Tuesday, October 18, 2011

Still At The Hospital

As of Sunday night, we were waiting on peds surgery to come take a look at Peyton.  We were also waiting on an ultrasound which would help them see if there were actual pockets of infection in the abscesses.  Neither ever happened by the time Monday morning rolled around.  When the pediatrician did his rounds Monday morning, he took a look and decided to scrap the ultrasound altogether.  He had surgery paged and they came to take a look.  The redness had extended beyond where it had been.  The inflammation was a lot worse than the night before.  Clearly, the infection was spreading.

Peds surgery came around and they decided that it would be best for Peyton to have a little surgery to try to completely drain the abscesses.  There was discussion about how best to do that since she's not a good candidate for anything other than a complete general anesthesia.  They decided to take Peyton up to the procedure room in the PICU where they had a doctor up there administer and monitor her with conscious sedation.  He used ketamine and propofol.  I guess he gave her a pretty hefty dose because she was still fighting after all the ketamine was administered.  I was holding her hand and she had a tight grip the whole time. She was moving around a lot.  With the propofol she calmed down some, but she never closed her eyes.  She never went to sleep.  She never lost her grip.  It lightened a little, but never lost hold of my hand!  She fought that anesthesia.  She wasn't feeling the procedure (at least not that we know) but she was not out!

The procedure went well.  I got to stay with her the whole time.  I managed to stay on my feet this time!  :)  They didn't get as much out of the abscesses as they thought they would, but they did get some out.  The surgeon left in a piece of tubing.  There's two incisions.  The tubing runs in one opening and out the other about an inch and a half below the first opening.  Then the tubing is tied together in a knot on the outside.  I guess it holds the area open to drain.

As of this morning, the inflammation is way down and the area is less red.  It's still pretty red right around the main area.  Where the redness had spread is still red, but not bright red like it was.  It also  hasn't extended beyond where it had gotten to yesterday.

She's on a couple different antibiotics for now.  I haven't had any word as to how long she will be in the hospital.

You can read more on all this over here:

