Saturday, September 22, 2012

CT Scan and Bronchoscopy

Finally it's the end of a very long and stressful day. Victor had his firct CT scan and bronchoscopy today. This is part of his standard care, it's basically to have a good look at his lungs and see if there are any areas where damage might have occurred, or if there is any sign of infection or inflammation. By doing these tests before he shows any signs of infection we can hopefully prevent any permanent damage to his little lungs.

Once again, our day really began the night before. I got everything ready so we could leave the house by 6.10am and set my alarm for 4.40am for Victor's last feed before he had to begin fasting. I had received fasting instructions the day before: he had to stop eating solid food from 2am (irrelevant, as he doesn't have solids yet) and could have the last breastfeed before 5am. So I woke up to feed him in time for him to begin fasting, went back to bed for an hour, then it was time to go.

We arrived at PMH at 6.45am and began upstairs in the Same Day Procedure Unit. We filled out lots of paperwork, weighed Victor and put him in a little hospital gown. The anesthetist spoke to us, as did a doctor and several nurses about what was happening today and gave us the opportunity to ask questions. Just about everyone asked the same questions, with one of them being when did Victor last eat. I told everyone who asked that I last fed him at 4.40am, but he had a tiny bit of apple puree to take his enzymes with at the time as well. I had completely forgotten about that until I had already given him the apple, but I figured that since it was such a tiny amount it wouldn't really matter. No one really seemed to know if it was okay or not, until the anesthetist told us it was fine. We went downstairs to the radiology department, where we met with more doctors and nurses.

This is where I have to mention that 99% of the time, nurses are wonderful people who do fantastic jobs and are really caring and good at what they do. But sometimes, they are not so fantastic, and unfortunately today we ran into a couple of nurses who perhaps needed to go on holiday or something.

We sat in the waiting room, and had more nurses come in to speak to us. Once again we were asked when Victor last ate, so once again I told them at 4.40am and he had a small amount of apple puree at the same time. One nurse then said "Oh. He had apple puree? Nope, he wasn't supposed to have that. Have you told anyone about that?" we said yes, we've told everyone. "They didn't tell me that," she said to the other nurse in the room. "Did you tell the anesthetist?" Yes, we answered. "Well, look, you weren't supposed to do that so we'll probably have to delay everything. We've had problems with this before, there's strict rules about it. Next time do not give him the apple puree." She decided to tell us off in a very passive aggressive way.
"So next time we just don't feed him at all then? Because we have to give him enzymes before he eats, otherwise there is just no point in feeding him as it will go straight through him, he will get a very sore stomach and diarrhea," we explained to her. She didn't actually answer that, and just kept saying that now everything would have to be delayed. Luckily, this is when the anesthetist came in and said everything was fine, the tiny amount of apple puree did not affect anything and we could go ahead as planned.

Another nurse told us that if we wanted to, one of us could take him into the procedure room and stay with him as he went off to sleep. I said that if it was okay, I would like to stay with him for that. When it was time to go in, yet another nurse came to take him. I said that I had been told I could go in with him. She asked me who had told me that, and seemingly reluctantly let me come in and stay with him as he was put under anesthetic.

I carried him into the room, which contained a CT scanner and another table, which is the one I placed him on. He smiled around at everyone as the little mask went over his nose and mouth and he wriggled around and then began to close his eyes.
"Okay, thanks for your help," the nurse said. I found that comment to be quite condescending. It felt to me as if they really didn't want me in there at all and thought I was being...not really sure...overprotective? Annoying? Either way, the feeling I got was that they would roll their eyes about me once I left. It was a really terrible attitude for them to have, especially on such a stressful day for us. I understand this procedure is not a big deal to them, but it is for me. This is the first time my baby had gone under anesthetic and the first time he'd had a procedure away from me, not to mention the fact that he is only four months old. But I knew that he would be in good hands with the doctor doing the procedure and the anesthetist looking after him.

The procedure, as described to me, was having a CT scan first to look at his lungs. This is to identify any potentially damaged areas (hopefully none) and just to have a good idea of what his lungs look like.
The bronchoscopy was next. This is where the doctor inserts a small camera on the end of a flexible tube down his throat, into his lungs. They looked at the airways to see if there were any signs of inflammation, the colour and quantity of any lung secretions, and to see if the airway stayed open while he breathed instead of flopping closed. They also squirted a small amount of saline into each lung and sucked it back up, taking mucus with it. This will be tested for various germs in the lab. The doctor also did tracheal brushings, which is scraping a few cells off the trachea to be tested for signs of inflammation.

I went back into the waiting room to join Phil and Felix, and that's when we spoke to a researcher about the clinical trials we are participating in (that's for another post).
We took Felix to the hospital Cafe and gave him some breakfast, and then we were told that Victor was all done and in recovery. I went back upstairs to wait for him while Felix finished breakfast. Phil then took him to play in the 'Megazone', the playground on Level 7.

I went in to see Victor, looking very small on a big hospital bed. He was just in a nappy, his little hospital gown had been taken off at some point, and he was wearing a peach-coloured beanie. He had an IV line placed in his hand and a monitor on his toe, measuring his heart rate. He was beginning to wake up and was seemingly disoriented and very unsettled. I picked him up but he was still very upset. I asked if I could feed him, but the nurses had just called for the Ward staff to come and get us and they didn't want me to start the feed only to be interrupted. Personally, I think that would have been worth the risk as he just became more and more upset. Not even his salt supplement helped (it usually settles him) and of course, his dummy was in the car! The Ward staff arrived and we were handed over to them and went up to the Same Day Procedure Unit.

I gave him a feed but he was still very unsettled and basically cried through the attempt. Phil and Felix arrived with the dummy, and I was able to rock him to sleep and finally he settled. The Ward nurses did a few obs, checking his heart rate and listening to his chest. He had a little bag in his nappy to collect a urine sample, so they took that off and took out his IV line and the heart monitor still on his toe. He also had a pretty large bandage right at the top of his thigh, almost in the groin area which was where blood was taken during the procedure. He woke up during this but was much happier and back to his usual self. We went home and had lunch, and then Victor had a very long nap. (So did I!)

He has been coughing a bit today, which we were told was a common side effect of the tracheal brushings they did as part of the bronchoscopy and should only last a day or two. He has also been a bit sleepier than usual, which is to be expected.

Me and Victor
The doctor told us that everything went really well, and we should get the results by Tuesday. He said that Victor's lungs are looking good, with no signs of inflammation, and not too many secretions at all. The airway is staying open as he breathes.

I was given Victor's little hospital bracelet and the tiny mask they used over his nose and mouth to keep as a 'souveneir'. Not really sure what I'm supposed to do with it as it holds limited appeal as a mantelpiece ornament...

2 comments:

  1. Wow Lauren! We were lucky to get nice nurses on our first CT & Bronch but apart from that I could relate to every single thing you wrote here! Love your blog! XXx

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    Replies
    1. Thanks Elli! I'm glad you had a good experience. Our subsequent bronchs were much better!

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