central out, PICC in

Things just move faster here in the PICU. We are constantly having to make decisions and question the necessity of various tests. With no central line Andrew had to get poked multiple times about every 3 hours last night for labs (both venous and capillary). He is really starting to be weary of other people around him, which is sad because normally he is a very social kid. We just hope that soon forgets this experience and starts to be trusting again. This morning was as unorganized as can be. Our night nurse didn't realize that she needed to start platelets a half an hour before his central line came out because his platelets were at 18,000 and surgeons prefer 50,000. This mistake almost compromised the surgery, which was done at the bedside. Our day nurse picked up the slack, in time for the surgeons, who showed up a half an hour late and started administering sedation before they were ready to do the line removal. Long story short Lizzie became a primary assistant to the surgery performed on Andrew getting things for the surgery as well as getting people like the charge nurse to draw up extra doses of ketamine and versed. Eventually the fellow came (who was more or less supposed to be directing the surgery) and Andrew was so squirmy that they needed the attending to come help. As soon as the line was out, the i.v. team was supposed to be here to place the PICC line. They were late as well and so Andrew had to be kept under sedation for a while. The I.V. team was unsuccessful after 3 tries of placing the PICC and so one of our oncologists stopped it and demanded that the radiologist do it with his special equipment. So the radiologist on call came in and placed the PICC line. Andrew's sedation, which was only supposed to last for maximum an hour, lasted from 9:30am-12:00pm then 1:30-2:00pm. The interval between the sedations he slept, and has been sleeping for the 2 hours after the final sedation. It is good to see him at peace even though they say it sets him back from recovering from his breathing issues. It's a constant toss up here whether or not more interventions will make more interventions necessary.

Good news, between doses of Tylenol, his fever only went up to 100F this morning. We don't know if this is a fluke or if his fever is actually dropping. We have had false drops in his fever before. Other good news is that his white blood cell count increased to 0.4 (normal is 6-17), and he had monocytes and bands!!! Thank goodness for neupogen.

We had a special visit from Robert, Tanner's dad. He really brightened our day and helped us feel as though things were going to turn out well soon.

We feel hopeful that Andrew's condition will continue to improve. We aren't leaving the PICU very soon, but progress is being made. We really appreciate the thoughts and prayers.