I will try (TRYYYYY ok, it’s hard when you’re as verbose as myself!) to keep this one shorter. Since the hospital network has decided I can’t get on Facebook anymore, I will try to update here when anything exciting is happening!
So after spiking a crazy fever last nite right around bedtime, things have been nicely calm around here today. Everyone has their own theory about why she spiked another fever, top of that pack is that she is still septic/bacteremic. It is unlikely considering the antibiotic/antifungal coverage she is on, and the fact that the PICC line had been in for less than 8 hours at that point, but it IS the most logical. Good thing Kendall has never once followed the “logical” path for anything – because that means we are more likely dealing with one of the other working theories:
Autonomic response to the major pain of trying to restart feeds into her J-tube (this is my theory).
Possibly a “last hurrah” type of push from her body to kick the flu to the curb since she had just had her last dose of the tamiflu (antiviral) about two hours before the incident.
Basically, nobody knows. I think autonomic response because she had been feeling pretty crappy from the feeds since about 3 in the afternoon, and she finally passed out asleep around 7 after just being real quiet and puny that whole time (typical for what we see at home when she is in pain from feeds). At 8 pm she woke up SCREECHING in pain, our nurse and our care partner both were walking down the hall and came running in here to see what had happened, and they once again paged the sr resident in panic mode to get her to order something stronger than tylenol NOW. our PCA was almost in tears herself because we could not get kendall calmed down at all and she was like – “how do you fix her at home:? how do you get her to stop screaming?” And I just said, I can’t, and I don’t, that’s part of why we’re here!
As they were ordering tylenol suppositories, zofran and versed, we noticed she was super hot, covered in goosebumps and shaking. Rectal temp was 101.4, which isn’t too bad, but it is definitely a fever, and definitely much higher than she’d been in two days. We put the tylenol in, and thirty minutes later checked again, and it was up to 102.8. I am sure if we had kept checking it, she would have spiked even higher. Even I myself was very concerned with how hot she was getting and how much she was shaking – it was reminiscent of our first nite here in the ER when she had the rigors from spiking a temp. (For the record, this is a new thing for Kendall, both spiking a temp and having the rigors with it.) But we stopped the feeds altogether for the nite, gave her the zofran in her IV (anti-nausea med), started her new med to deaden the nerve pain in her gut (Elavil), and she passed out asleep within about 30 minutes. Shortly therafter, she “de-satted” (her oxygen dipped down to 65), and it took her a couple minutes to slowly climb back up to the low 90’s, where we watched her and let her hang out for a few minutes before giving her a little oxygen. Within a couple hours, her temp had dropped down to 96 degrees, so she got huddled up under every blanket we had in the room, and she slept until 7 am this morning. The docs had decided yesterday to give her a “lab holiday” – meaning they didn’t pull any labs this morning bright and early! It was a VERY nice and welcome break!
And our day today has just been a lot of hanging out – watching Kendall come back to herself, making messes with lotion and baby wipes. She has sat up a little bit more today, still pretty shaky trying to sit herself up, but once up she can balance pretty good! I am very glad to see this, as she usually loses motor skills for a good few days after an illness, and I am imagining that one this bigtime will put her back at least a week or so!
We had a few tests today – but I’ll update about those in a separate update so that those of you chomping at the bit for this one can get it!
thanks for checking on us!
Terra and Kendall from the W1104