Day 3 PICA

I can’t say PICU without wanting to say chu or boo. But nonetheless we have entered day three in PICU.

I have just done my normal 5am wake up, pump take it down and check on Max. He is doing well but the decided to try and let him breathe unassisted for a 30 mins to see how he went.

He managed for a while with a bit of a low level of breathes (12 when it should be more 23) but decided he was going to stop entirely whilst I had gone to pump. So they’ve turned the ventilator back on.

Yesterday the husband went home for the afternoon to see the twins and whilst he was gone it was a bit of a female friendly zone on the ward. We were talking Rue Paul (apparently very good), dogs, men, potential engagements. All light hearted and very funny. Im not sure if it is because I have started to relax a little or whether it genuinely was a lot quieter on the ward but we had a good day.

Max has been quite fiesty, the first night he was here he pulled the catheter out. Today he has pulled the canular in his foot out and the later in the day decided to pull out the feeding tube. Everytime he gets moved, or nappy changed he seems to get a little angry and all the stats do what they shouldn’t. So takes a while to calm him down and get him back in the room. But the majority of the time he is behaving and it is very calm.

He scared the nurses a little bit and decided to hold his breathe again earlier in the afternoon too. Apparently went every colour of the rainbow before going a lovely purpley blue. But he seems to be doing it when I’m not about which saves me the stress at least I guess!

He is still on morphine and is being fed ebm mixed with his iv fluids. Only 16ml an hour but it’s something and he is taking it. He is also being given another drug that calms him down and makes him sleepy when he starts to get a bit too lively.

I didn’t wake the husband up until 10am this morning, I think he was confused how late it was. When we got back down to the boy, the consultant came over and said he thinks we’re close to getting him off the ventilator! He then disconnected it to see how he reacts in a managed way and he did really well. So they have given him steroids to help with inflammation of the voice box and have stopped iv/milk to ensure he has an empty stomach. He is currently asleep but once he wakes up a bit I think they are going to give it a go.

His Ventilator is out! Just on oxygen now, still has the catheter and feeding tube in but so glad the ventilator is out. They are going to keep assessing him throughout the day as well as increasing the feeds quantity but reducing frequency. So giving him 3hours worth in an hour. He is currently on 16ml an hour (100ml per kg per day spilt across the hours) which seems like nothing but is apparently all they need. If he can handle the higher amounts without too much pressure on the lungs causing him to stop breathing again we will be discharged to a ward where they can monitor him.

He behaved! We are now awaiting a bed on the ward or hdu but it is already gone 8, unless there is an emergency we will stay here.

Time to get some rest. We’re still in their rooms upstairs as we’ve not been given a Ronald MacDonald room, but to be honest so long as we are near Max I don’t care.