This was very hard for me to have him put back on the ventilator, but I didn’t really have the feeling he was ready that morning when they took him off. But this was the first time that Dylon had never not made extubation the first time. All of this was happening around shift change, for some reason Dylon really likes to cause the nurses problems at this time. I saw the nurse who was going to have Dylon for the evening as I stepped out for them to place him back on the ventilator and I was very upset. I remembered her from our other visits in PICU; she and I did not get along well at all. Christine, the nurse that had him all day, stayed with him until he was settled and then came and talked to me in the waiting room. Everyone knew that I was extremely upset, first because Dylon was not doing as well as we hoped, and second I felt uncomfortable with his nurse, and third, the respiratory therapist he had that night was new and unfamiliar to Dylon’s care.
Dylon had a bad night; he was having withdrawals from his medicine, and the doctor kept ordering bolas (an hours worth of medicine at one time) of his sedation medicine, but it was not helping. My dad had stayed in with Dylon during the night and around four o’clock he came and got me because Dylon was so fussy. First thing I asked the nurse was, are you sure this central line is still good, and he is actually getting his medicine. She assured me it was and he was. Later that morning the doctor asked her the same thing and she assured the doctor that he was getting his medicine. Well, that morning Christine came back in and was getting report, Kathy the charge nurse walked over and noticed Dylon fussing. She immediately checked his central line and saw that is was not any good, all of the medicine was leaking on the bed. She started trying to get an IV in but Dylon is such a hard stick the doctor had to come do it for her. After she hooked up his medicine to the IV and gave bolus’s Dylon settled down. The plan for the day had been to wean his sedation medicines more so he would be alert enough for extubation next time, but instead his medicines were upped higher than they had ever been. Let me just say the nurse we had that night we never had again and will never have again, end of story!
Monday, March 15, 1999 (Day 33), they finally got to wean the ventilator back down. Dylon was on a peep of 9 and when the doctors made there rounds they turned him down to 5, this is a very big jump. They also turned him back to volume support, and started sprints on volume support for 8 hours and then to a setting on the ventilator call C-Pap for 2 hours. Melinda came up and visited and brought a birthday cake, because Dylon now had an older Mother - I was 30.
Tuesday, March 16, 1999 (Day 34), the plan was for the ventilator to be turned as low as it could go and for it to be set were Dylon had to do most all of the work himself. His lungs were better but he was so weak he was unable to breathe deep enough to keep his lungs opened up. The peep was turned down to 3, and the sprints to 4 on and 4 off volume support. They started decreasing the sedation medicines again. Dr. Green talked about trying to extubate Dylon again on Friday.
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