Day +55
WBC 4.9
Max had a good night and good day so far. His oxygen is now down to 40% and this afternoon they lowered his rate on the vent from 22 to 20 (breaths per minute) . As I write this, the doc is about to lower his setting to 18. He is not breathing over the vent when he is asleep. When he rouses a bit for diaper changes or vitals he takes some spontaneous breaths. He is going to have a bronchoscopy sometime tomorrow. They will try to open up the right upper lobe of his lung that has been collapsed for quite a while. They will also check cultures.
Dr. Sweeney, the ICU attending and anesthesiologist, has been brainstorming to try and figure out what is going on with Max. He is going to suggest a study of Max's upper GI to see if reflux is causing the breathing problems. When he is nearing extubation ENT will talk to us about scoping him in the OR.
They have been weaning him off of his Terbutaline (IV bronchodialator) all day and just shut it off. Now maybe they can remove the IV he has in his scalp. We should know shortly after the results of his next blood gas.
He has had a strange rash in his diaper area, unlike one we have ever seen. It also appeared on the back of his neck. The docs feel it is yeast and are treating it with Nystatin cream. Dr. Charnas, Max's neurologist, came by today and said Max is looking good from a neurological perspective. He would normally do an MRI when Max is 90 days out of transplant, but may take advantage of Max's current intubation and do an MRI now. The BMT docs will be discussing this with him.
That's it for now. Keep praying for progress for Max and all of our friends here in MN.
-Margaret
Max had a good night and good day so far. His oxygen is now down to 40% and this afternoon they lowered his rate on the vent from 22 to 20 (breaths per minute) . As I write this, the doc is about to lower his setting to 18. He is not breathing over the vent when he is asleep. When he rouses a bit for diaper changes or vitals he takes some spontaneous breaths. He is going to have a bronchoscopy sometime tomorrow. They will try to open up the right upper lobe of his lung that has been collapsed for quite a while. They will also check cultures.
Dr. Sweeney, the ICU attending and anesthesiologist, has been brainstorming to try and figure out what is going on with Max. He is going to suggest a study of Max's upper GI to see if reflux is causing the breathing problems. When he is nearing extubation ENT will talk to us about scoping him in the OR.
They have been weaning him off of his Terbutaline (IV bronchodialator) all day and just shut it off. Now maybe they can remove the IV he has in his scalp. We should know shortly after the results of his next blood gas.
He has had a strange rash in his diaper area, unlike one we have ever seen. It also appeared on the back of his neck. The docs feel it is yeast and are treating it with Nystatin cream. Dr. Charnas, Max's neurologist, came by today and said Max is looking good from a neurological perspective. He would normally do an MRI when Max is 90 days out of transplant, but may take advantage of Max's current intubation and do an MRI now. The BMT docs will be discussing this with him.
That's it for now. Keep praying for progress for Max and all of our friends here in MN.
-Margaret
posted by Mike Ciacciarelli
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