Yep, the wee man was here for only two days and today we ended up taking him back in! We had a quiet day on Friday and Saturday morning. Then at around midday he started getting rather agitated and his breathing didn’t seem great. We removed his tracheostomy dressing and gave him a dose of paracetamol. His breathing seemed to improve as did his temperament and a lovely afternoon was had by all. His gums are very swollen and we just assumed teething.
In the evening we gave him some more paracetamol with his feed as he was rather unsettled and his oxygen requirement went up from 0.2 to 0.4 litres per minute. By the time Verna came to do a night shift he wasn’t really doing very well, he was very unsettled, his heart rate was high at around the 180s, even though he was supposed to be asleep, and his temperature was up! Another dose of paracetamol, some piriton to stop him itching his hickman line (and because it has a drowsy effect) finally settled him and his heart rate dropped to 170-ish whilst asleep overnight (when he is well it should be down in the 120s). Verna had an OK night and after Verna left and the paracetamol wore off, Massimo got really unsettled. Heart rate racing and he was just looking tired out as though his sleeping was restful. We decided to give him another dose of paracetamol and take him in. By the time we were washed and dressed, the paracetamol had kicked in and, apart from red, red cheeks, he seemed to be OK. We took him in and as doctors cannot assume teething to be the cause of a temperature, especially not one that hit 39.6ºC as Max’s did this morning, they started on a series of test. After taking bloods from his hickman line, they flushed the line as usual, but the line split totally and is now completely unusable. It will be removed tomorrow and a new one inserted at some point later this week. They did a urine test and a chest x-ray which both showed no problems. His bloods have shown that there is a slight something somewhere.
As the afternoon wore on, Massimo became more and more unsettled and even the mild sedative they gave him seemed to have little or no effect. We weren’t very happy with how he was, but the doctors said that there was little more they could do for him on the ward and, as they didn’t feel it was a respiratory problem, they didn’t feel that transferring him to PICU was the right thing to do. Still not very happy, we left him in Verna’s capable hands as she is very kindly looking after him tonight on the ward.