Wednesday, June 16, 2010

Day 10: Shato APH

Yes, still here... We had the best of hopes for going home today. Everything was going according to plans. But I noticed she was feeling pretty warm early and sure enough her temp was 100.6 and we desided to just watch it for awhile since we had to wait until after 4pm for the TPN to be delivered. It didn't seem to want to budge and held pretty steady around 100.6 and 100.7 the lowest it went all day was 100.2. It was 101.1 before bed. Whithin a few hours of going to sleep though it was down to 97.7R. We are all kind of scratching our heads...

She looked great as usual all morning definetly not showing the effects of the day she had yesterday. Riley is so amazing, she never lets anything stop her. I love that girls spirit and hope to have half as much strength as she has one day!

The Resident was all ready to send us out the door and wrote up the paper work. The nurse however had called the attending to tell him about her temp and he was much more nervous and asked what I wanted to do. I said lets see how she does over the afternoon and we'll go from there. We have a long history with this resident. She took care of Riley for almost the entire month she was here the first time as a baby. She has also been on with us occasionally through out and has a LONG history with her. I can guarentee you Riley is one of those patients she will never forget and changed the way she is as a doctor... This paticular attending has also seen Riley before, he took care of her when she had the urosepsis. He was the one who told Dr. Ulrich he didn't think she really even needed to be admitted going off his initial exam and "how good she looked" he was trying to send us home the next morning. I thought he was going to fall over when he saw her blood culture growing out 2 different organisms and it showing she was bacteremic. Needless to say I think he knows better this time than to "blow off" one of her fevers. The resident was telling me later she wanted us to stay until 8pm or so to watch her but he wanted to watch her overnight. She said, if I pitched a total fit he would let us go but... Of course staying til 8 would't work anyway since Wil had a class at 6 and Liam had a 9am Dr. appt. So, we all comprimised and had them go home and agreed to have him come back in the morning to get us after Liam's appt.

Truthfully I have no idea what to do... I asked Wil what he though he said he doesn't know either. I don't think anyone does. She has had a very stressful few day and her autonomic issues could be acting up due to that. BUT the main issue is she had had that femoral line in for over 8 days. This is not good. After about 5 days your risk of infection gets extremely high and goes up everyday there after. So, there is also just as good of a chance that this could be a massive infection brewing and I do not want her new line compromised! So, we are all at a loss. Even at this very moment I am unsure what to do tomorrow. Another major issue if we go home is it's almost Friday and Riley ALWAYS likes to act up on Friday nights. It's murphy's law! To top it off her pediatrician is on vacation so we are totally on our own and would have to bring her back to the ER here if we had any issues.

So, just say a prayer for us that we will be able to know what the right thing to do is without compromising her health. I'll update tomorrow when we make a desicion...

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