Going for the jugular…

It’s been awhile since we were the busy room in the unit.  Unfortunately, that changed today.  Rudy made it through the first of his three hour sprints in the early morning before I even got to his room.  From 11 on, he started to get more and more fussy (with a high heart rate and breathing) and the usual steps to calm him down (holding him, changing positions, suction, rescue doses of sedatives) didn’t change things much over a four-hour span.  While the team worked to eliminate possible causes, things became clear when his temperature spiked and his blood gases indicated he was headed toward acidosis.  The infection we’ve been monitoring in the picc line was now presenting itself as something that needed to be reckoned with.  Remarkable how quickly things can change—the same tests gave no indication of anything being amiss just hours earlier.

Just after 3pm I signed consent forms and left the room so the team could insert a new picc line.  One of the reasons why the team didn’t just pull the line out of his arm right away was the simple fact that they are running out of sites to start lines on Rudy’s little body.  This turned out to be all too true as they started trying to insert into Rudy’s groin.  When that didn’t work, they tried to put a subclavian line in his chest.  Two hours into my exile from the room, I was called asking to give consent for them to go through the neck into the jugular vein if chest insertion wasn’t possible. 

So I set out on what turned out to be five hours of trying to keep myself busy.  There’s a surreal feeling to the times where we have to leave Rudy for a procedure.  If it doesn’t last longer than they say it’s going to it always feels that way.  All I really wanted to do was curl up on a couch somewhere with a quart of Ben and Jerry’s, but I decided to take a walk around campus (OK, I did get an ice cream cone to safely offset any calories I might have burned).  Turned out to be quite a long walk, but most of my exertion was directed toward not checking my phone every 30 seconds.  About the time I thought it would be smart to get an early dinner while I couldn’t be in the room anyway, I got that call about consent to go for Rudy’s jugular.  On hanging up, I found myself in another one of those surreal moments of uncomfortable weirdness—“Yes, go ahead and stick my son in the neck.  Now, do I want Thai or a burrito?”  Pretty good food, but not much enjoyment.

I walked back to the hospital a bit frustrated by how familiar this whole place and routine are.  I know the stains on the sidewalk.  I know it’s around shift change so I headed to the West elevator because the East gets crowded.  I recognize too many of the faces coming in and out of the building.  I saw a couple of nurses from labor and delivery and walked the other way as I just didn’t feel up to elaborating on why we’re still in the hospital 16 weeks after our encounter with them.  I set up in one of the weird little lounges on the floor waiting for the call from the unit and pondered what decorator decided that pictures of polar bears would go well alongside the Great Wall of China mural (once again, at a moment when I’m not able to focus much on anything else—it’s polar bears again).

I got back to Rudy around 8:30pm and he was resting comfortably with the line in his neck and the suspect one gone from his arm.  Dr. Robert still feels very good about where he is, but put a hold on extubating tomorrow.  That really bums us out.  We were so close—and still are, but wisdom would dictate that Rudy have at least a day of rest since this afternoon unfolded into more of an ordeal.

At long last it’s quiet here in Rudy’s room and I’ll just sit here with him for awhile as Nurse Betty keeps an eye on everything with her trademark quiet efficiency.  Weary?  You bet, but tomorrow’s another day and we’ll look to get back on track.  Please pray with hope for Rudy—that he’d get good rest and be strong to move off the vent this week and that, now that the picc line has been changed, this bout with infection is safely behind us.