First, I want to say that yesterday marked 11 years that I have been married to my best friend. He is truly an amazing man...loving, supportive, and incredibly unselfish. I thank God for the blessing of having such a wonderful husband. I love ya, babe!!
Well, our stay at home capped out at about 7 hours. I knew Nate wasn't up to par yesterday morning...he just looked puny and literally begged to not get out of bed. He kept saying that he didn't want to go home and he didn't want to sit up and he really didn't want to be lifted out of the bed he had inhabited for the past 5 days. But since it was Friday, and it was a holiday weekend, and all the newbie residents had started, we were really wanting to get out of here. I thought for sure that Nathan would start to feel better when we got him home.
He perked up for a little bit at home but had a hard time moving around and was still in a lot of pain. When he had a hard time with his afternoon feed and his temp started to rise just a tad, surgery said they wanted him to come back. It was a good thing that I was quite lazy when I got home and had not unpacked quite yet.
Yesterday was also the opening day for our brand spankin' new peds ER. We have always had a joint ER with the adult side. They made it kid-friendly on our side and did great with the kids, but our little town has been so excited about the new and separate ER that was being created just for peds. While happy about it, we did not want to be one of the first visitors in it. But, everything was really, really nice there...great colors, aquariums, an underwater theme, quite a few separate rooms. We only had to wait about 3 minutes before they got him back, and an IV was started, labs drawn and D10 given within about 15 more minutes.
I haven't seen his labs, but they said everything looked okay with the exception of his bicarb being a bit high. That kind of threw me because it has always been the exact opposite with him. His bicarb is usually really low due to metabolic acidosis. Last night, it was showing that his body was looking more like it was struggling with a bit of respiratory acidosis and metabolic alkalosis.
However, his breathing has been very shallow and his rate has been really low all week. Since he is so much of a belly breather, each breath he takes causes pain around his tube site. We have figured that he has stopped breathing as much because it hurts to breathe. And since he isn't taking as many breaths, its causing a sort of shift in his acid/base balance that he is having to compensate. Additionally, he has been in so much pain all week that we think he is rather anxious about the pain, causing him to guard his stomach so much and not want to move. Whether he is still experiencing excessive pain or if he is just more anxious about having the pain is what we don't know. His CBC did not show a left shift like we were wondering, which would have suggested an infection. His temp was 99.4 last night but dropped down to his normal temps a little after starting D10. So, we are pretty confident that his rising temp was due to the stress he body was under.
The plan today is to keep him on oxicodone around the clock to stay on top of any pain he is still having and hopefully get him to where he is not as anxious about moving around. They are concerned that he didn't do well with his feeding yesterday afternoon, so it will be good to see how he tolerates it later on today. I'm hoping yesterday's glitch was just because of all the stress on his body as well and that we just need to take things slower. He still doesn't want to get out of bed, but I am hoping that with staying on top of managing the pain all day, he will agree to take a walk around the unit this afternoon or evening. The longer he lays in bed all day, the weaker he seems to get, so I'm anxious to get him up and moving some more.
So, that's about it right now. Obviously, we know that Nate's body doesn't respond normally to a lot of things, but its still hard to know what to do when it doesn't do what we all expect it should. Hopefully the little guy will perk up soon.