Back in the PICU-Damn It!

Well, we've been home since Tuesday afternoon.  I've been worried about him ever since then. He has been sounding crappy, needing lots of suctioning, and seeming uncomfortable.  On Friday morning I packed our bags expecting we may be sent back to the hospital at our scheduled appointment with Ambrose's PCP.  She didn't think he sounded so bad and sent me home to give him albuterol and chest PT.  He's had trouble maintaining good sats, developed a fever and had sternal retractions by Sunday evening.  I took him to the local ER, knowing he needed to go back to Dartmouth.  We arrived, via ambulance at 2 am.  I'm running on no sleep.

He didn't sound so bad last night but his chest X ray told a different story.  It looks even worse than it did when he arrived 3 weeks ago.  They put him on pressure support on the ventilator.  That means he is breathing on his own but with extra pressure supplied by the vent.  He triggers the breath and then it gives him extra pressure to open his lungs more, then CPAP to prevent lungs from collapsing on exhale.  I had to change his trach at 4:30 am to a tight-to-shaft cuffed trach due to his having a big air leak which prevents them from ventilating him adequately.  They didn't have the correct size in this whole huge hospital so we had to use a size smaller and they had to order the right one.  

They poked him many times for blood cultures. In a little while they will be trying to put in an IV. (Not an easy task.  Ambrose is a notoriously difficult stick as was Sophia. ) They agreed to not put one in unless they determined that they really need to treat with IV antibiotics. We are waiting for Amy, an IV whiz who put his in last time. Then they need to straight cath him for a urine culture which will also not be fun.  I've asked them to give him some ativan but it may not get here in time for the IV.  (They are sending her down from another unit)

He has been coughing a lot and seems very uncomfortable.  Hurry up with that ativan!

Gotta go. Please keep Ambrose in your prayers!