Ending a Long Week

Andrew decided to give everyone a scare today. Around 4pm, he was sleeping comfortably and behaving himself. Apparently he then did his little "eyes snap open and he's wide awake" thing. That part is normal behavior, but then he immediately dropped his heart rate and stopped breathing. Obviously a low heartbeat isn't normally his problem, so it was quite surprising, as was the speed with which it happened. Unhooking the ventilator and "bagging" him brought his saturation up pretty quickly, but then he went back to his normal antics. He had a high heart rate, high blood pressure, very low lung volumes, and seemed to be generally distressed. Blood cultures were taken and initial test results showed an elevated white blood count and other signs of infection, so they started up some discontinued antibiotics. It eventually took a couple of hours and a lot of medication to get him under control. Meanwhile, I was 1000 miles away in Seattle.

By the time the nightly shift change was over, everything seemed to be back to normal.....at least until I got there. The one thing that was still working well was his feeding. He was already up to 28 cc per hour, scheduled to go to 30cc (full feeds) at 4am. When I got there, he finally looked comfortable and was sleeping peacefully. He woke up and was looking at me, then let us know that he needed a diaper change. We found some blood in his diaper, which then led to a belly X-ray. Though there was no sign of anything obviously wrong on the X-ray, but they're stopping his feeds for the night and canceling his overnight sprints. They'll get a follow-up in the morning.

Though this was probably just a reaction to continued infection and some respiratory distress, it was a scary reminder of just how fragile Andrew is. He's stable now so there's no immediate worry....try to have a happy Friday.