2/12

We are back up on the tenth floor which is the surgical floor. They moved us off of the ICU unit around 3:30 yesterday. Peyton's vitals and numbers were all great. He was not swallowing his saliva and he was constantly drooling and coughing up secretions. I found myself suctioning out his mouth often so he wouldn't choke on his saliva. The team reassured me that this was not out of the ordinary seeing that he had just had been extubated. They told me that it took some patients a couple of days to start swallowing again on their own. He also was not peeing so they used a foley catheter a couple of times to help empty his bladder. We had a couple of chest x-rays done and his lungs and chest looked good. They put a water seal on his chest tube to see if they would be able to remove it which we did later yesterday afternoon. He was receiving chest PT every few hours as well as a nebulizer. His two IV's in his left hand and arm got infiltrated so we had to stop those and remove them. His arm got red, extremely swollen, and firm to the touch. Those were his last two IV sites and since he was not swallowing on his own the IV team came to assess the placement of a new site. Unfortunately we were running out of real estate seeing as his right arm had the arterial line and his legs and feet looked like little pin cushions with all of the bruises. They tried one foot and couldn't thread the IV so they lost that. Peyton was so out of it/drugged that he really didn't even flinch. They fortunately found a very small vein in his left foot that they could use and were successful in placing the IV. They removed the arterial line and from there brought us up to the tenth floor. The pain team had stopped by because I had noticed that he was having little tremors in his hands/arms. After assessment they were unsure if he was having withdrawals from the drugs or if there was something else going on. We decided that it was best to remove the chest tube so that we could remove the paravertebral catheter to see if that would help relieve the shakiness. They started him on a small dose of methamphetamine and toradol for pain/withdrawal. It would take a bit to see if this would help.
Chris came to relieve me and stay the night with Peyton. I came back first thing this morning. They seemed to have a pretty good/uneventful evening. From my observations this morning Peyton's swallowing function has gotten a little better. It seems as though he is definitely swallowing some of his saliva. He has started grabbing on to things and sucking on his pacifier. He still has some tremors and it is something that I will address with the pain team when they round. He seems to be in some pain so I want to make sure that he shouldn't be receiving anything else to lessen the discomfort. He has started peeing on his own which is a step in the right direction. We will continue with the chest PT and nebulizer treatments. Dr. Jennings and his team round at 10:00 and I want to ask about when we are going to start trying to feed Peyton. I will update as anything changes.