Learning about PICC's....

The idea of a PICC line really scared me when they decided to put one in Broderyck's right arm for long term IV's. It also really scared me when they told me that I would be the one administering the antibiotics after we go home. But after the nurses have given me paperwork and let me practice  under their supervision. We will also be assigned a home health program to come and do dressing changes and provide the antibiotics, saline flushes and heparin flushes. It will stay in for at least 6 weeks.

Getting ready to put in the PICC

After the PICC was put in, under an awesome dinosaur wrap

 

A PICC line is, by definition and per its acronym, a peripherally inserted central catheter. It is long, slender, small, flexible tube that is inserted into a peripheral vein, typically in the upper arm, and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access. It is similar to other central lines as it terminates into a large vessel near the heart. However, unlike other central lines, its point of entry is from the periphery of the body � the extremities. And typically the upper arm is the area of choice.

A PICC line provides the best of both worlds concerning venous access. Similar to a standard IV, it is inserted in the arm, and usually in the upper arm under the benefits of ultrasound visualization. Also, PICCs differ from peripheral IV access but similar to central lines in that a PICCs termination point is centrally located in the body allowing for treatment that could not be obtained from standard periphery IV access. In addition, PICC insertions are less invasive, have decreased complication risk associated with them, and remain for a much longer duration than other central or periphery access devices.

Using ultrasound technology to visualize a deep, large vessel in the upper arm, the PICC catheter is inserted by a specially trained and certified PICC nurse specialist. Post insertion at the bedside, a chest x-ray is obtained to confirm ideal placement. The entire procedure is done in the patient�s room decreasing discomfort, transportation, and loss of nursing care.

Prepare for the eventual let down....

On Monday the 27th I couldn't have been happier they ran antibiotics, did blood tests and told us that everything was trending in the right direction. His wound started to look a lot better and I thought we were in the clear. We went to clinic on Wednesday and that blood test showed that things were still going in the direction that we wanted them too and the wound team looked under his bandage and said that it looked really good. They said that I wouldn't need to change the bandage until we came in the following Wednesday but gave me an extra bandage, just in case. The cardiologist told us we could just do oxygen at night and that he could stop taking lasix. 

This is the point where I get my hopes up and start to think that everything is going the way it's supposed to.

Then of course on Thursday Broderyck started acting really uncomfortable again, crying and not wanting to be put down. I figured he just was still sore from surgery and didn't mind holding him almost constantly. Saturday his bandage was about 3/4 saturated and I decided to change it, then that night he started breathing heavier and running a fever. Sunday morning his second bandage was completely saturated to the point that it was falling off.

I called the hospital and they said that since it was Sunday that we'd need to come tot he Emergency Room but the Cardiothoracic Nurse Practitioner would meet us there. We switched the bandage once more and I packed a bag and we headed on our way. When we got to the hospital the Nurse Practitioner looked at his wound and knew it was bad, and the admission process started again...

for the 3rd time

They starting running antibiotics again and determined they were going to do exploritory surgery to see how deep the infection is. They switched the time a couple times today and had to run some IV fluids and do a blood transfusion before they could take him back to the OR.

They took him back around 6:30pm and it's now 10:15. They had a hard time finding veins for an IV because he's been so picked on by the lab that he's running out of good veins. Last I heard was that it was a really deep infection and that they had to take the wires out of this chest to be able to clean out his chest better. 

After this surgery he will go back to the CICU and be back on a ventilator. I really hoped that it was going to be a simple fix and I am praying that when they fix this that Broderyck will be able to go home and be a normal baby...

he is supposed to be learning to smile and roll over...not spending 1/3 of his life in the hospital.

The Nurse Practitioner just came and gave us an update. She said that it just didn't look as healthy as it should. They cleaned his chest out with antibacterial fluid and will put a wound vac on for a couple days and put a chest tube back in.

Please let this be it...
The OR nurse is supposed to call if the surgeon can't call us before 11:30.

I love waking up to good news!

Well I've been pretty upset being back in the hospital. I wish that Broderyck could be home, being a normal baby, not having to be poked and prodded all day long. With blood tests at 4 am, x-rays at 5 am and then the doctors coming to do their rounds and looking at him at 7 am. I have been really worried when they tell us that we can go home one day and then add more days. But I have been trying to not get my hopes up, so when the Doctors came in this morning and their talk sounded like we were getting to go home today I got pretty excited. It won't be until later in the day, but still. Especially since everything bad is trending down, he's eating well, his weight is going up, his wound looks a lot better.

 He's going to do his last iv antibiotic today and then they're going to be discontinued. He won't be sent home on antibiotics because there isn't an oral option, and they don't want to do a PIC line. So we'll go home for a couple days and keep changing his dressing and then come back for a check-up and make sure that everything is still trending down. 

