Home at last

Carson was discharged late this afternoon from Childrens and we are home re-cooping from the past two days. He is in a lot of pain when his Tylenol w/ Codeine wears off and stops talking completely and kicking/hitting about 30 minutes before his next dose is due. We are almost positive the aggression is solely connected to his pain level and his inability to talk due to his throat hurting so much.

Last night was rough. He needed Morphine around 8:45 for break-through pain that caused him to start crying and screaming around 8pm. Thank goodness the ENT doc on-call was generous with his medications and Carson was pain free by 8:50 and sleeping by 9:45. He had a ton of desats all night long but they were all minor in the low to mid 80s. His baseline oxygen saturation was hanging around 90-91 so they debated adding a cannula for the night but Carson was not having anything on his face so they just watched him closely and stayed on top of his q2hr Albuterol and q4hr Flovent. He was wired this morning when he woke up and wanted to run around the room, down the hall, jump on the bed, scream, etc but REFUSED to eat or drink. Al finally got him to eat some jello, a few bites of eggs, and to drink some chocolate milk and we were cleared for discharge right before 4. Thank goodness because I did not want to stay an extra night because he wouldn't drink or eat.

We're home and resting for the next few days. Eli was "excited" to see Carson (his new favorite word is excited) and Macy licked him all over. It was obvious that our little man was much more comfortable at home than in the hospital and went right to sleep once he was in his own bed. I'm hoping the antibiotics and pain meds keep him infection and pain free for the coming weeks. Thanks for all of the well wishes. It was a new experience having Carson in surgery/recovery compared to Eli who is an old pro. It's much more tiresome with a 3.5 year old who isn't used to constant surgeries and hospitalizations than with a 20 month old who has had more than I like to count. I'm off to bed now but look for some great pics of Eli tomorrow on the blog.

Here are the pics of Carson's bronch. The top two pictures show the narrowing of his trachea (tracheal stenosis). The trachea should be a round, ring shape but as you can see, Carson's is a boxed shape with the right and left sides flattened by scar tissue. This scar tissue was caused by his intubation and ventilation during his NICU stay at birth. As I said in the previous post, he should grow out of the tracheal swelling and croup due to this narrowing in about 5 years. The bottom left picture is where his trachea splits and goes into his right and left lungs and the bottom right picture is of his vocal cords. Enjoy!

In-patient

Carson is out of surgery and up on the 4th floor of Children's Hospital for the night (at least). He did really well during surgery and he now has no tonsils or adenoids and brand new tubes in his ears. His ENT said that his tonsils were very large and that he will be a new kid with them out. His other ENT surgeon came out to talk to us and show us pictures of his bronch and tell us about Carson's trachea. It turns out that Carson does have tracheal stenosis but it is minor and WON'T require surgery. He has about a 10% narrowing of his trachea caused by being intubated at birth in the NICU. This narrowing is made up of scar tissue and makes his trachea square shaped instead of nice and round (I'll definitely post pics when I get home and scan them....they are cool!). It is almost 100% responsible for all of his croup in the past 3 years. His ENT said that we don't need to do any dilation procedures to try and widen the scar tissue or (thank God) any reconstructive trachea surgeries. The bad news is that we now must just wait for him to grow out of it. Their best guess is that it will take about 5 years before Carson doesn't get croup with every upper respiratory infection. They will treat him with steroids every time he gets a cold and/or URI so that the swelling and inflammation of his trachea is kept to a minimum since it is already partially narrowed.

Now on to post-op in the room. Carson is having a anesthesia reaction. He is bright red all over his face and arms. He is extremely tachycardic (around the 130-150 resting) and hypotensive. He is also having respiratory complications along with the reaction so they put him on q2hr Albuterol in addition to his Flovent and antibiotics. Carson has only desatted 4 times and it was only down to the 81-83 range so we aren't too concerned about his respiratory status but they are doing q30min vitals on him to make sure he's stabilizing and not getting worse. They finally have him off of the Morphine and moved onto Tylenol w/ Codeine and he is tolerating it pretty well. He is very nauseous from swallowing all of the blood but they are holding off on the phenergan order for another hour to see how he does. He will be on IV fluids until discharge because he isn't having much fluid intake and they don't want him dehydrating. So far we have gotten him to eat two whole purple Popsicles and three tiny bites of vanilla pudding. He also drank 2oz of apple juice.

I'm off to go watch some more movies, ready books, and try and make my big baby feel better. Sometime today I have to squeeze in some study time because my statistics final is tomorrow morning at 10 and it is cumulative over the whole book. I'll try to update tomorrow when we get home. Pray for an uneventful night full of sleep and good sats!

