Monday, March 1, 2010

Watching Elias Closely

We are watching Elias like a hawk today and have been this past weekend. It was a rough one reminiscent of pre-nissen surgery days over a year ago. We found blood built up at the tip of his central line. At some point overnight the device that secures the line came off and the clamp to the line opened. Elias rolls and moves a lot at night so it happened at some point overnight we think. Being under his clothes it is tough to see and since it had not happened before there was no cause to suspect. We held our breath as we flushed the line and changed the cap hoping that it was not clotted. Thankfully, it was good. HUGE sigh of relief. On Saturday Elias was just listless and seemingly had no energy at all. The few times he actually sat up he would fall right back down. He just wasn’t feeling up to it. He was also having intense airway closure problems. You could literally hear it collapsing. While it has been this way for several weeks now this was by far the most concerning.Those were the only symptoms other than an overactive leaking fistula so we knew it was possible he was having side-effects from the IVIG. He did vomit mucus late evening in the typical fashion of becoming overwhelmed with secretions. Sunday was different. He vomited on five separate occasions, some mucus and some were feeds as the day progressed. The final episode was a series with very large amounts each time in the span of about 5-10 minutes. Not that anyone really wants to know, but there was puke everywhere. Elias was very bright red and flushed after this particular episode. I got a temperature, which was low for him 93.5 in the left are and 93.9 in the right arm. Katharine got home from work about 2 hours later she got 93.7. Elias is typically 95.7. I checked his O2 sats to make sure he had not aspirated any of the vomiting, but they were fine. Elias was obviously tired, but seemed to have a little energy to him. We are hoping that nothing serious is brewing. We will get another temp this morning and if it is low again i suppose we will have to call the FA clinic to make sure they don’t want to do anything. Low temps can be just as bad or worse than high temps. We have considered that with the overactive fistula the last several days and Elias’ history if behavior prior to diagnosis of that it could be another UTI. We are hoping not because the medicine they give him for that makes him so nauseas. Although, I’d rather it be something like that than something more complex or serious. We will keep you posted on how things go today.

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