Wednesday, October 16, 2013

Working out a few small issues..

So, yesterday we did two rounds of lasix to help pull off some of the excess fluid that was in his belly. He was weighing a few pounds more than he should have, and his belly was really distended, so this was necessary. When we woke up this morning, the first thing that we noticed was that Parker's urine output had slowed significantly and that his urine was really dark. Those are not good things for a patient with a brand "new" kidney, so they called in the renal team to take a look. His blood pressures were a little low, his eyes were sunken in, his urine was very dark. Basically, we took off too much fluid and he was now dehydrated. The doctors gave him a few boluses of IV fluid and added some free water to his formula and things have started to perk up a bit. We also did an ultrasound of the kidney, just to make sure that urine wasn't backing up into the kidney. This was a pretty amazing experience for us. This was the first time that we have gotten to see our baby with a healthy kidney!

The morning got off to a pretty rough start with our nurse. Parker's Prograf- which is an anti-rejection medicine- has to be given at very specific times- 8 a.m. and 8 p.m. Before the medicine can be given in the morning, they have to draw blood for a tac level. This will tell us exactly what his Prograf level is so that we can make adjustments accordingly. This morning, however, it was 9:15 and the his tac level still had not been drawn. So, his medicine is now an hour and a half LATE! You know that this was not a pretty situation, because now I am pissed! The nurse was pretty much trembling in her shoes after I said what I had to say. So around 9:30 his kidney team came by to round, and the nurse was just giving him his medicine. Of course, I make sure that they are well aware of this, so that they can also handle the situation. They began questioning her as to why it was so late, and poor girl was literally shaking. She didn't have a good excuse, other than she was rounding other patients, and they had a hard time with Parker's heel stick. The doctor's weren't accepting it, though. Needless to say, the doctor laid into her when she left the room as well. I don't think that anyone will have that problem with her again. I'm sure she will be in the room at 8:00 a.m. sharp!

The only other issue that we are having is actually his tac level. Yesterday it was in the range of 5.4 and we are looking for a range of 8-10, so they gave him a "supplemental dose" yesterday, just to give it a boost. Today, however, his tac level was over 12. So tonight we are holding his Prograf, and making changes accordingly in the morning. This is going to be a trial and error situation for a little while. This is why we have to be in clinic twice a week for six weeks once we are discharged.

Once his hydration and tac levels are controlled, and he is on a home feeding schedule, we are ready to talk discharge. He is doing amazing for only being six days post surgery. The only pain medicine that he is on is Tylenol around the clock. His incision looks beautiful. There isn't any more drainage, and it is healing pretty nicely.We are planning on going home with the catheter, but have an appointment to meet with urology two weeks from the day of surgery, so sometime late next week.

We are pleased with his progress. Other than the dehydration, the issues that we are having are minor and to be expected.

This was his urine this morning. Not enough of it, and way too dark! 

This was our outing to go to the ultrasound department.

Waiting for our ultrasound

 This is our beautiful new kidney! 

Cruising the hallways, waiting on the elevator.

He is sitting up for small periods of time now. 

This is his incision which gets really close to some private areas as you can see. It looks great for six days post surgery, though. No redness or swelling.

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