Carson's in surgery

We're waiting in the parents surgery waiting room at Children's Hospital for Carson to get done with his ENT surgery after arriving this morning for pre-op at 6:15. He is having his tonsils and adenoids removed, ear tubes put in, and a broncoscopy/laryngoscopy done to determine what his tracheal irregularity is. His left ear looked a bit infected in pre-op but they decided to go ahead with the surgery and pump him full of antibiotics b/c he needs to the tubes to prevent future hearing loss. His tonsils were at 3+ today with no illness so his ENT is happy to get them out of there. This should help him tremendously! They ended up giving him Versed prior to going back because his sensory issues were on overload this morning without his meds and with the extra anxiety/stimulation of pre-op. Thank God for Versed. He was a much more pleasant child after it and wasn't banging his head on the bed and bed rails. He was wheeled off to the OR with his handsome puppy in one hand and a kiss on the forehead from Mommy and Daddy. We should hear from the two surgeons in about 1.5 hours.

I'll update once he is out of recovery. We are hoping he is able to come home after several hours in recovery instead of needing to stay the night.

Another Life Lesson

Today was a hard day. A close friend of my little sister's was killed in a car accident on Wednesday at the young age of 22. They grew up together starting from first grade. We were on swim team together throughout out childhood, worked together as life guards at the local pool, and even lived in the same neighboorhood. Our parents continue to go out for drinks on occasion and play cards a few times a year. His dad lives a few houses down from my parents and a smile and wave from Sean was a welcome occurance after dropping off or picking up the boys from their house through the past few years.

Today was his showing. It's never easy going to a showing of someone you have known for years and years. It is even harder when the life lost is young and vibrant. Full of love and life and joy. Sean was a neat kid and it is an incredible loss to those who he touched in his 22 years here. May he rest in peace and continue to enjoy the art, music, and good wine wherever he is as he did here with those that he loved and that loved him. I pray that his family is able to find some sort of peace in the coming months and years. I hope my little sister is able to deal with loosing yet another classmate and friend (she has lost so many out of their graduating class already).

As a mother I have held my boys a little tighter once again because it is amazing how quickly life can change. They each got extra kisses and hugs tonight and Carson probably thought Mommy was a little crazy for wanting to snuggle longer at bedtime instead of turning out the lights early. I hope I never have to deal with the loss of one of my children. We have come too close a few times but to have that reality is unthinkable.

Last Week of the Quarter

This week begins the last week of my winter quarter. While I realize this brings me to the point of being ONE QUARTER away from graduation on June 9th, it also carries with it a boat load of stress, papers, exams, lab tests, discussion board postings, and studying. My planner is packed from beginning to end with nowhere to even squeeze eating in....hopefully I'll get at least four showers this week (I truly hope this is sarcasm).

The boys are doing well. Eli went through a lovely respiratory virus last week and ended up on steroids once again. I don't know exactly how many round of Orapred this makes for him this winter but it is a ton. He is still on Albuterol in addition to his normal BID Flovent but his wheezing is getting better and he's only coughing a lot at night now. We also had a great visit to his surgeon last week. His stats were 25lbs 1oz and 33.75" long. They decided to switch him to a shorter stem length on his MIC-key button b/c his old length was too long and he was continuously getting acid burns from leaking stomach acid out of his stoma. His new size is a 14 french, 1.5cm length. It had completely fixed his leakage probably and his stoma is healing with the help of some stoma barrier cream.

Carson is also having a good week. He has found a couple new loves. The first is crafts. Aside from the normal obsession of trains and trucks, Carson now wants to make crafts with scissors, tape, construction paper, markers, crayons, staples, punch-out shapes, pipe cleaners, etc at school and at home. It is adorable. He comes home from school everyday and pulls out piles of "pictures" that he made for me. His teacher, Ms. Linn, told us at his parent/teacher conference on Friday that he gets all excited to "make Mommy beautiful pictures b/c he knows his Mommy will love them". Gosh this age is wonderful. His second love is a bit harder to swallow but typical for a soon to be four year old. Carson has become infatuated with calling people names. Now these aren't mean names or rude names.....they are food item names. If you are in his presence you may be called any one of the following items: Coconut tree, pineapple, chicken, pear tree, grape, chicken pop, turkey, chicken livers, apple head, coconut lovers, pineapple bush with grapes, etc. It is becoming quite the annoying habit that is one of that hardest we've tried to break. Just imagine walking down the grocery isle to get your bread and an almost 4 year old shouts, "Hey you Pineapple bush!" in your direction. This is what my day consists of. Somebody please tell me this phase passes as well...



I am going to wrap up this post and finish procrastinating. My books are calling my name with their incessant nagging, "study me, learn me, know me". If I can only make it through the next 9 days, I will be ONE QUARTER (that is 10 short weeks of class!) away from graduating with my Bachelor's in Nursing! Oh what a day that will be.