Pediatric ICU

I know I am way late in posting about this but it has been a crazy weekend!

Averi continued to throw up into Friday.  I could tell she was feeling worse and worse because she never really woke up or went to sleep and just rolled around in her bed moaning.  Later in the day she started randomly screaming out, which I've never heard her do.  They tried changing her feeds to a continuous feed in hopes of stalling the vomiting.

In the afternoon, she added excessive diarrhea to the mix and spiked a fever in the 102's.  I think I've said this before, but fevers are a really big deal for the oncology patients, so they gave her some tylenol, started her on an antibiotic, and took several blood cultures.  The tylenol didn't seem to help at all, with her discomfort or the fever, and I was told that she couldn't get motrin because it affects platelets.

I finally picked her up to try and calm down the rolling and moaning (every time I picked her up she would throw up so I was trying to leave her laying down).  I sat down with her in the chair just as the nurse came in to check on her.  She looked her over and then asked if she could turn on the lights to take a closer look.  Averi's skin was mottled and her legs were cold even though her head was burning up and her fever had gone over 103.

The nurse wanted to get her blood pressure but couldn't get the machine to work so she left to find another one.  Thirty minutes, a new cuff, and 6 machines later, she manged to get a reading showing an almost non-existent pressure.  By now, Averi's arms were cold as well.  Luckily, Dan arrived as the blood pressure machine search was going on.  Finally, the doctors were brought in and everything started to blur together.

The doctors wanted Averi on the bed so they could look her over.  When I laid her down we noticed that she wasn't focusing on anything and her eyes were glossed over.  Soon the ICU doctors arrived to assess her and more machines were turned on.  It turned out that she basically had no blood pressure and her heart rate was over 200 bpm.

At one point, her eyes rolled back in her head and she started seizing.  I didn't see it because I was on the other side of the room trying to get Kaili to sit still by making her some food.  Dan said it was the first time he has ever thought that Averi's life was in jeopardy.  I looked over at him at one point and his eyes were red.

She was septic, all of her blood was infected.  They gave her a bolus of saline in her broviac and her heart rate immediately went down a little.  Then she was taken away to the PICU.  Dan went with Averi and I stayed with Kaili in the room.

(A couple of hours after being admitted to the PICU she was already looking better...yes, this is better.)

Once in the PICU, Averi was started on more antibiotics, given several more boluses of saline until she could be given a blood transfusion, and had a catheter put in.  No one ever gave us a straight answer, but from what we heard she was suffering from a combination of sepsis and hypovolemic shock (severe dehydration).  I have yet to figure out why she didn't have an IV going once the diarrhea started.

(Her med concoction in the PICU.)

She was kept in the PICU for 2 days and slowly started looking better.  They finally brought her back up to the oncology floor this evening.  Obviously, she still isn't herself but she's had great improvements since Friday.  She's still a little fussy and sleepy and doesn't really want to play, but at least she will focus on us and lift her arms and legs.  They are slowly upping her continuous feeds to make sure she can tolerate them and the antibiotics are going to be decreased tomorrow.  Hopefully she can get some good rest tonight.

I'm praying that this isn't a sign of what's to come every month with the treatments, but I know in my heart that it probably is.  I know she's strong and she's a fighter, but there has to be an end to this madness sometime, right?