A little bit negative

Here's my sweet boy today. He's still very puffy, but his fluid balance was negative around 300mls yesterday. That's good - it means he's getting some of the fluid off. He's just still so puffy and bruised, it hurts me to look at him. He's on a fentanyl drip to help keep him comfortable. He was still opening his eyes today and listening when we spoke to him. They are having to tread a very thin line by keeping him intravascularly dry while supporting his blood pressure with the dopamine. Today they've had to give him blood, platelets and ffp. I'm not sure he'll have a negative balance tomorrow with all that extra fluid. We'll see. His vent settings are still high as they are having to support him due to all the edema. His peak pressures are usually in the 30's to 40. His blood gases are pretty good, though. Today his white blood count was high and his CRP was 6. His chest x-ray was a little questionable - they've drawn blood cultures and took cultures from his dialysis output and his ET tube (his breathing tube) and started him on antibiotics. I think the pseudomonas that grew from his ET tube on Monday is probably not just a colonization, but was an early infection that is now causing some problems. We don't need any more problems. Just pray that he responds quickly and well to all the treatments they're doing. While you're at it, say a prayer for his little bottom as it is still very raw. They've now placed a duo-derm on it. It's a dressing that stays on for several days. They've also increased his feedings today to 8mls/hr of portagen. Yesterday they switched from 5mls of 1/2 strength to 5mls of full strength. So far, so good.

Ok, so on the bright side... You won't believe this, but he had 18mls of urine out yesterday! I would have to look back, but I think that's the most he's had since he's been on dialysis. I was wondering if it was the high dopamine - he's at 10mcg/kg. Dr. Henry (the attending) said maybe one of the heart meds - but she would just be guessing. He's just such a complicated little boy, no one really knows what makes him tick. Whatever the reason, I'll take it. Dr. M always said there was no reason for his kidneys to quit working.

I wanted to let everyone know how much I appreciate your help. We have people signed up to sit with Maverick in the evenings through Friday (and I need to call some of you back for further out - I just need to take it about a week at a time right now), and our friends and family have been a tremendous help with the kids. Thank you all very much. More tomorrow - jc