Wednesday, January 19, 2011

Caleb is still up to his old tricks. When I got to the hospital this morning, he was still on the ventilator, his oxygen saturations were in the upper 60's and he was agitated.

They tried sprinting him early this morning to see if he could be extubated. He had a chest x-ray at 2:00 am and it looked great. He did well for his first sprint so they started his second sprint around 5:00 am. His oxygen levels dropped and he got so wound up it took three nurses to hold him down and calm him. They gave him morphine, Versed and Ativan. I am pretty sure that the amount of drugs that it has taken to calm him down would leave me in a drooling pile on the floor. They quit the sprint, turned the ventilator back up and took another chest x-ray and found that his left lung had collapsed.

They think that his lung may have collapsed because there was some fluid around it and his breathing may have been shallower, not allowing the lungs to fully expand. Whatever the reason, they were not overly concerned and increased the ventilator pressure to try to reinflate the lung.

Caleb's blood levels were low, so he got a blood transfusion. He was also low on magnesium and potassium, so he got some more of each of those. They decided to start his diuretics back up to get him to pee off some of the excess fluid. His weight was not up much, but they think that he needs to be drier to breathe better.

He required a decent amount of sedation today to keep him comfortable and they are suctioning a moderate amount of junk from his lungs. This junk is somewhat bloody and they are not sure why. His oxygen saturations ranged from 65 to 77 while I was watching.

At evening rounds, everyone seemed pretty happy with where he was at and I think they feel that the lung may have reinflated. The plan tonight is to keep an eye on him and if it looks like he can be sprinted again, they will take another chest x-ray to see how his lungs look. I am not holding my breath however. When I went back after supper, he was still agitated and his sats were in the upper 60's again.

Caleb may also have the mother of all headaches. Because the surgery changed his blood flow so substantially, his head has much more blood pressure than it did before. This is causing some of the puffiness in his face and sometimes causes a severe headache. When you put your hand on his head, you can feel his pulse in his entire head. It is no wonder he is uncomfortable and agitated.

We will see what tomorrow morning brings. Everyone seemed hopeful that we are on the right path and that things really do look good. The overall impression that I get is that this is not an unexpected bump in the road and it will just take a little more time.