Pediatric Intensive Care

We're settled into our new home away from home. Bobby is doing OK. As we'd expect, he is in a lot of pain and is taking quite a bit of morphine. He has three tubes inserted into his chest to drain off excess blood and fluid.The nurses know from talking to older kids that the tubes are excruciatingly painful. They have to be shaken and wiggled every hour or so to keep the fluid draining. Bobby winces everytime it happens. We have to balance the comfort of the morphine against the benefit of getting him off the breathing tube. Morphine suppresses the respiratory system, so they can be more aggressive with the medication as long as the ventilator is doing the work of breathing for him. But, the air blowing in through the vent puts pressure on the heart and arteries that have already been through so much today.

Bobby is just starting to take a few breaths on his own over and above what the ventilator does for him. Right now, the vent is giving him 16 breaths a minute which is almost enough to keep his carbon dioxide levels at an acceptable level. The doctors will slowly lower the number of breaths he gets from the ventilator. Fewer breaths means the carbon dioxide will rise and Bobby's body should compensate by taking some supplemental breaths on its own. If he doesn't start breathing more, that will tell us that he's too sleepy to breath on his own. At that point, the doctors will decide either to keep him on the morphine and vent for the night, or lower the dose and wake him up some more.

He is a bruised little boy this evening. His face is swollen from the bypass surgery, but that will go down in a few days. He has a central line in his chest that they use to put in IV fluid and medicines. He has an IV in both wrists. He has those horrible chest tubes. He wakes up for a few seconds here and there, but I hope he's mostly oblivious to what's happening now.

In other news, Bobby's mohawk continues to proudly rise above it all.