Blow Out

Yesterday was a tough day for Aaron. His arterial line failed the previous night and the GI docs had ordered a boat load of tests to be run early yesterday morning. They tried for a new art line but were unable to get one in so they drew blood from where they were poking him. He was none too happy with this and put up a big fuss. Unfortunately putting up a big fuss requires significantly more oxygen and he was quickly maxed out. His nurse quickly reattached his pre monitor to make sure he wasn't shunting, which he wasn't. When he gets that worked up he has a hard time calming down, even with drugs. The doctor decided to cancel his echo and not wean the flolan anymore to give him a break. Unfortunately the GI docs also ordered a comprehensive abdominal ultrasound which did not get canceled. When I walked in it was under way and shortly after I came in our nurse came back from lunch. She was not happy the ultrasound was taking place. She mirrored my feelings exactly! She called our n.p. to ask what was going on and found out she had kept it in place.

While the ultrasound was going on the team came in to do rounds. I saw we had a new fellow this week, she is only a first year so I will see how this plays out. They decided to not try for another art line again (thank you!, I'm sure Aaron says the same thing!). They also upped his feeds to 28 mls a feeding and discussed all the results that were back from the labs drawn earlier, all seemed to be ok. They decided to do one more urine test to see how much protein was in it.

Last night I was able to hold him for a few minutes and we weighed him. I noticed his belly was a little firm but that it looked smaller. He weighed 2240 grams (down from 2360!) and his belly measured 32 cm (down from 34!). His FIO2 is still in the 40's and I am guessing his CRT is low after all the blood tests yesterday morning. I may ask them to run a CRT today if he is looking pale. After we got him settled he went back to sleep only to get fidgety a short time later. The nurse realized she forgot to give him his extra calcium so she got in there to give it to him. She commented that he was gassy when she opened the door up. He continued to be fidgety so I mentioned he may need some extra pain meds. She went to get it and then asked me if I wanted to check his diaper just in case. When I opened it up he had a huge amount of stool. We weighed it and it came in at 18 grams, all stool! No wonder he was fidgety! I looked over and he had tears in his eyes. He can't vocally cry with the respirator but tears he had! Poor little guy. After I changed him I pushed on his belly and it was much more squishy, just how we like it.