Thursday, May 26, 2011

Day 3 Update

Cain constantly amazes me and yesterday was no different. He had an exhausting day and it was exhausting for me to watch all he had to endure. He was such a trooper though.

Throughout the day several of Cain's meds were cut back. He had been receiving drips of Milrinone (for helping his heart squeeze and dilates vessels) and Precedex (which is an IV sedation) and both of these were stopped during the morning. Since the Precedex was stopped he started receiving Oxycodone to help with pain.  At lunch time the Dr's okay'ed Cain to start on a regular diet so we gave him some milk.  Shortly after drinking some of the milk he threw up.  I felt terrible for him because you could tell he needed to cough but that it just hurt to bad for him too cough.  I think he ended up with mucus in his throat and it made him sick.  Poor guy!  Afterwards he was switched back to a clear liquid diet so all he has had since Sunday night for dinner is Pedialyte and juice.  His sheets had to be changed from him being sick so Brad was able to hold him.  We were really excited about the thought of holding him but he seemed to be in so much pain that we put him back in his bed as soon as the new sheets were put on.

During the afternoon they started removing some lines which was great because that means Cain is progressing.  They pulled his ART that was in his groin and the Central line that was in his neck.  Both of these procedures took suture removal.  Cain was a champ and laid there for the most part but it broke my heart to have to watch him scream out in pain at times.

Cain had a peripheral IV line that was in his left hand.  Our nurse checked the line and it seemed to be working just fine so maintenance IV fluids were put through it for Cain.  Shortly afterwards Brad noticed Cain's hand and fingers were very puffy and his fingers had turned purple.  Somehow the peripheral line was no longer working and the IV fluids had been pumped directly into the tissue of Cain's hand.  Cain had an arm board on his hand to protect this line and it ended up cutting off the circulation to Cain's hand as his hand was swelling.  Brad went to get our nurse and she started cutting off the arm board as fast as she could.  By the time the arm board came off the top of Cain's hand was milky white and his fingers were as purple/red as they could be.  The whole thing was so swollen and hard.  A specialized wound care team was called in to look at it and tell us what needed to be done.  We had to start putting heat compresses on it every 15 minutes and he had to keep his hand elevated.

Since that peripheral line was no longer working Cain needed to get another peripheral line put in.  They called in IV therapy to assist with this.  They are the specialists and usually the ones who can get lines put in the best.  They stuck him once in his arm and once in his foot but couldn't get a line in on either try.  Watching the IV therapist try to decide where to stick him was absolutely terrible for me.  He kept commenting on how Cain had needle pokes all over him.  It just broke my heart.  You can honestly see little scars on his ankles where he has been poked in the past and he has about 10 needle pokes on his wrist right now just from trying to get lines in on Monday.  It's so sad to see.

Since IV therapy was unsuccessful at getting a line in they had to use the vein finder.

The green light is the vein finder
I've never seen this instrument but it was pretty neat.  Brad and I both got to check out our veins.  The charge nurse was called in and after 3 more needle pokes she finally got a new peripheral line inserted in his foot.  I am praying this line continues to work.  I don't think I could stand to watch him be poked with a needle one more time.  Seriously, it is terrible.  We would have to hold his hand and soothe him as he cried out in pain.  It was almost more than I could take.

He has been receiving Oxycodone and Dilaudid to keep him comfortable.  He was on a liter and a half of oxygen through his nasal cannula and his sats were staying in the 90's.  The nurse tried to see what he would do coming off the cannula but his sats dropped into the 70's when she would try.  They will work on weaning his oxygen slowly and eventually he should be able to sat in the low 90's without it.

Cain was the best patient even through all he went through yesterday.  The faces he would give us were heart breaking and the crying out in pain was just terrible.  It is so not fair that someone so young should have to go through so much.

Thankfully he continues to make progress and is looking great aside from his pitiful faces he makes.  I am dying to see his sweet little smile again soon.  Check out his pink lips.  I have never seen his lips so pink.  I sat beside his bed and cried happy tears the other night just looking at how pink his lips and toes are now.  It's the best sight in the world.


The Heberts said...

Holli and I have been praying for Cain every night. This morning when we looked at your new Blog she said, "I hope Cain will be safe and feel better." Give him hugs and kisses from us. We love y'all!

Kathy said...

Reading this post just made me cry for you and Brad and for Cain. I just can't imagine! Amazing how pink his precious little face and lips are. But that poor little hand! Continuing to pray for ya'll.
I'm off for the next 4 days if you need anything.

The Hitchcock Family said...

I know exactly how you feel about holding him. That was so hard for me and Jason too!! We wanted to hold Colby and comfort him so badly, but he was just in so much pain being touched. Hang in there!!

I hope his little hand is better. I'm sure that was very scary for you guys!!

Susan Walsworth said...

So sorry about Cain having to endure all the needle sticks. Praying that the line holds. Hope he feels better soon. God Bless Cain and his family.

Anonymous said...

My prayers are with you guys. I wonder why they removed the central line(fever?high wbc count?).

I prefer PICC lines on my patients Im not a pedi nurse, but for adults we leave PICC lines in for up to 4 weeks. We get blood draws, give iv fluids, tpn, etc.

Ofcourse it does have risks(As do central lines, and regular iv's). Bloodsteam infections, blood clots, etc., Personally I have never seen complications related to a PICC(however our nurses are well trained on PICC line care).

I'd google and research if I were you guys. Also when my patients have to stay in hosp for a while they start getting depressed and what not so I bring in dvd's for them (all comedy). Laughter is the best medicine. Its important to keep spirits high, and positive attitude in everything.