Morning Update

We had some very scary moments last night.  Moments when things were heading south in a hurry and we weren't quite sure we could stop the direction they were headed.  But prayers poured in and Brendan stabilized.

As Brendan's blood pressure dropped it was explained to me that the infection causes the blood vessels to dilate and get "saggy".   The norepinephrine (which constricts the blood vessels in the arms and legs) was increased rapidly (from .03 to .08) to get his blood pressure up, but then, the constriction of the vessels actually caused his heart rate to drop (since his heart didn't need to beat so hard to move the blood through his body).  The pharmacist bringing the epinephrine to the room confirmed that that could happen, although he said he's only seen it once or twice.  So epinephrine was used to get the heart rate up and keep the blood pressure up.  That helped immediately. (Although Brendan will attest that messing with epinephrine (think adrenaline rush) is an uncomfortable thing.  It took some adjusting to get him feeling alright.

Overnight the epinephrine was backed off .01 at a time until they were able to shut it off completely (around 2:30 a.m.) as he could hold steady on his own.  I heard Brendan talking to the nurse during the night so I knew he was alert and doing better.  At 4 a.m. we were up with diarrhea and he did test positive for c diff.  They had already started the oral vancomycin yesterday so we are already seeing improvement there.

After a night of being afebrile, Brendan fevered again at 5 a.m.  He was given tylenol, and then 45 minutes later, motrin, to bring the temp back down.  The doctor came to check him and he told us that since he has stabilized, they will try to get him moved up to the floor as soon as possible to avoid the bronchiolitis epidemic they are having here in PICU.

Chemo has been delayed until Brendan is doing better.