Friday, August 17, 2012

Out of Surgery and in PICU

Eli got to the hospital Wednesday morning at 8:30.  He had his ECHO and we met with the surgeon to go over his plan.  We got to the floor around 10.  We were never able to get an IV.  So many attempts and so many bruises.  We got 1 IV in and started fluids and lost it 12 minutes later.  So anesthesia came and adjusted everything and we were able to keep fluids running thru the J until right before surgery to keep his sugars stable.  He went down to pre-op around 6:30 thursday morning.
Anesthesia and the surgeon spent quite a bit of time going over procedures and precautions.  Some things had to be adjusted since Eli was going into the OR without access.  They ended up giving him some versed thru this J tube and that really calmed him down.  They were finally able to get an IV in his head right between his eyes in the OR and were able to get surgery started.  They both came out and talked to me saying that his veins are shot and very thin.  They would be right inside the vein with no return of blood and the moment they tried to push they kept blowing.  They aren't sure why this is happening.  They were able to get a Hickman placed.  It's in his upper clavical and chest right over his heart.  The surgeon was happy with the placement and we were able to use it within 2hrs of surgery.  We have had no issues giving fluids and drawing labs.  They admitted Eli to PICU after surgery and that's where we still are.  His HR struggled a bit late yesterday evening and the doc ordered an EKG.  All looked good.  He stabilized.  Lovenox was started last night and no bleeding so far with that. 
Currently he is back on his elecare feeds thru the J tube and we are pushing all fluids thru the hickman.  This morning the team is coming with the pharmacist and the dietician to work on getting meds switched over to IV as well as a permanent fluid and feed schedule. 
We are hoping that he will be able to go back out onto the floor today.  They are also hoping to run some more metabolic testing today as his protein levels are still low and more nails are falling off.
Lastly we got some of the initial biopsy results back late yesterday afternoon.  They are another set of findings that the doc doesn't quite understand.  They showed hemosiderin containing macrophages in every level of the colon.  Basically this means that the hemoglobin (blood) is eating basically blood.  White blood cells are eating red blood cells.  They aren't sure why this is happening.  There are some explanations but they are still trying to figure out what this means for Eli and what we need to do next.  His GI doc is meeting with the pathologist on Monday to look over the slides and chat some more about it all.
We will be inpatient until atleast monday as we have to get to a therapeutic dose of lovenox as well as getting all of his fluids situated and obviously ordering all of his supplies and such to go home.  They team is already working with his case manager, DME's, pharmacies, and nursing agency to get the home stuff taken care of. 
We are exhausted as always but everyone is very hopeful that we are on the right track.  I will update more later tonight after we meet with the teams today and have more info!
Here is Mr Eli waiting for his ECHO.

Here is Eli in Pre-Op hanging out with his baby.

Eli and his baby after surgery in the recovery room.  Notice that baby came out of the OR with her own hickman.

Eli and his baby both showing off their new hickman lines!

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