PICU here at CHKD is hopping. I really hope that all the kids that are having to stay will be okay. I have seen far more teary eyed parents in 2 days than I have seen in other Antibody Rounds.
Jesse slept until 7am when we woke her because her blood pressure was really low (78/33). The rest of her blood pressures have looked great. Her heart beat, that is another story… but I digress.
Around 10am everything began for getting the antibody. First they start a saline bolus through the line they are going to use (the red one currently). Then they place her on continuous morphine, give her Tylenol and Benedryl, and then hook her up to the Antibody at 10mls an hour.
In this round, we have a shot to help rev up her immune system. Today she jumped on us when we gave her the shot, and caused a mm scrap on her leg. I have had this happen before when she isn’t being held strongly enough.
Between the bolus and starting the antibody is about an hour. As we were counting down to starting, a nurse came around telling me that I had to leave because the doctors where getting ready to do surgery on a child at the far end of the unit. The doctor wanted things as sterile as possible, which includes making visitors leave.
I guess my panicked look helped me. I looked at this nurse and exclaimed we are starting antibody in less than an hour! I really didn’t want to have to leave Jesse because if something goes wrong, well I want to be there.
The nurse was nice and took pity on me. They hid me in the room. Two of the oncology nurses also became trapped in Jesse’s room during the sterile surgery. Jesse’s doctor for that day (not her primary) came to see us. She was aggravated that they gave her a hard time about coming into the unit and not letting the other nurses out. Her question was what if something happens to my patient?
Luckily the surgery was done in less than a half hour.
As for Jesse, I noticed that her heart rate was climbing. Around 12:30pm, we took her temperature. It was at 37.9C. We gave her some Tylenol, but her heart rate didn’t really reduce itself. In fact we gave her a extra bolus of morphine because she said ow and from her heart rate we thought she might be in pain.
Around 3pm, I started hearing them saying Jesse is going to move.
At 3:30pm, they came in and moved us to the step down unit. This is on the same floor as PICU, but doesn’t require me to call in to get to her and each room has a bathroom!
It’s the little things.
Jesse was asleep when we moved her. When we got into our new room, the nurse took her temperature: 38.3C. This is considered a fever, and they cultured her caps. I am so glad this is happening at this point. Now we can avoid the whole line issue at the end like we dealt with last Antibody. But I will have to watch them with the antibiotic because it is closely related to rocefrin. Rocefrin is the antibiotic they give her on the last day of being here. The one we are currently getting is closely related.
Here is my concern, we will get the antibiotic she is currently getting on Friday morning. Then they will tell me they can’t give the rocefrin for 8 hours. And I am stuck sitting here until 5pm when I should have been out by lunch. So this is something that I will be mentioning to her doctor to make a note of for the over zealous resident who doesn’t bother to read how this all works. (Sorry last antibody really ticked me off… ).
I am not sure at this point if we won’t be discharged from here. The nurse tonight is far from pleased to be over here by herself. I think that she raised enough stink that they called another nurse in to help her. I can understand because she needs someone to verify medicines with. And calling the other side to have someone walk over is an extra hassle.
Jesse’s heart rate is around 169 tonight, and her temperature is on the rise. The antibody will finish at 11pm. Here’s hoping that her temperature comes down over night, heart rate lowers, and they fix the TV for Mike… otherwise he is going to be miserable tomorrow.