Pause

Andrew had another really rough day today. He had continued signs of infection in his blood tests and continued respiratory distress. High CO2, low oxygen saturation, and low lung volumes accompanied by high heart rate, high blood pressure, and general discomfort. All the problems seemed tied to him "clamping down," whether voluntarily or involuntarily. Though neither is really his fault, the respiratory issues are all tied to other larger issues.

They still don't know exactly what the problem is, but it likely involves his digestive tract. With the blood in his diaper yesterday, the possibilities include colitis (colon inflammation) or something similar. So far there haven't been any similar signs today, so it's possible the inflammation has subsided a bit. There are also several worse possibilities, but none of the tests (blood cultures, belly x-rays) have so far pointed to these options. That being said, the only thing we really know is that we're not sure exactly what's going on.

We do know that whatever is going on, it's having a detrimental effect on his lung situation. He's fragile, and a problem in one system can cause other, seemingly unrelated, problems. Today, those problems required several doses of sedatives and paralytics, extra oxygen, and a higher rate on the ventilator. In the end, after several 'episodes,' they decided to be proactive rather than reactive. Instead of waiting for Andrew to cause a problem and then trying to catch up with drugs, they've decided to put him on 'pause' until his body has time to recover on its own.

So, he's currently on a constant drip of narcotics and paralytics. This requires that the ventilator be turned up to full support (30 breaths per minute), but it also means that his body doesn't have to focus on breathing. It's free to fight off the infection, heal completely from the surgery, and start back up his normal digestive processes. He's back on antibiotics and temporarily off all feeds. His numbers (oxygen/CO2) all look pretty good, though that's to be expected at such high vent settings.

We don't expect this to turn into another month-long ordeal like the last time he was fully sedated. Hopefully the antibiotics will take effect and his infection will clear up in a couple of days. Then they'll let him come out of it and wean back down on his settings.

Needless to say this wasn't the best way to end an already exhausting week. The vibe in Andrew's room has been somewhere between somber and grim; the doctors have also spent far too much time in there recently. It's been scary, and he's not out of the woods yet. Until they either identify the problem and fix it, or until his body has a chance to heal, there's always the chance of worsening issues. Andrew (and we) definitely need some rest....hopefully it will be a relaxing, positive weekend.