Soda

Tyler was finally able to get some fluids.  His lactate continued to rise, despite the decrease in blood sugar from the insulin infusion.  Jeff, the nurse, and I decided that the one to correctly guess the lactate levels would get to give Tyler a popsicle.

Well, we were all wrong because the numbers were way high.  Then, Jeff, the attending who understands that medicine involves the occasional obtuse solution, said, "These are just numbers.  Look at him.  He's doing fine.  He's probably dried out, I mean, look at his CVP--it's four.  Give him some fluids."  So Tyler got to drink and his numbers improved.  Then he got a popsicle which made him happy, and then the old Tyler was back:  "I don't WANT ORANGE!  I WANT A BLUE POPSICLE!"

At about midnight, Heidi recommended I go to sleep.  The nurse was going to stop his fentanyl drip and just give him morphine prn, which should help him sleep.   I turned the chair into a bed and closed my eyes.   Heidi went to sleep in some women-only bunk bed room.  Tyler was up pretty regularly, asking for soda, until about 3:30 this morning.  His art line failed and they had to get blood from his finger, but it's all kind of a haze now.

The nurses' shift change is at seven, so when they started discussing Tyler, one of them said, "It was a rough night."  I sat up in my bed to listen, and they saw me and closed the door.  So I stood up and opened the door to listen.  It's interesting how they talk differently when the parents are around.  Still, they were discussing the case and said that Tyler had to be defibrillated five times in the OR.  Why didn't they tell us that yesterday?  They probably worry that we'd worry.

I'm tired.  Tyler is in pain when he's awake.  It is too early to say we're out of the woods.  He has some leads connected to an extra-corporeal pacemaker that occasionally has to fire.  Right now, every beat is regulated by the pacemaker.  No one can say for sure whether the junctional rhythm will turn back into sinus rhythm.  If not, they can install a subcutaneous pacemaker, but we'll see.

Thanks for your comments on the blog and facebook.  People want to know how to help.  Your prayers help, and Heidi could use some company at the hospital (even though she'll never ask for it).  I'm going home today because it's Scott's birthday and I want to spend some time with him.