Seriously, a line infection?

If you are keeping track...Ryder turned 6 weeks old yesterday!  Just to make sure we are not losing sight of child development here ... from babycenter.com "Your baby may not be able to talk yet, but his face is sure telling you a lot. He's experimenting with different facial expressions — pursing his lips, raising his eyebrows, widening or squinting his eyes, and furrowing his brow." 

As a parent, of course, you need to keep in mind these cues when trying to figure out what your baby is telling you...because obviously, each baby's temperament is different.  So here goes:
Pursing his lips = "Mom, why did you let them stick this straw back down my throat?  In case nobody told you, this is NOT a pacifier"
Raising his eyebrows = "Umm, precedex?  What happened to the morphine, versed, ativan and methadone. This stuff is crap."
Widening or squinting his eyes = "What was that???  Oh, my ventilator alarm.  Nope, IV line pressure increasing alarm."
Furrowing his brow = "Seriously, a line infection?" 

Yep, unfortunately Ryder celebrated his 6 week birthday with a PICC-line infection.  E. faecalis for my medical buddies.  He had 1 random fever the night before that didn't recur after his warmer was turned off.  Good thing for that little fever though which prompted the blood cultures...he otherwise showed no sign something new was going on, wbc ct nml, blood pressure fine (actually he is still on nipride to keep it down).  Maybe that's why he was having trouble weaning off the ventilator?? Who knows.  Also for my medical buddies:  He was started on vanc initially, still awaiting sensitivities, gent added today for synergy.  Overall he seems to be just fine, no more fever, vitals all fine.  His art line and peripheral cultures drawn when the vanc was started were positive and new ones were sent from his lines today. 

Everyone asks if it's hard being the parent if you are also a doctor.  Mostly, no.  HLHS RAS/Norwood/EdI/ BT shunt/blah blah blah.  If I learned any of that it is filed WAY back there and Wikipedia is far more accessible.  This new problem is a tough one though!!  CVC infection = remove line pronto.  Less palatable though when your little guy has to have his upper central vasculature preserved for his future surgeries and it's just sad when you have to put in a new IV right?  So no complaints right now that his vanc is infusing via the Enterococcus-slimed PICC line.  What about length of therapy?  Hmm.  He has the following foreign bodies right now:  BT shunt, pulm artery patch, atrial thrombus, PICC, art line, shrapnel from his fetal procedure in the RV, temporary pacer wires.  Yikes.  Longer seems better, but not thinking home IV therapy is popular in pediatrics.  But that's too far in the future to get wrapped up in.  Today, just waiting for the sensitivities and new cultures.  No Infectious Disease consult yet.  Actually, our esteemed surgeon was mocking me yesterday when they decided not to order one.  He should know the world couldn't function without ID consultants to take medical histories.  It's also possible that they took into consideration the fact that we would review the treatment plan with at least a dozen ID consultants anyway :)

For now, prayers for dying bacteria, progress on the ventilator and more diuresis (yes - sometimes if you are here long enough issues repeat themselves)...staying positive though - he is NOT septic and he seems very comfortable tonguing his endotracheal tube...too comfortable...come on Ryder- it's the PEDIATRIC ICU - keep it G - rated!!!