Poked

If there was a word to sum up Karsie's day today... it would be "poked."

Let me rewind and start from yesterday afternoon.
When we left in the afternoon, Karsie needed to get another IV (this makes #6 since being readmitted). We came back in the evening and she had the IV and was getting a really low dose of TPN and lipids. We felt pretty good about the extra fluids and calories. Karsie ate like a champ yesterday and last night and today. She has handled her feeds fairly well with her usual occasional sit-ups. Today the doctor called and wanted to put in a PICC line (an IV that goes into a central vein). This way Karsie wouldn't have to have a new IV every other day. A PICC line is also ideal for TPN because the TPN itself can cause tissue damage if it leaks out of the IV, therefore a central line is better. Getting a PICC is a sterile procedure, so we stayed until the ladies found some good veins to try for the PICC and then we said goodbye. A little later, we got a call saying that after 4 tries, the ladies couldn't place a PICC and were not going to try any more. We got in to see Karsie this evening and she has a new little bald spot on her head and 4 different bruises from the attempts... and no PICC. While we were visiting, the nurse was concerned about the IV that she had in her arm, and so the nurse practitioner was going to try for another PICC line in her leg. We are hopeful that this one will work as Karsie is running out of good veins for IV's and we don't want her to be poked anymore than really necessary.
Tonight at midnight, her volume goes up to 60mL every three hours and we are hoping she will continue to handle her feeds with minimal spit-ups.

The TPN has given Karsie a little boost in energy and the nurses would agree that her personality is back to her normal NICU-self (still different than her home-self).