4/18

For the most part yesterday was pretty uneventful. Seeing that Peyton is on a paralytic we have just been monitoring his blood gasses, lung x-rays, and fluid output. He broke his fever which means the antibiotics are fighting the klebsiella along with the strep pneumonia. We have been administering Lasix to try and help him move some fluid that he is holding on to. He is extremely edemous/swollen which is not overly concerning at this point seeing the amount of fluid he was given during surgery. Mid-day he lost all access. Both of his peripherals became infiltrated and his Picc line was in his neck so we could not use it. We put an emergency page in for the Picc nurse to come and try and pull back the line one more time. Fortunately she pulled the line back, we took an x-ray and it showed that we would be able to administer his meds through the line. It is still not centrally located so we have talked about trying to place a central line if necessary. We have had him on a continuous small volume feed through his g-tube which he has seemed to tolerate. The fear is reflux and aspiration so there was talk of putting in a gj tube when sent to IR to assess his vein anatomy/access and replace the Picc. We are working with the team to see if this is necessary or just a precautionary measure. His blood gasses have continued to improve and his chest x-ray showed a small improvement in his left lung. His swelling looked a little better this morning but he is still very puffy. They put the foley catheter back in to try and help him void some fluid while under the paralytic. We have also put an order in for some bedside PT to help try and mobilize some fluid retention. They are going to try and take him off of the paralytic today to see how he reacts. Other than that everything is pretty much status quo. I know this may sound redundant but we continue to be overwhelmed by the outpouring of thoughts and prayers sent Peyton's way. We are overly grateful to everyone as this is the time where we need the extra help. Peace. xo