CVICU Day 26

4 Months Old!!

This has been a rough week for Team Steele. On Monday October 12th Steele was showing several symptoms of morphine withdrawal from his morphine weening, namely, a high heart rate, a fever, and agitation. A routine blood sample was taken to make sure Steele didn't have an infection. This is done every time he has a fever. When cultured, the blood sample grew bacteria. Another blood sample was taken the following day on Tuesday October 13th; it did not grow bacteria. So either the blood sample from Monday night was a false positive (poor sterile technique=contamination), or the sample Tuesday night was a false negative.

After careful consideration, the team decided that they were going to treat Steele as if he did indeed have a blood infection and they started a 10-day course of antibiotics and changed his status on the heart transplant list to status 7, which is the lowest status. Their rationale was that if he did have a blood infection, he couldn't accept a donor heart because the surgery would be too risky. Brenden and I were really discouraged with the news because that means 12 more days (10 days of treatment plus two days of proving he is clear of infection) of Steele not being able to accept a donor heart even if a compatible heart became available. Meanwhile, he continues to grow and needs the new heart more every day.

Today, one of the nurses noticed that Steele's peripherally inserted catheter (PIC) was leaking; the bandage covering it was soaking wet. Upon closer examination, the catheter line was broken and leaking all of his heart medication (milrinone) into his bandage. We have no idea how long the catheter line was broken, but the nurses and doctors acknowledged that it could have been the source of contamination in Monday's blood culture. We will never know if Steele had a blood infection or not, but because the team always errs on the side of caution, he must wait 12 days as status 7.

We are very thankful the nurse noticed the wet bandage and found the broken line, if not then Steele could have gone 24 hours without receiving the heart medication he needs and might possibly have had a cardiac arrest. And of course losing the PIC line means needing more access, so we had three different poking attempts tonight (Friday at 5p) to get a new IV. Thankfully, one very gifted nurse, the "vein whisperer," got the IV on the third try. Steele was tough, though, and even gave the vein whisperer a coo and smile after the poking was over.