Blocked?

Ashley Kate's face took on a new, but unfortunately familiar look over the weekend. I had hoped it was temporary, but it lingers still and along with the lack of blood flow from her PIC line we are suspicious. The feeling is that she has a blood clot. Somewhere. Again. The question is this: Is it stationary and attached to the inside wall of the vessel? or is it traveling? We have to take a closer look.

Either way its not good news for Ash. Blood clots are dangerous. If it is stationary we will probably start her back on blood thinners so that it does not grow as the blood trys to flow past it(usually its coumidin and that drug in itself has a whole list of issues associated with it). If it has broken free and traveling(which may explain the temporary blockage of her line) then I have no idea what we do with it. I just know that blood clots in the major vessels are a dangerous complications of central lines. I also know that currently we have no choice but to have a central line of some type. Either a PIC or a broviac. The placement of those lines is getting harder and harder the older she gets because of the frequent access to her veins. Her access is becoming more and more limited making it more and more difficult because of the thick scarring in her veins.

We are planning a visit to her local doctor today and he is planning a vascular ultrasound for her at some point this afternoon to see if we can locate a culprit. It is my hope that there is not one, but I am prepared to be told that there is. Our goal is to do this local. If management can't be done local then Shreveport is my next goal.

Ash is currently on feeds of 50ml an hour with a goal of 80 being the ticket to getting her off TPN support and line free. We are a long way from 80 with only advancing 5ml at a time if her stool output meets the required guidelines. Thankfully yesterday it did(for the first time in several, several days) and we got to advance to 50 this morning. This recovery is proving to be very, very slow with lots of ups and downs.

So, I'm off to bathe a very puffy pickle, and then take my puffy pickle to the pediatrician. From there who knows what our day will hold? Talk to you soon. Trish