Sunday, October 16, 2011

How Our Weekend Went

Saturday morning was all about the Race For The Cure.  We actually got out as a family.
We got home from the race around 11:00am.  The nurse arrived at noon.  When she arrives, she does a routine assessment.  She found that what appeared to be a diaper rash starting on Friday now appeared to be a couple of abscesses.  They were dark and pretty hard around the area.  She was also pretty red and inflamed.  Her temp was about 99.3.  Ron, the nurse and I debated bringing her to the ER.  We decided ultimately that if there was even a question that we might, then we might as well go now.  So we did.  
Peyton was seen right away in the ER.  The doctor felt that the abscesses, while definitely present, were still relatively small.  She said that if they were to drain them, they'd have to sedate her.  First, she's allergic to Versed, which is what they'd typically use.  Second, with all her health conditions, she's not one you just jump into sedation without a really good reason.  We got an antibiotic and were sent home.  The doctor said she would be in on Sunday as well and to come back if we felt like things weren't improving.
On Sunday morning, I woke up and saw that Peyton's pulse ox monitor was displaying a heart rate of 173!!!  She's normally around 105 or so first thing in the morning.  I get concerned when it's creeping up in the high 120s.  I took her temp - 102.3.  I woke Ron up and told him to get ready.  He immediately thought it was the abscesses but I said no, it's the heart rate and temp.  The abscesses too, though - they were far worse.  The swelling had increased tremendously and the area that was hard had expanded.  I wasn't sure if the other issues were symptoms of the infection or if we had a potential respiratory issue going on as well because she's had some increased secretions lately which were also yellowish.
Back down to the ER we went around 7:00am.  Again, we were seen right away.  The resident said the abscesses would have to be drained.  She had to discuss with the attending since there was the whole sedation issue.  They ultimately decided to give her morphine and to use a numbing patch over the area.  Then they would incise and drain.  Eventually, they began the procedure.  Poor Peyton was such a little trooper.  My heart goes out to her for all she endures!  She had to have 4 or 5 shots of lidocaine in the area first.  Diaper area, people.  OUCH!!!  I watched the procedure and I watched her.  She was not happy and I don't blame her one bit.
Suddenly I started to feel a little light-headed.  There was a chair right at the bedside, so I sat and continued to comfort Peyton.  The nurse was on the other side of the bed opposite me.  She asked if I was ok.  I told her how I was feeling.  The feeling continued.  I got a little nauseous.  The doctor said "Mom looks pale."  Then the nurse told me I should transfer to the recliner type chair that was beside the one I was in.  I did that while she got a cool wet towel to put on my forehead.  She also paged for some gatorade STAT.  When that came, I was feeling a bit more nauseous.  She gave me some bags just in case.  I took a few sips of gatorade.
Not sure how much longer it was, but I vaguely recollect opening my eyes slightly to see my left foot propped on a chair.  I no longer had the gatorade in my hand and the towel was gone.  How odd, I remember thinking.  I remember my face twitching.  Then I remember faint noises all around me.  I remember hearing "She's turning blue."  I remember the surroundings as being dark and fuzzy.  Don't know how to describe how I felt aside from that.  When I opened my eyes slightly, the EMT (who was doing a peds ER rotation) was on my left.  I heard loud beeping on my right.  I was lying on the floor.  I remember people pushing Peyton's stretcher aside as they continued working on her.  The EMT, in his lovely British accent, asked me if I could open my eyes.  I did.  He asked if I was diabetic.  I am not.  They did a finger stick and checked my glucose level.  It was fine.  I had an oxygen mask on my face.  The EMT asked if I knew what day it was.  Sunday.  He asked if I knew what month it was.  I kind of laughed (as much as a recently unconscious person can) like it was a silly question, but I actually had to think about it for a few seconds.  My inclination for some reason was to say December.  I did settle on October.  He said he would skip the other silly questions for now.  Then they began discussing how to get me onto a stretcher.  Eventually I was moved onto one and off I went to the adult ER!
Long story short, I had a vasovagal reaction (a sudden drop in blood pressure) which they think could have been a combination of me not having eaten much and then the sight of the procedure Peyton was having.  I don't get that because it wasn't bothering me!!  Then I had a syncopic episode (fainting).  Then I had a couple little seizures (the twitching I vaguely remember).  They did and EKG, bloodwork and urine test.  Of all that, all that came back was that I had a mild urinary tract infection!  Who knew.  It took me passing out to find that out!  I am sure that was not the cause of my "episode".  They ordered me a food tray.  I ate what looked edible and it was good.  Yes, hospital food was good.  I think I was too hungry to care.  I am fine.  I am tired.  I feel stupid.
Now...while all of this was going on with me, Ron was not with me at the hospital.  Peyton was on her own!  They had someone from Child Life sit with her while she waited in the ER to be admitted.  I was able to text Ron and he came back to the hospital after church.  Apparently I missed the incident at church where a burning bag of popcorn caused the entire building to be evacuated!  Had Peyton been well, she would have been there...in her wheelchair...with no elevator to get her back down to the 1st floor (the special needs ministry is on the 2nd floor).  Wonder how that would've worked out.  The evacuation didn't last long - and the service did actually proceed.
Back at the hospital...Peyton was admitted.  They set up her crib in a spot that would be easy to see from the nurse's station since no one was here with her.  Poor kid!!  When I eventually got up to her room, the resident and med student were in.  I saw the abscess area.  The incision has been packed and the area covered.  It was looking significantly better at that time.  They cultured the drainage.  Waiting for results.  It could be staph or MRSA.  They said it's mostly likely MRSA.
As of Sunday evening. the redness and inflammation is as bad as ever - worse even.  At this time, we're waiting on an ultrasound.  The doctor said it's possible there is another pocket of infection.  They're going to talk to peds surgery to have them come take a look.
For now, we're in the hospital (well, Peyton is admitted...I'm just with her!) and hopefully things will start improving soon!  We appreciate your love and prayers!