Well, it's alright, if you've got someone to love,
Well, it's alright, everything will work out fine.
Well, it's alright, we're going to the end of the line.
--Traveling Wilburys, "The End of the Line"
Since I'm a big Tom Petty fan, and I also like Roy Orbison and Bob Dylan, I've always liked the Traveling Wilburys, especially this song. I've tried to work it in as a blog title before, but Jen hasn't gone for it. She's off getting some time with Luke and a nap, since last night was kinda long. So you're stuck with me and my song choices.
The end of the line I'm talking about today is the end of Jay's IV lines. Now don't get too excited, he still has an arterial line and a PICC line (a long catheter that goes from about his elbow up the vein to almost his heart) and 9 different IV pumps. He has had trouble maintaining a peripheral IV line. He's had three different ones in his right arm and one in each foot. With each one he keeps getting phlebitis--inflammation of the vein--sometimes as quickly as 24 hours after it is placed. One of the drugs he is on (amioderone) to control his heart rhythm is extremely irritating to the vein. Ideally it would be given through his PICC line so it would go into a large vessel, but he already has too many other things running through that line that have to go there. So he has to get this drug through the small peripheral IVs. Today they came to put in another one, and realized that they didn't have anywhere left to place one. So no more catheters in his hands, arms or feet.
Coincidently, the docs are weighing how much to feed him by mouth, and if they can switch some of his IV meds to oral. Fortunately, amioderone comes in an oral liquid as well, so after a consult with the electrophysiology team (heart electricians), he is going to be getting this through his nasogastric feeding tube. We have asked how long he will need this drug, since he only had a brief period of arrhythmia and had no heart rhythm issues prior to his surgery. The answer we got was (more or less), "Until someone has the cajones to stop it." Based on how bad his arrhythmia was, that's going to be a while. By the way, here's a photo of his ECG from that night.
And there's about 30 feet of paper that looks pretty similar. So, yeah, he's going to be on amioderone for a while.
Since they are now thinking about giving him some food orally, he got a visit from the speech therapist to check on his ability to swallow. We quickly became fans of her because she graduated from NC State, and her parents live down the road from us. Jay became an even bigger fan when she broke out the applesauce. He can't drink liquids real well yet (the CPAP forcing air through his nose doesn't help), but he did great with the applesauce. No coughing, and he opened his mouth to ask for more. Tomorrow, she promised guacamole.
This afternoon, he did try to talk some more, and we got both a "Daddy" and a "Mommy." Even better, he smiled. A real, toothy, two-year old smile. Credit for the smile goes to both Jen's coworkers who sent up some toy tools (along with a wonderful box of additional goodies--Thanks!) and my mom. He reached out to get tools, and with some encouragement pretended to saw off Granna's (my mom) finger. When her finger disappeared, he smiled. We couldn't help ourselves--we had to do it over and over again.
It is amazing how much of a roller coaster this is for me and Jen. Yesterday, in spite of getting Jay off the vent and getting to hold him, I just couldn't feel positive. I was going to write a blog post, but the only songs I could come up with were "Comfortably Numb" by Pink Floyd, "I'm Tore Down" by Eric Clapton, or "No One Ever Told Me" by John Lennon. I couldn't help but think about all the additional hurdles Jay has. Most of that seemed to come from a lack of sleep (we were up all night the night before since they extubated him at midnight) and too much time hanging out in the CICU. The gloomy rainy weather for the past several days didn't help either. After getting out to the RMH, getting a good night's sleep, hanging out with Luke, and seeing the sun again, I'm in a much better mood. That smile didn't hurt either.