PICU Day 3

He is extubated! The breathing tube is out! Logan's chest X-ray improved this morning and even before they stopped his sedation he was movin and shakin! He was ready. After being extubated he was really fussy but maintained his airway well. He has stridor. This is a high pitched whistling noise. He most likely has a sore and inflamed airway so they gave him a steroid called decadron. The nurse and doctor said today would be a rough day as the medications wear off and he struggles with some pain. He has maintained good vitals and is on high flow oxygen by nasal cannula.

Today's plan is to keep him comfortable, advance his feedings, and continue antibiotics. At some point his central line will be removed when he is ready to transition off of his IV medications. He will also move to a step down ICU room as well.

His hemoglobin stayed the same as yesterday. It is 8. A normal hemoglobin for Logan is 12. His platelets have improved so the plan will be to recheck it in the morning. The intensivist thinks the drop in his hemoglobin could be from the high dose of vancomycin antibiotics or the infection. It is not at a point of needing intervention. He is not bleeding, so no need to replace it. His body just needs  rest in order to make more red blood cells.

Right now he is resting well and Grandma and Grandpa are on their way to sit with him so Joel and I can go vote. Most likely we will have Lauren come visit tomorrow. I miss her very much and I am sure she would like to see Logan. Our dog Molly seems to be doing well with our neighbors Joe and Kayla. Thanks guys! Sometimes it is easy to forget our first baby, Miss Molly. She is such a good girl! As always, I will keep posting with updates. Thank you for all the prayers and support. Our little boy is coming back to us!

PICU Day 2 Update

Here is an update on our stay in the pediatric intensive care unit:

Logan has remained intubated, but don't worry he made some good efforts to pull out the tube today! He remains under sedation but wakes up periodically to remind us how strong he really is. His endotracheal tube (breathing tube) has been acting up today. When he was first intubated there was a lot of swelling in his airway. Now the swelling has gone down. That leaves space between the trachea and endotracheal tube for air to escape. It has made him a bit uncomfortable at times as he does attempt to breathe on his own. It also makes a small whooshing noise when he exhales. His oxygen levels have remained good with slight dips at times but nothing significant. The ventilator beeps a lot and they have attempted many adjustments with no success.

So, the new plan for tomorrow is for Logan to get a chest X-ray early in the morning. If that has improved since today, the doctor will shut off his sedation and let him wake up. Once he is awake the doctor will extubate him. This means that the doctor will pull the tube out. Freedom! Unfortunately this comes with risks. He is being extubated a little earlier than planned due to the constant leaking from his endotracheal tube. There is a chance that he may not be ready to be extubated and if that is the case, they will place another endototracheal tube. I have a feeling he is going to do great and will be happy to be free but we are ready for either option.

This evening the doctor had a few lab tests repeated to make sure Logan's system was in the best possible shape before extubation. His potassium was a little low so they have increased the dose he is getting. This isn't a huge deal. The doctor said he wants to have it bumped up because a low potassium often causes lethargy and we certainly don't want him pooped out before the big event. His platelets and hemoglobin have also dropped since admission and can be due to many things but are not at a level of great concern and this will be monitored closely.

His feedings were started again today at a slow rate and he is tolerating well. He is making lots of pee which makes us happy! His vitals are great and his temp has stayed down all evening but he is still getting Tylenol and Motrin. The EEG monitoring is complete and no seizures were detected so we are pretty confident that he had a febrile seizure. He will still go home on an anti seizure medication called Keppra. We will then follow up with his neurologist to see if we should continue it.

His sister Lauren is up north with family and is doing great. She has been playing with her cousin and probably getting pretty worn out in the process. I am so thankful to have such a wonderful family that can pitch in and take her during these times. It is so nice to have her in good hands. She doesn't quite understand what is going on but maybe that is a good thing. I miss her so much and can't wait to see her.

I pray for a restful night for Logan and a successful extubation tomorrow. They are getting ready to let me hold and cuddle him. I am a little giddy right now. Keep you posted on the big event tomorrow.

Update: they let me hold Logan before I published this posting. I didn't realize how much I needed to hold him. For the first couple of minutes I was a ball of nerves. I was so worried about all of the tubes. After I relaxed the emotions hit me. I couldn't stop thinking that the last time I held him, he almost slipped away from me. The last time I held him, he stopped breathing in my arms. That helpless feeling was overwhelming. After a few minutes of good healthy crying I was able to smile and be ever so thankful for the precious gift in my arms. We witnessed a miracle yesterday. When he started to breathe again after the paramedic stimulated his gag, I felt like the moment he took his first breath as a newborn. I now know he had many angels sitting on my shoulders yesterday morning. Logan had Grandma Cindy, Cousin Taylor, and Aunt Leah and Aunt Jeni as his on scene angels! And I know Gigi, Grandpa Gregerson, Grandpa Mervyn, Cousin Sarah, Cody, and probably a few other angels were all there helping me and the paramedics guide Logan through. He is a fighter and is as stubborn as they come. I have no idea where he gets it! So I lay here now with no words left to say other than thank you.

