Wednesday, January 29, 2014

PICC Line In. PICC Line Out...

Today was the Worst day ever.
Philip got his PICC line inserted yesterday and it went well. It wasn't the most stable position but in far enough where they were comfortable sending us home and having home care teach us to do the infusions of his antibiotics. This morning they changed the dressing and sent us on our way with the line out 3cm. We got home around 12:30 and the pharmacy dropped off the supplies by 1:00 and the home care nurse was over by 1:30 to start. Philip's dressing was saturated in blood so she had to change it again before we could start the infusion. So while my poor sister and Dan held him down she proceeded to take the dressing off. I won't  begin to tell you you the screams he was making from the tape being taken off. One word...Horrific. I thought I saw the line come out a little but she measured and said it was the same as what was in his discharge papers. She cleaned and redressed the site and tried to flush it but met resistance and saw that fluid was coming out of the entry site at the skin. So she had to undo the dressing again to evaluate it to make sure there were no kinks. More screaming for poor Philip. So after a few calls we were sent back to the hospital for the PICU team to evaluate it and see if it was salvageable. So off to the hospital we went at 2:45 where they undressed the site again. This time I held him down screaming. His poor skin was so raw at this point. They measured the catheter and it was 8cm outside now. Meaning only 10 cm were inside his body only reaching to his shoulder. Not far enough in to do its job properly so they had to take it out completely. The purpose is to have it snake far Into his body closest to the center like where his heart  is. So we were readmitted and brought up to our room, Which is in the new pavilion and is private so we were happy about that.  Now they had to put in yet another IV so he can get his antibiotics till we figure out what to do.  3 STICKS to get the IV in this poor baby.  Enough already!!!!  How much can this poor baby handle??!  I just can't anymore.  I wish they could stick me. He 's getting wise to what's going on and knows if I put him down someone will most likely be poking and prodding him.  Just frustrated all around.  Tomorrow we will decide  if we should try a PICC line again or  just go for the neonatal line and stay in  the hospital or  do multiple IV sticks over the next couple of weeks.  Let's hope whatever happens, things go a little smoother from here  on out.

Tuesday, January 28, 2014

Friggin' Bacteria!

Well, It's been a while since I updated everyone on Philip so here it goes…
Saturday morning, Philip developed a fever. So I called the GI office and they sent us to the ER to get some blood work done but be ready for a 48 hour stay. Normal protocol for someone with Biliary Atresia. So after a ton of blood work, urine culture, and ultrasound it looked as if his Bilirubin and liver numbers increased as well a white blood cell count a little. The major concern with having had a Kasai is an infection called Ascending Cholangitis. Since his intestine is hooked directly to his liver, there is now a direct "highway" so to speak for the bacteria which we all have in our intestines and we need to aid in digestion to creep up(Ascend) into the bile ducts in the liver. Being his bile ducts are malformed this causes the backup of bilirubin and can cause liver damage. They admitted us and His fever persisted overnight and spiked at 104. So even before the final results they started aggressively treating it as if it were cholangitis. Because he is doing so well after the Kasai that is another reason to treat it so aggressively. The treatment consists of 21 days of IV antibiotic called Zocin. Yes, when I heard 21 days I about passed out. So we have been in the hospital since then and he is getting his antibiotics every 6 hours. We thought maybe it could be a virus but after starting the antibiotics and no fever since Sunday and the trend of his bloodwork, it looks like it is indeed cholangitis. Today he is having a PIC line put in which is sort of a more temporary permanent IV line that can stay in for the whole 3 weeks so they don't have to keep sticking him. They will try to put in a pediatric line so he can come home and a home care agency will show us how to administer his medicine at home. If not they may have to put a neonatal one in and he will not be able to come home because home cares will not care for one that small in. We are a little stressed out trying to figure it all out right now but we are praying the PIC line works and we can come home and he continues to respond well to the treatment. Philip on the other hand is charming the pants off of all the nurses and staff. And he rocks that hospital gown!