Many things are staying the same. He's still on the ventilator, sedation (Versed), pain killer, targeted high-dose antibiotics, IV nutrition, anti-seizure medicine (phenobarbital), albumin (protein for his blood to help it suck up nutrients) & Lasix (to flush excess fluids out).
He started being tube-fed formula which will slowly replace the IV nutrition. He’s tolerating it well. Right now he’s up to 12 ml / hr and he’ll go up to 20 ml / hr for now. Eventually they’ll increase it because he’ll need more calories, but it is currently being supplemented within the IV nutrition.
Finn had been showing signs of activity. But don’t get excited, that’s almost only ever when they pinch him during exams. He probably sleeps 23 ½ hours per day. On occasion he’ll be up without being pinched, but it doesn’t last long.
He’s starting to not like the ventilator tube and he’s showing signs of pain when he tries to cough or whenever they need to change how he lays (every 2 hours because he started to have a sore on the bottom of his neck). The fact that he doesn’t like it is good… who should want to live with a tube down their throat if they could control it otherwise? They bumped up his pain killer and sedation to compensate. They will soon replace the sedation medicine (Versed) with a different one (Precedex http://en.wikipedia.org/wiki/Dexmedetomidine) that will make weaning him off of the ventilator later easier. The current one suppresses his natural ability to breathe, and since he’s weak, that’s exacerbated. The new sedation medication also allows him to be “out” while still responding to stimuli.
His 24-hour EEG the other day showed no signs of seizure activity, but he just had one this morning. He got a dose of Ativan to stop it, but he was already showing signs that it was almost over at 2 ½ - 3 minutes. The neurologist had them add on a second anti-seizure medication (Keppra?) which will help and is kinder to the body so it is ok to be on the two. He also said the doctors didn’t need to give him Ativan this time. As long as the seizure stopped itself within five minutes Finn would have been fine.
He is going for an MRI this afternoon or tomorrow morning to see what his brain looks like. I’m hoping they don’t see a label on it called “Normal, Abby” (www.youtube.com/watch?v=yH97lImrr0Q ). All joking aside, they are looking to make sure his brain is formed correctly and has all the right things going on inside. One of the scans from when he was born had a finding that they couldn’t explain. Back then they said “We’ve got this new machine and it’s really sensitive. It’s showing this sort of thing we’ve never seen before on some patients. Right now we have no reason to believe it means anything.” That along with knowing that meningitis kills brain cells and brain cells don’t grow back, the neurologist wants a peek. One of his regular… gosh, I just said regular to refer to 1 of his 8-12 PICU…doctors will be with him the whole time. The only real risk is that the ventilator tube might get nudged out of place while he goes in or out of the machine. They can hit the stop button and roll him right now and “bag” (the oxygen bags you see all the time on hospital shows when they roll someone in from an ambulance) him very quickly and then fix the tube if needed. Other than that, he’ll get special non-metallic leads and his IV and meds will be pumped through special pumps.
Finnegan will be having IPV (intrapulmonary percussive ventilation) treatment for twenty minutes every six hours. This hooks into his ventilator tube and shoots bursts of air into his lungs to breakup secretions that haven’t left his lungs yet. Whatever it mobilizes, they then suck all out.
This feels so weird. The infectious disease doctors talked with me for a little while today. Some kids with this flavor of meningitis go straight to General Pediatrics and drink out of a bottle never needing the ventilator. Others are worse-off than Finn is. There’s a three week old baby here who has meningitis and needs more help than him.
Finnegan has been visited by several of his caretakers from the NICU. It's been great to see those friendly faces, but we always wished we'd see them under different circumstances.
Finnegan has been visited by several of his caretakers from the NICU. It's been great to see those friendly faces, but we always wished we'd see them under different circumstances.
The good news is that this has been three days in a row that the blood cultures have been negative for the bacteria, so that means sepsis is on its way out of the door. His fevers have pretty much ended and for almost a whole day they didn’t need to regulate his temperature at all. Right now he has an inflated air heat blanket on him because his temp went down to 96.3, but hopefully his body will knock that off soon.
The past two days have really been filled with a few ups, a few downs, and mostly just a lot of staying-the-sames. It’s scary that we won’t know what, if any, long-term effects Finnegan will have from this experience. He’s bound to have something since he isn’t one of the lucky who get to bypass the need for intensive care. But then again, he’s in an amazing Pediatric ICU and he has you, your family, and your friends all praying for him and sending well-wishes. We are big believers in the power of prayer. It got him safely out of the NICU! Christine and I pray every day at home thanking God for seeing him through safely and for the intentions needed by those who prayed for him, and for those who for some reason or another need praying for, but won’t ask for it. Of course here we do it several times a day!
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