Day 3 CV-ICU March 23, 2017

Today started out better after the shift change at 7:00 when I came back and saw that we had the same nurse as yesterday, Cora. She is so good with Nicholas and she takes really good care of him. She was very happy to hear that Nicholas started peeing regularly and did not need to be re-catheterized. She was also sad to hear that he had such a rough night with all the nausea and vomiting. 

The blood pressure issue seems to have worked itself out for now, both the right and left ventricles are pumping efficiently and at normal measurements. The thing that has been challenging is the upset stomach and lack of food. My boy is very hungry, and so far has just had ice chips and water and he feels like he's starving. 

When Cora asked how the night went, I broke down. I couldn't sugar coat the way I felt about the nurse and I told her I do not want him to care for Nicholas again. She validated my feelings and said she would talk to the charge nurse tonight at shift change to make sure Nicholas gets a different nurse. 

The radiology department came by early this morning and took an x-ray of Nicholas's chest, and the respiratory therapist said that we could move Nicholas off of the high flow nasal canula and on to a regular canula that is lower velocity. Nicholas's oxygen saturations have stayed in the low to mid 90's all day today. He has also stopped the albuterol treatments. 

The doctors wanted to wait to allow Nick to eat or drink anything but clears until after the morning echo. The echo was at around 11 and I was told that the LV looked as good as it did yesterday; no better, no worse. At around 1:00 our nurse got permission to give Nicholas some water and saltine crackers. Shortly after a few small sips and 1/2 a cracker, he started heaving again. So they gave him benedryl to try to calm his stomach and to rest. They also gave him a patch that is used for nausea that lasts for 3 days. Simultaneously they put him on a pain medication that is pump style and Nicholas has the button which he can push when he feels he needs pain control. The dosage had to be modified after the first pump, as it made him very loopy and he started feeling really strange and it seemed to have an exaggerated effect.

Nicholas fell asleep until about 2:30. When he woke up he looked like he was in pain. He didn't answer me. I was under the impression that the doctor was going to come to remove that cardiac line that is taped to the outside of his chest and wraps around his heart inside. I knew he was going to need pain control for that so I asked him again if he needed pain control and that even if he wasn't in pain, he would need pain control when they came in to remove that line. I pushed the button myself in anticipation. Almost immediately he was completely unable to speak or make eye contact. Cora, the nurse, called the attending doctor into the room 911 style and the doctor ordered Cora to remove the patch from behind Nicholas's ear. Within like 30 seconds he was coming out of the drug induced stupor he was in. Again, it reminded me of the hallucinations from 5 years ago, only this time it looked like he was having a stroke or a seizure or something. The doctor said we should probably include that patch on his allergy list, but she said she wonders if a smaller dose would do the same thing. It appears that Nicholas is very sensitive to drug dosages and he doesn't need the usual amount. 

While I had the doctor in the room, I asked when the cardiac wire was going to be removed. She said that they actually changed their minds, that they were going to wait at least another day or two to see if the left ventricle was getting any better. This came as news to me, as the day before they gave me the impression that his LV looked even better than it did in surgery. I asked the doctor to explain to me what that meant, because I felt confused since they told me the LV looked good, just like yesterday. She said that the left ventricle struggled somewhat after surgery and that they always give dopamine to help the heart contract, and that yesterday during the echo it appeared that the contractions were better than they had been in surgery. Needless to say, the LV has not improved since then. So I asked what would happen if it doesn't improve? She said that they might just need another day or two to see more improvement or there is a possibility that they would have to go back in and loosen the band. 

Lord, please give me strength.