Saturday, March 19, 2011

Selah's Saturday Morning Report

I apologize that I didn't get a Friday report posted.  Everything is fine, but yesterday just didn't give me a free time slot to sit and type out Selah's day. 

My husband came to the hospital for lunch yesterday, and I went over to the Ronald McDonald House to do some laundry.  I have chosen not to leave Selah's bedside since she's been admitted, except on Wednesday when my mom stayed by her side while my dad and I went to the Ronald McDonald House for a tour since the hospital gave us day passes.  Wow, what an awesome ministry RMH is!  Volunteers serve meals for lunch and dinner every day (although I haven't been able to take advantage of that because I don't want to leave Selah to go over there), and they have free laundry facilities with all of the necessary supplies.  They also have a playground, playroom, exercise room, and lots of rooms for families to stay overnight for any length of time, as long as their child is in the hospital.  It's GREAT!

I walked around the hospital and discovered that the cafeteria here actually has really good/healthy food options.  The hospital also has some extraordinary gardens and waterfalls and outdoor pathways, as well as several great playrooms and lots of neat things to keep kids occupied.  Of course, Selah can't leave her bed, and as an infant, she doesn't need the playroom, but the options are great for mobile kiddos.

After I finished my laundry, my hubby went back to work, and shortly afterward, I discovered blood on the sheets behind Selah's head, at the site where Selah's catheter exits her skull.  I had the nurse call for the neurosurgeon's nurse practitioner to examine further.  After removing dressing, cutting hair (that the dressing was stuck to), the nurse practitioner determined that Selah had pulled on her head catheter, which popped the stitches out (it was sutured into place), which caused the catheter to come out of her skull a little bit, which caused bleeding at the puncture/hole, along with some fluid leakage.

This puts Selah at a much higher risk of infection now.  (She was already at risk due to having a hole in her head, but this puts her at higher risk.)  Since Selah doesn't have an IV, she's not getting IV antibiotics, but she is getting oral antibiotics four times per day.  Hopefully that (and lots of prayer!) will keep Selah from getting a brain infection. 

The nurse practitioner turned the room into a sterile environment so that she could flush the catheter tubing to make sure Selah's line wasn't clogged.  (It hadn't output any fluid in over 24 hours.)  She didn't really want to have to do the flush because it's another potential source of infection entering the brain, but it was necessary to determine if the line was clogged.  The nurse practitioner kicked me out to reduce the amount of possible infection during the flush, and within a matter of minutes, she discovered the line wasn't clogged.  She's just not exactly sure why there hasn't been any output.

Shortly after the nurse practitioner flushed the line, she called me back in to ask if I'd mind assisting her with the cleaning and re-dressing of  clean the head wound at the catheter drainage site.  I was delighted to come back in to help make Selah feel more secure by having her momma by her side, so I got on the sterile gown, mask, etc. and held Selah down while the nurse practitioner worked on the wound.  OUCH!  Selah was not happy about that procedure!  She is one strong girl, that's for sure!  It's amazing how much power and strength this 5-month-old baby has when someone is doing something she doesn't like!

After the nurse practitioner got everything clean and re-dressed, she explained to me that Selah is at an extremely high risk of brain infection right now since the catheter is no longer sutured in place, and there's some leakage at the site.  She was going to contact the neurosurgeon as to the plan and get back with me today on what they want to do.

Selah also had labs drawn this morning, so if her levels are off, she may need an IV again so they can replace fluids she's losing through the external drainage via shunt.  And if they decide to re-suture the catheter (or if they decide to pull the catheter out), she'll need an IV to get meds administered for either of those procedures.  I'm not sure how they'll get an IV in since the PICC team and multiple IV experts didn't have any success after 6 attempts under sonogram!  She may need to go to anesthesia to calm her little body down so they can have better chances of getting the IV into a vein, I'm just not sure.

I'll try to give another update later today once I know more.  Thanks for praying!!!

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