Thick blood, thin idiom

Over the weekend Ford had trended into what looked like a solid recovery from his post-MRI crash, so much so that by Sunday he seemed to be almost back to his chipper self - as evidenced by the following video:



We thought we should clarify that the episode he experienced after his MRI was not technically caused by the scan itself. It was a response to being handled, transported, sedated, and muscle relaxed, all of which needed to happen for the test to proceed smoothly, once again illuminating that beautiful catch-22 of the hospital. But I feel like attributing part of it, proudly, to our son's blossoming personality. Obviously he seems to like it best when he's comfortably nestled in his crib, left to laze about, suck on his sponge and ogle the nurses. But so much so that he has developed a ferocious will-to-leisure (props to his dear old dad), and he becomes so furiously indignant when nurses and doctors start to futz over him that he works himself up into dangerous tantrums. He starts fighting off their attempts to calm him down and, though it usually subsides quickly and harmlessly, occasionally gives us a run for our money. It would be funny to watch if it wasn't so damn scary. I have started to affectionately refer to him as my "little World Cup star" for his flamboyant displays of crocodile tears.

Nevertheless, his chest tube continued to drain the accumulated fluid in his pleural cavity and we assumed he was getting off the rocky road.

But early Monday morning we woke up to a call from the hospital letting us know that Ford's sats and blood pressure were dropping again and they had intervened with an infusion of Dopamine, which had so far helped to level him off. By the time we arrived at his bed he had started to deteriorate even more and they were systematically upping his supports. The rounding doctors decided he was exhibiting symptoms of septic shock and ordered a round of tests to find out for sure. They quickly started him on broad spectrum antibiotics, with the usual hope that by the time they got the results of the tests back they would already be well into treating the bug, and continued to deal with his faltering vitals - occasionally tossing us the oh-so-helpful "lets hope a heart comes soon" line.

As the day wore on he received several boluses of albumin (a blood product that helps raise pressure by increasing the volume of fluid in his veins), a full on blood transfusion to thicken his blood and combat his low hemoglobin (which helps raise his O2 saturation), additional infusions of Epinephrine and Vasopression (both of which constrict blood vessels and raise blood pressure), doses of some kind of corticosteroid (for exactly what I'm not too sure, but it did produce extremely dilated pupils, or "steroid eyes"), and arterial IV line (to get a constant measure of his fluctuating pressure), an ultrasound of his abdomen (which is extremely swollen and distended), several bags of ice packed tightly around his body (to combat soaring temperatures), and most importantly a near constant barrage of bum pats and head rubs for our poor, writhing baby, who spent the whole day shifting himself around his bed in obvious discomfort.

By the end of the day they had him stable enough to start pulling back on his inotropic support and Ford finally fell into some sort of exhausted sleep-like state. Christa, who had spent around 16 hours at his bedside that day, decided to call it a night and we too collapsed into our own exhausted sleep-like state, miles away from the hospital in our lonely mid-town pad.

Today was a little better, Ford even had the gall to smile at me when I got there in the morning - prompting the necessary parent-child exchange: Is this all a joke to you!? Do you realize what you're putting us through? Wipe that grin off your face! There were ups and downs. Ford quickly relapsed into his uncomfortable twisting and fussing, was tightly refusing any attempts to feed him a water soaked sponge (usually his favourite thing), but was again looking relatively OK by the end of the day. None of the tests they sent off have yet come back positive for any kind of blood infection, but they are still holding firm to the septic diagnosis.

Hopefully this too shall pass.

I feel like we're starting to wear that idiom a bit thin...

shit. fans. hitting. clean-up ensues.

after a couple of weeks, that were as lovely as possible considering the situation, Ford spent the past few days reminding us of how very sick he is. it's been a hard few days and we're worse for the wear.

oh the usual trauma and near death experiences - bleeds, blood clots, heated debates surrounding his enoxaparin, hypotension, bradycardia, being resuscitated with albumin but not being so far gone to need epinephrine (bonus!), "personality conflicts" with staff, oxygen sats tanking out, CO2 flying sky high, resp rate nearing 100....

some things normalize over time (like tubes up noses), some things don't (ie near death experiences).

amidst the above, Ford had an MRI of his head - the process of which triggered the 4th-6th items listed, and today, an insertion of a drainage tube into his chest to "tap" the pleural effusion that had been increasing over the past few days and causing the last 4 items mentioned.

in anticipation of the chest tube insertion, the CCU docs made the controversial decision to hold his morning enoxaparin dose - a subject that inspires great anxiety in me, and also triggered, over the past couple days, many tears.

uncharacteristically he's been asleep since wednesday morning. he can wake up - he does when you change his diaper, because he hates it when you change his diaper - but he won't bother to open his eyes and slips back into sleep as soon as you let him.

that said, poor little one was so swollen this morning from the "fluid push" yesterday he couldn't open his eyes even if he wanted to.

the chest tube insertion went very well. they were prepared for him to react as he did to the MRI (nearly dying), but he remained stable and 210mls came out of the tube straight away. and it's still coming. that's a lot of fluid for a little chest and it's been putting a lot of pressure on a little lung.

he should have some better days soon. already, with that much drained, his resps, CO2 and sats are trending back to safer ground.

some smiles a couple weeks ago

nick can always crack him up: