Good-bye ICU, Hello Ward 3C

Hooray, we moved out of ICU today!! Actually just this evening. This morning we were told that there were no beds available on the Ward and so we'd have to spend another night in ICU ... another night on that rock hard chair. But late this afternoon a bed became available and after supper we were moved upstairs. From what I understood in ICU we were suppose to go to the Step-Down ICU, I guess we just got the first thing available since we received a regular room, but at least it's an "isolation" (or private) room. Whatever the case we're out of ICU and we have our own room with a cot ... not even a pull-out bed, but a cot!! Yah!! (Never mind the fact that the last couple times we asked for a cot and were told that they no longer use them because they are unsanitary ... all depends on who you ask, but this time it was just there when we arrived).

So, the real information ... how is James doing. Not much has really changed from yesterday. He had a bit of a spell during the middle of the night, making us once again wonder what the original cause is of this inflammation as this spell seemed to be reflux related ... our only hint in this is that he starts coughing and then asks for a bowl, we are assuming he asks because he feels food coming up ... but being just two we can only assume. The resident said this morning that once he gets to the Ward we can start assessing the cause(s).

James woke with a fever again this morning, but thankfully one shot of tylenol reduced it and it didn't come back throughout the day. He was not very alert or active for most of the day, seeming very tense and unhappy and often just staring off into space ... or at least in the direction of the TV. He sweat an awful lot today, making us check his temperature often, but it stayed okay after the tylenol. He continues to be on oxygen nasal prongs. His SAT levels hung in the 93-94% most of the time, okay all considering, but not getting better. His breathing was up again, often in the 70-80bpm. I was told that this can be expected for a couple more days. They did not do an update x-ray today since yesterdays showed enough improvement. James' IV line came out this afternoon and thankfully he is tolerating his g-tube feeds and had just received his last IV antibiotic, so they did not need to put a new one in ... all his meds will now be given via his g-tube.

Just before leaving ICU they ordered more blood work ... poor guy, thankfully only one try this time. James' ammonia levels came back high this morning. I do not remember what he normally sits at, or what range he is expected to be in. All they told me is that he had been around 30 and was now up to 80. It is not a critical level, but since it is rising they need to watch it. James regularly has his ammonia levels checked, this is a key part of his disorder. Ammonia comes from broken down protein, the liver converts ammonia to urea and then elminates it from the body. Ammonia levels rise when the liver is not able to convert the ammonia to urea. James' ammonia levels of course need to be monitored because of his inability to break down protein. James takes special medications each time he eats to help his system convert the ammonia to urea. When checking the ammonia levels they are watching to make sure that the liver and kidney's are still functioning properly. At this point there is not a major concern, but because they have risen and never have before they are keeping a closer eye on it (poor guy, that means more blood work) and will need to adjust his diet or put him back on IV if it stays that way. We have not heard back on what the evening blood work results were.

Upon arriving at our Ward room I guess James felt more at home as he suddenly perked up. He actually played with some toys, ate some spagetti and drank some juice (more then normal for James). He did also perk up a little yesterday evening, so it may not last long, but he didn't perk up near this much. Unfortunately with this perkiness we seen his breathing head even higher, so maybe an unperky boy is a good thing for a bit longer ... but he looks so sad and pitiful that way.

I also had an OB appointment today ... rather handy being in the same hospital ... as far as we can tell all is going well on that end.