Friday, September 16, 2011

Another Setback

Right as I finished my post this morning one of those not so great phone calls came in. In the early hours this morning Aaron's right lobe collapsed. This in turn set off his pulmonary hypertension and when the NNP listened to him his heart had a "gallop" to it also indicating pht issues from what I am told.

I grabbed my purse and Ronny dropped me off at the TRAX station on the way to work. Unfortunately TRAX didn't get the message I was in a hurry to get to the hospital as the train malfunctioned and after limping into a station we were told to board the first two trains so they could separate off the one having trouble. Needless to say it took longer than the hour it was supposed to.

When I arrived I noticed the vent settings had been turned up, not as high as I was expecting, but up. His FIO2 was at 40 and within a short time was turned down to 36. After doing cares, having an echo, and taking a trach culture he was back up to 50 but has come down again.

Rounds start about 12:30. Yesterday the Attending did rounds outside our room and didn't include me. This is the first time an Attending has excluded me from rounds when I have been here. I was pretty irritated with that as that is why I make arrangements to come in the morning. I think she sensed that so today they came in the room for rounds. When they were done with the numbers and basically saying they were going to wait to change things until after they get the echo results she turned to me and told me she was concerned they couldn't wean the nitric off or change him back to the other vent. I told her that I felt we went a little fast with things the last day or two and after hearing what happened with Aaron's lungs that he was not yet over the flu and pnuemonia. She said most kids get over that in 3-5 days. What!?! I have yet to hear of someone gettinig over pnuemonia in 3-5 days let alone a baby 4 lbs! After heariing what happened I was not surprised that he needed to go back up on the nitric when his lung collapsed as trauma always sends his hypertension into a tizzy. I got the feeling like she wants him to be farther along and doing better than he is. Don't we all! So my question is this, are you concerned because he's not following your timeframe or are you concerned about getting him to the CATH lab by next week, or should we be concerned that Aaron is still fighting the flu?

Here's my thoughts on the matter. Aaron is on his own timeframe, have we not figured that out yet??? This Attending is the first to think that he should be better by now as the last Attending told us when he was first sick it would take a while as well as all the NNP's we've had. So its been two weeks tomorrow since he got sick. Sick with both pnuemonia from the flu, and a staph infection. Cut the kid some slack for heaven's sake! If we don't make it to the CATH lab next week than we will go later. I would rather he go when he is ready, not when we think he should be ready.

There were some other issues during rounds today that I was pretty ticked off about. I need to calm down before I say more about it though. Usually I have a good idea of how things are going to play out during the day when rounds are finished. Today I felt like I have more questions and concerns than answers. Hopefully the echo will answer some of them. For now we watch and wait. Something we are certainly no stangers too.