October 2, 2009

Shortly after blogging last night I called to check on Gabe and learned that he was still not doing very well. The improved condition he was in when I left, apparently didn't last for too long. He was extremely agitated, was retracting (lots of quick shallow breaths) and his numbers were not sitting as stable again. Nurse "S" pulled all the tricks out of the bag, but nothing seemed to be working. After a good CPT (chest physical therapy) and some PRN's (extra doses of morphine and/or adevan) he finally started to calm, but was still not himself. Earlier in the day Nurse "G" was having some trouble with Gabe's PICC line. Come to find out the line had become clotted, meaning Gabe was not receiving any of the drips running through that line, and the drips going through that line were his Morphine and Versed. This means that the majority of G's issues over the last few days can most likely be attributed to the fact that all of his sedation and painkillers were cut off and he was having major withdrawls. Poor baby! The PICC line was pulled and an IV started to temporarily run his drips through until a new PICC line could be placed in the morning.

When Nurse "A" arrived this morning Gabe was doing much better and was resting comfortably. Unfortuantely he did look puffier then the day before, so it was decided during rounds that his FFP would be changed to every tweleve hours, instead of every six, and it would be chased by Diurel (diaretic). This is the concoction Dr "B" came up with, which successfually kept Gabe from puffing when he needed FFP. Unfortunately they were not able to get a new PICC line in, however they were able to place a deep IV, which will work for now to run his drips through. Gabe had several good blood gases so they were able to wean on his vent settings. They are still not down as low as they were at the beginning of the week, but they are lower than yesterday. I think the combination of stopping G's hydracortizone wean (and actually going up a bit), cleaning out his chest tubes, tweaking his vent settings and running a new line for his drips, has finally helped Gabe to get back on track. He spent the day hanging out with Nurse "A," snoozing and checking out his surroundings. We took today "off" and enjoyed hanging out with some friends that came into town. We look forward to seeing Gabe tomorrow. We miss him so much if we don't see him, but it sure does feel good to spend a day at home.