Friday, May 28, 2010
PCICU Day 1 Continued
Sorry for lagging updates ... didn't expect the activity level to be so non-stop the first couple days, but I've been trying to jot notes to bring everyone up-to-date as I can. I will try to organize the posts by date for some cohesion. Today is actually my first morning not in the hospital after discharge yesterday afternoon and I am missing my boy terribly. But we will be off to the hospital to see him as soon as the boys get up and about.
So to continue from our first opportunity to see Brandt, the ICU staff let us know that there was a bed available in the PCICU (Pediatric Cardiac Intensive Care Unit). I was thrilled to hear this, as all the ped cardiac team "hang out" there -- always at least one cardiologist on duty along with nurses trained and experienced specifically with heart defects. After an hour or so Glenn and my mom were able to go see him there . . . my legs still weren't working or I would have been right there with them, but I was so happy they could check on his status for me!
Whenever the unit admits a new patient or one coming from surgery they clear the entire unit of all visitors with a loud call of "we're rolling." This allows them to focus on the incoming patient to get his/her "nest" set up with all the necessary medication drips while maintaining the stabilization of all the stats they monitor. In Brandt's case, the ICU doctors had stabilized him with 2 catheters in his umbilical cord: the arterial line (UAC) which allows blood draws and the venous line (UVC) through which they administer meds. These lines are extremely sensitive, but a huge help in reducing multiple "sticks" to poor baby. Brandt's prostoglandins (meds to keep his ductus arteriosis open--which enables blood flow to the lungs after delivery) were already started through the catheters by the time he was in PCICU. Glenn and Mom let me know after their first visit that he was stable but with low BP and high oxygen saturation, which is typical due to the fact that nothing regulates the flow of the blood to the lungs once since he duct can't close. While they were there the cardiologists were performing a second set of echocardiogram tests to help determine more complete diagnosis and treatment/surgery plans. Glenn reported that Brandt did NOT like the echo, but he DID like to be swaddled and have his head rubbed. :-)
As SOON as my OB released me via wheelchair down to PCICU I was there! Contrary to our expectations, the "nest" was open with complete access to the baby, so we were able to touch and love on him as much as we wanted to, just no holding. The cardiologist on duty that evening approved us to hold him as long as he was stable, but almost immediately he started having scary breathing "episodes" where he turned blue right in front of us. His body just "forgot" to breath due to the prostoglandins, and his blood pressure numbers kept reading "soft" which we were told meant his chest line and cuff readings did not match. As a result they put off the "holding" time again. The nurse also told us almost all HLHS babies end up being intubated pre-surgery because of these exact problems--very typical of the medication side effects and mixture of blood flow in the "open duct" heart. We said goodnight to him with the nurse's reassurance that we could call anytime during the night, and that they would call if there were problems, but that unless the "episodes" decreased, he would likely be intubated by morning.