Then he gets to switch off the awful low fat formula on October 4th and go back to his regular soy formula he was on pre-surgery. Then of course we'll have to come back again for a check up to make sure he's gaining weight the way he's supposed to and that he isn't showing any signs of Cylothorax. 

I'm really thankful for everyone who has shown their support during this whole ordeal, everyone who has prayed for us, all of the doctors and nurses at Primary Children's Hospital who have taken such good care of Broderyck and who have helped me feel as comfortable as one can while living at a hospital going through these things. But I really hope we won't be back staying for a long time, if ever.

Not exactly the news we wanted to hear...

     Broderyck was released from the hospital after 9 days in the hospital. We made it home and everything seemed to be going the way it was supposed to, he obviously was uncomfortable, but who wouldn't be after all that poking, prodding and other intense things that a month old baby shouldn't have to go through.

     So as I'm thinking that everything is going the way it was supposed to on Thursday September 23 the top of his chest incision had some pus that was coming out of it. I of course was slightly freaking out because we had only been home for 3 days since our stay in the hospital. But I called the Nurse Practitioner phone number they gave me and left a message with the receptionist. Then the wait for a call-back seemed to be hours when it really was only probably 25 minutes.

     When she called me back I described to her what was going on and she told me to bring Broderyck in. So I called my mom since she had to drive us and she told me to pack an overnight bag because they were probably going to make us stay. So I packed a bag and got Broderyck all ready. When my mom got to our house from her work we got in the car and headed on our way.

     The Nurse Practitioner met us in the hallway and took us straight into an exam room. This is very lucky because they usually make you go to the Emergency Room before you get admitted to the hospital. The surgeon who did Broderyck's original surgery came in and looked at the infection. He had to cut part of it and clean the sight with Iodine and pack and bandage it. They then got us a room back on the third floor which is the Children's Surgical Unit, which is where we were discharged from. 

     They told us that they were going to let us go on Saturday. Well Saturday has come and gone and they told us there was no way we were going home this weekend, and a nurse mentioned that the soonest we were going to go home is Tuesday. Reason being that they have taken blood and urine cultures and it takes at least 72 hours to see if anything grows out of them...well in order to go home we have to have 3 clean days. 

     They at least know it's something bacterial, and have changed the way that they're doing the dressings which will hopefully help the site heal a little better. They also will be deciding what antibiotic will work best to get rid of whatever bacteria he has.

     I feel a little better when my mom comes to visit. Gives me a little break from the chaos because she really wants to see the baby. It's not that I need a break from him at all, it's just the situation. Being at someone else's will, someone else's schedule. It is still so hard for me to handle it when they come in and change him or feed him without waking me up. I know I am not doing anything wrong, and I really should accept the help while I've got it because I can't go home and be completely exhausted. It is so hard too to know he's uncomfortable, and having to ask for permission to take him for a walk outside the room.

Want to and have to are two different things...

I haven't updated my blog since July 8, lame I know. I just haven't had the time to even think about the computer. But now I have found a little bit of free time since I'm staying with my son while he is in the hospital and they have wi-fi internet here.

Well first off my son, Broderyck Rian Peterson was born at Ogden Regional Medical Center on August 16, 2010 at 5:02 pm. I was induced at 39 weeks, Dr's orders, and labor went pretty quick, epidurals are amazing, let me just tell you. If you have the choice, I say do it. It was a normal delivery and I got to take him home in the standard 2 days. He was 19.5 inches long and weighed 6 pounds 14 ounces. 

Everything was going perfect, except the fact that I switched him to soy formula thinking that his belly aches were due to a potential Lactose Intolerance, his first Dr's appointment went swimmingly, and his second appointment was scheduled for Friday September 10th. The day started great, I got a call saying that Broderyck had been approved for Medicade, then we got up got ready and drove to Ogden to his appointment. 

The nurse mentioned that he was breathing a little fast and when the Dr listened to his heart he said he could hear a little murmur, he wrote an order for me to take Broderyck to the lab to have some blood drawn, and to get him an echocardiogram at McKay Dee. Then they took his O2 Saturation and it was in the 60's, this is when the Dr called McKay Dee and told them to expect me.

This is when I really started panicking. I called my mom and told her what was going on, trying to hold back the tears. We got to McKay and the team in the NICU got him on oxygen and started doing x-rays and the echo. My mom and dad showed up at the hospital and I was trying to not cry while on the phone with the admitting department. The results of the tests  were not what I wanted to hear. His lungs were pretty full of fluid and they called Life Flight. Waiting for Life Flight to prep him seemed like forever. They let me say goodbye to him before they took him, that was the single most scary moment of my life.

