4/17

Yesterday continued to be a busy day bedside. Peyton, being the feisty little guy that he is, continued to move around here and there even on the morphine which is not ideal when being intubated. When he would get agitated his oxygen saturation levels would continue to drop. During his last stay in the ICU post tracheopexy the same sort of thing happened. Every time Peyton would start to move he would get bolus doses of morphine and dex to keep him comfortable and still. The issue that we found was that some of this was stored in his fat and when we were ready to extubate Peyton was not responsive enough to do so. Then we had the issue of withdrawals from the pain meds. The team decided that it was best if we put him on a muscle relaxer along with the morphine that will in turn paralyze him so that he can take time to rest and heal. His heart rate was a little high hovering around 170 when it should be around 130-140. He also spiked a temperature even through the Tylenol that we were administering. We tried to draw blood through both of his peripheral lines and were unsuccessful. We were still waiting on the picc line. The IV team came bedside and a picc was placed around 5:00 pm. Once placed they found a coil in the line so they did a high pressure flush that seemed to straighten it out. Blood was drawn from the picc and sent to the lab for cultures and blood gas readings. His blood gasses have not been great but slowly have been moving in the right direction. They have been playing with the breathing tube settings to manipulate the gasses in his blood. Unfortunately the picc line coiled again so they pulled it out from its central location (it wont be able to be used for PN) and saved it so that we can at least draw blood from it. One of the cultures came back showing a new bacteria so we have switched his antibiotic to cover the staph and this bacteria. Kelly our nurse also put a cooling blanket under Peyton which helped lower his fever and his heart rate immediately dropped. His Foley catheter was removed last night and they gave him a diuretic and he has had some good output on his own. He is pretty swollen which they are not overly concerned with seeing as they gave him a bunch of fluid during surgery. Hopefully he will be able to move more fluids today which will help with swelling. They have reduced the settings on his breathing tube and he hasn't desated which is a good sign. They are going to try and give him small boluses of nutrition through the g-tube and see how he does with that. I hope for an uneventful day and that Peyton continues to remain stable on lower oxygen levels which will be great progress. Thank you all for your continued prayers, support, and messages....this is the time we need them the most. Peace xo.