Re: How to deal with death of toddler death on picu..
Let me tell you the story of Daisy. Daisy was admitted 2 days before Christmas, with a history of fever, lethargy and some impressive bruising and petechiae. On CBC, she had WBC >100K with majority blasts- ALL. She was admitted to our unit, alert but puny. She was spunky enough to draw pictures for the staff and to dress in her 'fancy' PJ's. Daisy's appearance did not reflect the rapid and deadly changes taking place in her fragile body. At noon, her tumor lysis labs were normal. We were superhydrating her, giving Rasburicase, and preparing for pheresis ASAP. Within four hours, a dramatic change took place. Daisy became agitated and unconsolable, crying with belly and leg pain. Labs revealed the truth- her uric acid was off the chart, her renal function was deteriorating rapidly and the potassium and phosphorous were critical. We emergently intubated her and started CVVH within 1 hour- a feat, I can tell you. We were all hopeful we could stop the cascase of tumor lysis, but the arrythmias we prayed not to see began to skip across our monitor. Sinus tach, PVC's, V tach- We did everything to bring her K down, but we could not. As VFib and its subsequent shocks and meds were delivered, I knew. She was not going to survive.
We had a child who was drawing 12 hours ago and now- she was dead. I cried more with this family than I have ever cried with anyone else. Unabated tears and profuse professions of sorrow went on for hours. I knew we did all the right things clincally, and our patient died.
This happend over two years ago, and I can now recall the details without feeling the intense pain of the past. Daisy has become part of my history. Her story inspires me to continue to do the right thing, every single time.
I encourage you to continue to talk about your feelings with friends. Journal about your feelings. Take special care of yourself when these bad things happen. Allow yourself to spend a day in bed watching movies and eating popcorn. Don't be surprised if you find yourself very tired or moody without knowing why, even several days after a sad event happens. Reflect on your month and note stressful events. The results don't often show themselves immediately. If all else fails, find a great professional counselor to dump on.
Press on, dear friend. You can survive, if you determine to care for yourself well while caring for others. And for pete's sake- watch an episode of SNL and laugh your *** off- my therapy of preference every time.
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