Tiernan had a special visitor

Tristan has been very hesitant to come in.  He was worried about seeing him with tubes everywhere.  But for whatever reason, today was the day and he was the brave big brother.  Tiernan has been pretty worn out all day, and has not been opening his eyes much.  (That takes more work than one might imagine with all these drugs on board.)  But as soon as I said brother was here his eyes opened and he calmed down.  These boys have such a sweet bond. 

This one matches one from when Tiernan was a few days post op the first time too.  LOVE. 

 

Tristan came in several more times over the course of the day and knew exactly what he was okay seeing and what he needed to have covered.  Throughout everything, he has been in total control of his role and I love that.  But I know that he gets how important it is to Tiernan to see his big brother. 

 

The name of the game today, in Tiernan's opinion is how to be the most comfortable.  He is always moving and wanting to be in a new position.  I can't blame him.  Lying in one place for days on end is so frustrating and uncomfortable. He often ends up sprawled across the bed.  Some things remain the same no matter the situation.

 

On to the medical events of the day.

 

From a cardiac standpoint, his BP has been running on the low side most of the day, so they have been adjusting his meds a lot to get that to settle out.  But there is no reason to suspect anything but good stuff overall in that department. 

 

Can you believe that?!!!!

 

The Kidney's are nearly back to normal.  His Creat. was .7 this morning and he is still peeing like a champ.  Now, granted, there are a few diuretics in his system.  And they have managed to dry him out a little too much maybe.  The problem is that his lungs are on the wet side still and they need to keep him on the diuretics because of THAT.  So they are going up on some of his fluids, while at the same time trying to dry his lungs out.  Quite a balancing act. 

 

Speaking of lungs....His are still not quite ready to work on their own.  He is hanging out on the vent and his lungs are the only ones around that seem to think that is a solid plan.  As for the rest of us, we would like to see him get his PO2s up to 80 at least.  He also needs his O2 level (the percentage of oxygen in the vent) to be around 40%.  Room air is 21% O2, so they can be reasonably assured they can provide enough support in a nasal canula if he gets down around 40. 

The vent is a pretty big source of frustration for him.  (who can blame him, right?)

That said, he is beginning to tolerate it at least. 

 

Of course, that could be due to the large doses of Methadone and Versed and Ativan he is receiving. 

 

That and the fever that he decided to develop.

 

As far as this little fever is concerned, we don't really know what is causing it, but some things that lead the list of things that raise suspicion are:

 

1. UTI (urinary tract infection).  This is not out of the question since he had a Foley catheter for several days.  He has been indicating pain when he pees all day so I wouldn't be at all surprised. 

Incidentally, he was quite confused at the fact that I thought it was okay for him to go potty in a diaper.  He was quite resistant to that idea. 

2. He has a line infection.  This would be a smidge more concerning, but he is already on a few different antibiotics, so hopefully that isn't the case.
3. Post-op fever.  It's a thing.  But it's not a big deal.

Whatever the story, he is covered by meds (and prayers and good mojo) and he'll be moving on from this part of the recovery soon. 

He was soupposed to lose a few chest tubes and the LAP line, but the surgeons had their hands full with other surgeries.  So tomorrow morning it is then.  He will, by then, be showing some great responses to treatments and we can get him off the darn vent! 

He has random other little things to deal with, but right now I am so thankful that he is doing so well.