PICU Day 2

Today is Day 2 in the pediatric intensive care unit. Since my last post Logan is/remains...

Intubated on the ventilator
On antibiotics
On anti-seizure medication
Having continuous EEG monitoring, this monitors his brain activity to tell us if he is having seizures
Getting pain and sedation medications
Getting lots of breathing treatments
Getting Tylenol and Motrin for his fever

What we see: a restful angel who likes to wake up every once in a while and remind us why he is called Mr. Wiggles! He had a great night. Woke up for the nurse a couple of times. He has opened his eyes and moved his arms and legs. I am so thankful for that. His blood pressure maintained through the night with the support of the pressors. They have been able to stop them now and he is maintaining a good blood pressure on his own.  He still has a fever but is mostly controlled with medications.

I spoke with the pediatric intensivist (ICU Doctor) today. His chest X-ray has worsened. His blood and sputum cultures are negative. Basically, this is not a bacterial infection and is not influenza. He most likely has a virus. The X-ray is most likely worse because he aspirated during the seizure and he is also intubated, sedated, and not moving around. We are going to try his chest treatments where we shake him with a vest to help loosen the secretions. The doctor is going to start him on a steroid. Hopes are that this will help boost his immune system and give him extra help to fight the virus. He is considered to have sepsis.

Sepsis is a condition in which the body is fighting a severe infection that has spread via the bloodstream. If a patient becomes "septic," they will likely have low blood pressure leading to poor circulation and lack of perfusion of vital tissues and organs. This condition is termed "shock" and is sometimes referred to as septic shock, when an infection is the cause of shock. This condition can develop either as a result of the body's own defense system or from toxic substances made by the infecting agent (such as a bacteria,virus, or fungus). I got this off of emedicine.com. 

So, all in all he is not out of the woods yet. Like the doctor said yesterday, it will get worse before it gets better. So today might be a trying day but I know how well he responds to steroids and after two doses we will probably see a whole new kiddo. The plan is to keep him intubated today and tomorrow and then reasses after that. He keeps waking up so they re-started his versed drip. This is the one that keeps him asleep. He has remained on a fentanyl drip throughout. He is having some issues with edema (swelling), but he is peeing most of it off!

Joel and I are maintaining. The grandparents have been here to help. Emotions come in waves. It is hard to think that he was just in the hospital less than a month ago. I spoke with the ENT office and Dr. S. said we can still pursue his salivary gland surgery if he is extubated this week otherwise we will have to postpone it. 

Thank you for all of the support and prayers. Logan is so blessed to have so many people rooting for him. I will keep you posted. 

Seizure

Logan had a seizure this morning while we were visiting with our family this weekend. He spiked a fever at 1am. At 5am he still had a fever. I gave him some ibuprofen and within a few minutes my mother in law and I noticed his arm shaking and he was gazing off to the side. He would not respond to me and the shaking worsened. We called 911. While waiting for the ambulance he stopped breathing. Thank god I had the oxygen and ambu bag to help him breathe. The paramedics arrived just after he stopped breathing. They attempted to intubate him but he started gagging and started to breathe on his own. He called for a second ambulance and a helicopter.

We went to an airport a couple minutes away and met the helicopter. The flight nurse attempted to intubate him again but he was clenched down from the seizure. They decided to transport him as they were able to maintain his airway and he was intubated on arrival to the ER. He is now in the PICU at St. Cloud Hospital. The seizure stopped after a boat load of meds. The doctor is working to rule out infection. He had a CT scan of his brain that was normal. Urine is clear. They have performed a lumbar puncture to rule out meningitis. His chest xray looks good. He has a central line and is on dopamine (a medication to keep his blood pressure up). They have him on sedatives and pain medication to keep him comfortable and they are going to start monitoring for seizures.

The doctor does think he has an ear infection! Of all things, an ear infection! The doctor thinks he had a febrile seizure. I am worried that it lasted so long despite getting Ativan and Versed...he was seizing for about two hours. The doctor agreed and said neurology will be consulting. He gave me the option to have him transferred to Children's. Right now I want him stable and then we can decide but he is getting great care here.

Logan is in need of some major prayers right now. He is such a fighter! He almost slipped through my fingers today. I don't think I have ever been so scared in my entire life. I have a raging headache and queezy stomach, but I have my baby boy. That's all that matters. As always, I will update the blog as I have more news.