My mom and I got in the car and sped towards Primary Childrens Medical Center. When we got to the hospital we met a Dr outside the Cardiac Intensive Care Unit and walked us inside. There were about 20 people inside his room and we weren't allowed to go in to see him until they got him stable. A cardiologist came out and explained what was wrong with his heart, which was almost exactly what was wrong with my heart when I was his age. The surgeon then came out and said that they were trying to decide if they were going to do the surgery that night or in the morning, a few minutes later they decided that they needed to do the surgery as soon as possible and  he came and explained to us how he was going to repair it. I had to sign 2 papers for consent to put him under anesthesia and consent to do the surgery. Then we followed them to the doors of the Operating Room.

The surgery was estimated to be a 5 to 6 hour surgery and my dad brought my younger sisters, except for my youngest to meet us in the Surgical Waiting Room. He even brought us dinner but I didn't even feel like eating. It felt like forever, it helped that they called every hour to let us know the status of the surgery. At 2 am the surgeon came in and said that everything went great he told us that we could go see him in about 30 to 45 minutes after they got him back to his room and stable.We knew my dad and sisters weren't going to want to see Broderyck like that so we sent them home before we went to his room.

Seeing my son covered in bandages, tubes, wires and hearing the machines beeping was so scary. I felt so bad that he was on so many drugs, but I am so glad he didn't seem to be in pain. His chest was still open, word was that it was going to stay open until Monday or Tuesday. They do this because sometimes organs can swell and the skin can as well and they don't want a closed chest to put pressure on those organs or have the skin try and pull back apart. 

At about 3 am my mom finally talked me into going to try and sleep, when you're child in in the Intensive Care Unit they have little rooms where they let parents sleep. They base your need by how far away you live and how sick your child is. It consists of a twin bed, a rocking chair about about 2 feet of space around the two. Saturday I spent basically the whole day in his room. I started a journal for him, so when he grows up he can read exactly what happened.

Sunday my mom and I were awoken by the surgeon knocking on the Parent sleeping room door. He said that he was going to close his chest and had me sign the consent to let him do so. I was very excited that he was getting closed up earlier than expected. 

Monday they began to wean Broderyck off the Nitric Oxcide (which helps lungs assimalate oxygen) They must wean off alot of the drugs before they can take the ventilator out, which was the next goal.  

On Tuesday 2 of the 3 chest drainage tubes came out. It was so wonderful to walk in his room and see less machines and less tubes then there previously were.

Wednesday the 15th was my mom's 40th birthday, it also was the day that they ran 2 spontaneous trials where they turned off the ventilatior but left it in place to see how Broderyck would breath on his own. When the Doctor decided that everything looked great with the echo they had done that morning and that the spontaneous trials seemed to be successful the Respitory Therapist took out the ventalator. This was the first time Broderyck had been able to cry in five days and his voice kind of sounded like Donald Duck. But it was really good to hear his voice, regardless.

Thursday the 16th is when the last chest tube and RA's got to be taken out. Those were the last things that needed to be taken out before I could hold Broderyck, for the first time in a week. That was one of the hardest things about the whole situation, was to be a new mom who had spent 24/7 with her baby and then suddenly not be able to hold her baby. They also tried a bottle also, Broderyck wasn't really use to a bottle and some of his food still had to be fed to him through a tube but after some trial and error with a couple different kinds of nipples we found one that he semi-liked.

 

 They also discontinued most of the IV's also. The emptier the room got the happier and more relaxed that I got.

On Friday Broderyck finally got his Arterial Line taken out of his right wrist and got to leave the ICU and go up to the Children's Surgical Floor. This is a more hands on floor so that my mom and I could stay in the room and pick Broderyck up whenever we wanted. He still had a feeding tube though just because he was still strugging with eating the amount they wanted him to all by mouth.

On the 18th they took out the NJ tube after we were in the CSU room so Broderyck had to try and take as much by mouth as possible. Then on Sunday the 19th we got discharged. Getting discharged on a weekend was pretty stressful. The regular crew isn't really around so some stuff took longer than it would have during the week. But it  was so exciting to finally get to go home. To stop worrying, so much and to stop living out of a suitcase in a hospital. Especially after only nine days when the doctors first estimated 14. 

Broderyck will have a lifetime of clinics just like I did but he'll be lucky that I've already been through it so he will hopefully feel a little more comfortable about doing the tests.

 Being a single mom, especially having to go through emergency situations makes you very strong. I really never thought that I would be able to handle any of this alone. A lot of people questioned me before Broderyck was here and asked if I was scared to do it alone and I always answered "no," deep down I knew I was nervous but I knew I could do it, and this whole 39 days I have proved to myself that I am more than capable of being a single mom. Especially when the father hasn't even ackowledged the fact that he has a new son. Broderyck is the cutest little boy ever and I love him more than life itself and I know that I for sure never want to waste my time with someone who is anything less than perfect, and if it takes that person a while to get here, I am perfectly fine with that. I have my little family and I am more than happy with it.