Riley did not have a good day. His heart rate was high, his breathing was labored, his color was bad, his perfusion was worse, fluid drainage increased, he was fighting a fever, and a new chest tube had to be put in.
His right chest tube that has not had much output in the past couple of days has picked up significantly. It was draining about 100 milliliters per hour. His left chest tube--which put out about 600 milliliters yesterday--had slowed significantly. We have learned that dramatically lower output is not necessarily a good thing. An early morning x-ray showed a pocket of fluid. By late afternoon, another x-ray showed that the pocked had tripled in size. Dr. Karl (the surgeon) was paged and he came in to put a new chest tube in. The old right drainage tube was removed. Within an hour of placing the new chest tube, 480 milliliters had come out.
Dr. Karl explained that the significant amount of scar tissue in Riley's chest makes it difficult to drain fluid. An x-ray may show one large pocket. However, it is more likely that there are several compartments of fluid separated by scar tissue. Sadly, that means when one pocket is drained, a new chest tube may need to be placed to get at the additional fluid.
Most of the day, Riley's resting heart rate hovered around 150 beats per minute. There was much speculation about why this was happening. It could be because he is having a hard time breathing with so much fluid in his chest. It could be because he is just three days post surgery and his heart is still trying to recover. It could be because he is developing an infection and because he had a fever. Blood was drawn to test for an infection in his PICC line. We should get the results in two or three days.
There was also concern that he may be developing another arrhythmia. Fortunately, an arrhythmia was ruled out after doctors took an EKG and compared it to an earlier EKG. Riley also had an echo to look at his heart function. We were told that his heart function is OK and that it did not look any worse that it did before surgery. This was not encouraging to us. Shouldn't his heart function be better now that he has had the Fenestration? We will need to get some clarification on that tomorrow.
I guess we can be grateful that Riley did not throw up today. He struggled with constant gagging, but he did manage to keep all of his Gatorade and two small bowls of berries down.
Saturday, March 24, 2007
A crummy day
Posted by Mother in Chief at 3/24/2007 09:08:00 PM
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3 comments:
I'm sorry to hear Riley had such a tough day. I'm keeping you guys in my thoughts and prayers. Also, Drew was admitted to UCD last night with pneumonia. So we are busy trying to be in two places at once too.
I am sorry Riley struggled today. It must be unimaginably hard. You say he ate a bowl of berries so he must be awake through much of this.
I don't expect you to get time to reply but perhaps someone else knows. Is the fluid that is draining some of the pre-surgery effusion or is this new post-surgery fluid. Where does this fluid come from? I recall them draining a bit of fluid after Wren's surgery so perhaps it is common post-op as well as due to PLE.
We pray that today is a better day. It is great that Riley was able to eat and drink without vomitting, though. We hope you get answers to the pulse rate and fluid today. See you soon. Much love and prayers, Auntie and Stephen.
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