Sunday, August 30, 2009

Port-a cath....Check!

Kaitlyn had her port-a-cath placed this past Thursday! She made out fantastic!! Her surgery took about two hours and she was taken straight to PICU afterwards. We wre allowed into PICU before they extubated her. I wanted to be the first to assess her before they pulled the intubation tube. She was starting to wake up, looked good and lungs sounded clear so we went ahead and pulled the tube! We put her right on bi-pap and she maintained sats of 100% (perfect). Overall this surgery has been one of our easiest :o) She had a bit of discomfort for the first couple of days from the incision in her chest and the cut down on her neck, but nothing that couldn't be managed with a little bit of tylenol.

Because Kaitlyn has a history of blood clots (in both groins...both venous and arterial!!) she will need to remain on anticoagulation meds for as long as she has an indwelling catheter! It seems as though this may be the toughest part of placing the port for Kaitlyn. The haemotologist has her on warfarin to extend her clotting time to prevent clots forming around her indwelling catheter. For the first 24 hours warfarin acts as a coagulant instead of an anticoagulant!!! So we had to have Kaitlyn back on Enoxaparin injections. We were allowed to bring her home Friday night, but only on a pass. They couldn't discharge her properly as they needed to check her INR levels Saturday and the labs aren't open on th weekend for outpatients. When they checked her INR levels (to see what her clotting rates were) her level was 8!!!!! They want her level to read between 1.5 and 2!! Crazy. She had to have a dose of oral vitamin K through her G-tube and we had to stop both the Enoxiparin and the warfarin for Saturday night. Then we got to come home Saturday night again on pass from the hospital as we had to take Kaitlyn back into the hospital to have her levels checked again Sunday morning! Kaitlyn's INR level was 1.6 Sunday morning which is exactly where we want her.

This also means that we were finally discharged from hospital and Kaitlyn is back on the warfarin. We have to have her levels rechecked on Tuesday and I'm hoping that her levels are fine by then too. Once she is regulated on the warfarin she will only need once a month checks to make sure that her levels are fine. Her levels shouldn't change too much from day to day as Kaitlyn's diet never changes. The only time we will have to have her levels checked more often would be when she is ill or when she is taking an antibiotic.

Anyway we are thrilled with how she has done so far and are hoping she continues to do well with this port! It sure will make things easier for her when she needs venous access!

1 comment:

Devon said...

YAY! Great job, Kaitlyn! Keep getting better and I hope the blood issues stay in good ranges!