Last night I left a happy, coloring, pig tail wearing, baby girl at the hospital with her daddy assuring him that although I had not slept in the last two nights that Ashley Kate had and that once she was asleep he would be allowed to rest well (since our med schedule was reduced). He happily told us good night and Blake, Allison and myself kissed our baby pickle and went home to sleep.
This morning I arrived at the hospital to find out that Dave didn't sleep more than 2 hours all night(if even that long) because Ash was miserable and fussy the whole night long. I felt horrible knowing that Dave was already tired from his trip with the kids and that today he had a very full schedule as well as a class to teach this evening. I was so wishing I had stuck it out and sent him on home to sleep.
Then I looked over at Ashley Kate and was shocked! Her face was and is ENORMOUS! As are her hands. I picked her up and almost dropped her not expecting her to be as heavy as she is. Honestly I thought she was fluid overloaded by the looks of her face. Then her lab work came back. Her BUN is up to 59! We are so confused. Before her labs came back the doctor had rounded and decided to send her home this afternoon. This was all before I had really looked at Ash to notice the obvious changes she had endured overnight. Now with a BUN this high I am assuming we are going no where. Confusion? It comes in the fact that she has had IV fluids running non stop 24 hours a day since Friday's admission along with her TPN and formula. How is this child dehydrated? You would think her fluid status would be improving instead of getting worse. Her ostomy output was great yesterday and she had not vomited since the wee hours of Saturday morning. She's not losing huge amounts of fluid from anywhere. Why is she dry? I would venture to say that the only time I have seen her 3rd space fluids(dry inside the vessels and sending it out into the tissues causing extreme edema) is when she is septic. Which would make sense with a line infection except for the fact that she has been fever free since Friday evening. There are no signs of sepsis(an overall infection throughout her blood stream). So this all leaves us VERY confused and trying to figure out what to do. If we keep pushing fluids then her body could keep transferring them and eventually she has a tendency to transfer those fluid to her lungs and that puts us in real trouble, but we have no choice. When your vessels are dry you have to push fluids. I am pretty much on the edge not knowing which way this is going to go for us today. I've seen it get really ugly really fast in this situation, but other than being miserable from her swollen state she presents to be fine.
As far as fever and symptoms are concerned she has none. We are going to use some albumin to try and pull fluid back into her blood vessels and this may or may not work. Sometimes it helps her and sometimes it doesn't. I have no idea what is happening and who knows when or if we are being discharged. The doctor is trying to make some decisions now.
Her culture from yesterday is clear. The organism has been identified from Thursday and Friday's culture and has shown response to several treatments. Her antibiotics have been changed to only once a day and things were looking really good for her yesterday. She shows no signs of the infection. Today may or may not be a different story. I'm not sure how quickly this can be corrected, but we will have to wait and see.
So I sit here searching for signs of Ash among all the swelling and wait for the albumin to get started. I'm confused, but accepting it. Its just another day in the hospital living this crazy life of ours. I think Ash is getting better, but she might not be. Who knows?