The Fever for the Flavor of Getting Discharged

Bobby had a very restless night here at the PICU, sleeping for a maximum of 2 hours at a stretch. In spite of another day of regular doses of Tylenol, he spiked another, more serious fever of 102.9 F this morning. The docs are running more cultures, and are still waiting on the results of the respiratory shell panel done yesterday. If it's bacterial, they'll treat it with antibiotics, if it's viral, we'll wait it out.

Meanwhile, Valerie spoke with both of the surgeons and the advanced practice nurse, and it looks more and more likely that Bobby will be coming home with an oxygen tank in tow. They all seem very calm about it, and try to reassure her that it's temporary until Bobby gets stronger. Dr Kaushal has been talking to some of his colleagues across the country because he can't understand why Bobby's sats continue to be low. His conclusion is that Bobby's Down Syndrome is getting in the way of his recovery from the heart surgery because Ds frequently results in the lungs being compromised in some way. So, with some short term oxygen help and more time to recover, the hope is things will improve.

While we might like more clarity, the fact is, its good that Bobby does not have any of the usual complications of this surgery. If his pulmonary pressures were high (the most logical explanation for low saturations), he'd potentially be sprouting collateral veins for the next couple of years. If the Glenn shunt wasn't well constructed, it would mean an extra open heart surgery this week. Because Bobby's low saturations have no clear cause, we have ample room to believe that the situation may resolve itself in a matter of weeks. Its just a challenge for Bobby's computer programmer and market researcher mamas to trade a clear diagnosis for blind faith.

Bobby needs to be weaned off high flow cannula before we can go home. Unlike a regular cannula, the high flow sends some positive pressure into his lungs, giving them a little extra oomph on the inhale. But, the weaning won't start in earnest until Bobby's virus/infection is better. The poor thing has been laying on a bed of ice packs today to keep cool and is much more comfortable than he was last night. Valerie and I just sit and wait.

In my opinion, the hardest part about hospital life is that, most of the time, it's mind numbingly boring and the boredom is only broken by moments of extreme stress while baby boy gets extubated or his sats fall into the 50s. We all have our ways of dealing with boredom - you may have noticed that I like to blog. Valerie spent her time yesterday doing the Hokey Pokey.