June 2009 Hospital Stay... So Far

The who, Seven Bobby Pavkov, and where, at Phoenix Childrens Hospital Intensive Care Unit are all laid out. The what right now is Hypernatremic Dehydration. The why and how are not yet fully explored. Right now the most important aspect is just getting his electrolyte levels within the normal range. We'll get to the Guinness Record Inducing dramatic moment in a minute but let's go back to the beginning...



On Thursday, there was a runny nose with clear drainage. He also stopped "tolerating feeds," meaning he started gagging when the feeding machine was on. And then, he would push all his food (and bile) out through the burp tube when applied. On Friday, Seven's mucus had thickened and turned yellowish and a strange colored substance was excreted from his stomach through the burp tube. I took him into the Special Needs Clinic to see his pediatrician. Dr. Wendy tested the substance to see if it were blood, which might suggest there was a blockage in the intestines. That test was negative. We settled on the possibility of it being a virus, with the agreement that I would bring Seven back on Monday if he got worse. We would then check urine for an infection. I resumed Pedialyte feeds all day Friday and Seven acted fussier. Friday night was not very good. Jarrad woke up in the morning to a horrible diarrhea and urine mess. Seven appeared gray and had a seizure Saturday morning. Saturday night was not much better and Sunday a fever developed. I don't think Seven was awake for more than a few minutes all day Sunday.



In hindsight, we now realize the stars aligned in a perfect way to prevent a possibly fatal situation. On Monday, Jarrad did half an hour of cardio in the morning, ate a salad at lunch, and then did another hour of cardio that evening. I then proceeded to feed him another salad for dinner with fish as the only protein. He cursed me all night as he tossed and turned in bed hungry. At 2:00 am he heard Seven grunting and breathing funny. He woke me and we went to check on him. Seven was a limp sack of potatoes when I picked him up. He was breathing fast and shallow. His nose was a very deep shade of purple. His eyes were open, but he wasn't reactive. We did a few breathing treatments, trying to slow and deepen his breaths, to no avail. We also checked his pulse ox and he was at 94% oxygen level but 188 bpm (heart rate.) We woke up Ocean and threw ourselves into the car and headed to Phoenix Childrens. (We're so glad we are only a few minutes away now!) We rushed in to the ER and they immediately bagged him. Because Seven wasn't able to continue to breathe for himself, he was intubated and placed on a breathing machine. Seven at this point was at his limit for being able to handle his situation. We were admitted to the Intensive Care Unit for Hypernatremic Dehydration and there we currently reside. At the present, we are just focusing on trying to even out his electrolyte levels. His nose is back to a rosy pink color. He is however obscenely swollen. He looks like the Stay Puff Marshmallow Man. Giving a lot of IV fluids is essential to reducing the sodium level. Yesterday he was given quite a bit of medication to keep him sedated. The medicine is still lingering and Seven is sleeping comfortably. He has several IV ports in place and just this morning was given a femoral central line.



Here's the kicker, the Guinness Book of World Records moment. When blood was tested in the ER, the sodium level came back at 202. Surely that is a mistake, everyone thought! Normal sodium levels are 138-145. 170 is an emergency level. 202 doesn't even seem humanly sustainable. A mistake it was not. After several tests from different places in the body, 202 was confirmed. We are rallying to get a special plaque put up honoring Seven's accomplishment. Lots of doctors around were trying to convince us it wasn't possible to have 202 and still be alive, or at least not be continuously seizing. They ate those words once they found out it was true.



Still in the PICU as of Wednesday, we are working to correct all of the electrolytes that are off. We are still in the "dangerous level" but we are heading in the right direction. If we move too quickly, the brain and body won't tolerate it. We got up to these levels slowly and we need to go back to normal slowly. Lots of ideas are being thrown around and tested to try and understand why we got this bad. 202 is not really that fathomable, and we don't ever want to get here again, so its important to know how. However, the priority is stabilizing so we will work harder on how and why later.