Laid Out

Late this afternoon Ash's doctor laid out a plan and goals for the next 10 days. So here goes:

If Ashley's electrolytes will balance out overnight with the extra potassium boluses' and such then we will be discharged in the morning.

We will continue infusing her antibiotics over the next 7-10 days as we attempt to clear her line and her blood stream of the bacteria that is growing there.

At the end of those 10 days we will be admitted back into the PICU.

Then they will put Ash to sleep using this "temporary" central line that was tunneled through her neck last week. While under anesthesia they will attempt to place peripheral IVs in both of her arms or hands or wrists. Basically where ever they can find a vein. Once those are in place they will pull this line, draw blood cultures and bring her back to the PICU.

We will sit her for the next 36 hours and hope that the cultures do not grow anything back.

If they are clear at the end of the 36 hours they will take her back to the OR and place a Broviac central line into her left femoral vein and tunnel it up toward her rib cage.

During this time Ash will basically be on TPN and lipids along with IV fluids. Our hope would be to advance feedings to somewhere between 6-8ccs an hour to assist her bowel in healing.

For the next 10 days we need for these things to happen:

1. Remain fever free. She's been fever free for a little over 24 hours.

2. Line not to collapse forcing us into the OR before her blood stream is clear of the bacteria. If they were to take her now the new line would be infected in a matter of hours.

3. Her output to drastically slow down allowing us to keep up with her fluids.

4. Her electrolyte and fluid balance to remain within the normal ranges.

This is actually a very "tall" list of things to accomplish. If at any point this list becomes compromised we will be back in the hospital to "fix" whatever went wrong.

The slides arrived in Omaha today. We've gotten no word on pathology yet. The findings could change any and all of this list of goals. Currently the team in Omaha is on board with the plan here in Louisiana.

I can't wait to have this arterial line removed from her ankle. It is causing her a lot of pain although it is serving its purpose. They've drawn blood effortlessly from it over 10 times already. Her neck is healing. The steri strips are starting to pull away from the incision. It is really bruised and still a little swollen, but once those strips come off then her hair can be shampooed and I can begin cleaning her up a little bit.

I can't wait to get her back home. I'm so hoping for it to happen tomorrow. We had some offers submitted on the house today. Our realtor is looking them over and deciding which one would be best for us to accept. We are still waiting on a decision about the house we have made an offer on. The owner lives in Florida and its taking a little bit to get it all worked out. Anyway, our days are numbered in our little house and I just want to get Ash back there so we can enjoy them before it sells or before we are told we need to be back in Nebraska.