little while ago I spoke with Finnegan's Mr. Night Nurse, George. I told him that I was concerned that Finn's heart rate and bp was still rather high even though he was sleeping. He explained that the albumin in combination with the lasiks can cause his bp and heart rate to rise because it is messing with his blood (cleaning things out and making good stuff stick to it instead of float around). They also are keeping track of hydration to make sure he's not on too much lasiks. They check that by feeling his soft spot and whether it is sunken in (dehydrated) or not. The lasiks causes him to pee out all the bad stuff ("flush it out" is what the "technical" term is I suppose). So far his urine output has been superb. Well, George actually said he was a peeing machine. Now all of his levels have tapered off. His platelet count is still on the lower side, but has remained at the same level since he was admitted on Sunday. His 7pm labs showed a platelet count was at 60. George said they will intervene if the count goes near 20. On the other hand, his hemoglobin levels were 11 which were significantly higher than they were the day before when he was given blood.
Tonight he is going to put in another "monitor" into the vein where his central line is to measure his central venous pressure (CVP) with a transducer which will determine hypervolaemia (an abnormal increase in the volume of blood circulating in the body and often a result of excessive fluid infusion) or blood volume. If too much fluid is circulating they know to cut back on the lasiks and if too little is flowing they know to crank it up a bit. Essentially, this serves as another measure to make sure that Finnegan is getting the right care necessary. This adds another number and wavy line to his monitor. This one will be blue and have a range between 0 and 10. Finnegan's monitor also tells us his heart rate, blood pressure (continuous and hourly), level of CO2 output, breaths per minute, body temperature, and pulse ox.
Finn's due for a blood gas this evening, setting up in CVP line, and a chest x-ray in the morning. Otherwise, his care team said the plan for tonight is to keep him comfortable and sleeping; two things that I will also participate in right now! :)
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