Josesh needs for his oxygen level in the blood to continue to increase so they can start weaning him off the oscillating ventilator and onto a normal ventilator. Long ventilator use leads to other health concerns. He needs for his pulmonary pressure to go down so he can be weaned from the Nitric Oxide. He needs for his bowels to start working again so the gas stops building up and he doesn't rupture a bowel. He needs for his cranial ultrasound (tomorrow) to show that there is no bleeding in his brain. He needs for the tumors on his heart to not grow or multiply and ideally resolve themselves/dissappear.
Your prayers are appreciated.
Monday, May 30, 2011
Sunday, May 29, 2011
Joseph update 5/27/11
Joseph is now off dovutamine, epinephrine, and dopamine and his blood pressure is staying good.
He's taking two antibiotics but at this point they are just finishing the courses they started at check-in. All tests for infection have come back negative
He's taking one antiviral. They are waiting for the tests for viruses to come back still but told me it is extremely unlikely that he will have a virus at this point.
He is still on the high frequency ventilator. The blended air they are sending him is around 35% and his oxygen saturations are staying together and in a good range.
Lung development is the next hurdle. The last echocardiogram showed his pulmonary blood pressure being near the same level as his systemic bp. It should be 25 % of the systemic. This is an indication that his lungs need some development. The way I understand this is that the alveoli in his lungs are not compliant enough and they are creating pressure on the pulmonary arteries through the lungs. I'm being told that it is likely that the lung compliance will improve over the next days. They are doing another echo in the morning. In the meantime, they are putting nitric oxide into his air. Nitric oxide relaxes the muscles in his pulmonary arteries and causes them to open more.
He's taking two antibiotics but at this point they are just finishing the courses they started at check-in. All tests for infection have come back negative
He's taking one antiviral. They are waiting for the tests for viruses to come back still but told me it is extremely unlikely that he will have a virus at this point.
He is still on the high frequency ventilator. The blended air they are sending him is around 35% and his oxygen saturations are staying together and in a good range.
Lung development is the next hurdle. The last echocardiogram showed his pulmonary blood pressure being near the same level as his systemic bp. It should be 25 % of the systemic. This is an indication that his lungs need some development. The way I understand this is that the alveoli in his lungs are not compliant enough and they are creating pressure on the pulmonary arteries through the lungs. I'm being told that it is likely that the lung compliance will improve over the next days. They are doing another echo in the morning. In the meantime, they are putting nitric oxide into his air. Nitric oxide relaxes the muscles in his pulmonary arteries and causes them to open more.
Friday, May 27, 2011
Joseph update 5/27/11
Joseph update 5/27/11
All tests for infection have come back negative with the exception of test for fungal infection which is still pending but highly unlikely that he will have this type of infection.
Lung development is the big issue now. They believe the pulmonary arteries in the lungs are either constricted, underdeveloped or both, creating pressure on the right side of the heart that causes a valve to open in order to relieve the pressure. The valve sends the blood around the left side of the heart. The left side of the heart needs this blood in order to maintain the blood pressure to the body. The result is that they have to control blood pressure using medicine that dilates the vessels. He is on 3 different types of medicine that do this. He's been on maximum doses of all of these until last night. As his blood pressure rises, they are slowly weaning him off these medications.
The other issue that he is having is with the mechanics of breathing. It is stressful for him to squeeze and relax his lungs. They put him on a normal ventilator but that wasn't working well. So they put his on an oscillating ventilator that gives him 720 small breaths per minute. Additionally, the ventilator gives a constant stream of air that works to keep his lungs more open than a traditional ventilator. This is needed to keep his lungs from collapsing. His lungs want to collapse because the air sacs in the lungs (alveoli, 250 million of them) don't have enough surfactant due to the fact that he is premature and not producing this chemical yet. The ventilator was set to 100% oxygen. I believe this is largely due to low blood pressure. When the blood pressure gets low, the brain gets preferential treatment. The result is that the amount of oxygen measured at the left toe may be significantly lower than that measured at the right hand. By putting 100% oxygen in the lungs they can help keep oxygen to the extremities. Currently they have weaned the oxygen 65%.
We're putting the heart "tumors" on the back burner until we have dealt with the more immediate issues.
All tests for infection have come back negative with the exception of test for fungal infection which is still pending but highly unlikely that he will have this type of infection.
Lung development is the big issue now. They believe the pulmonary arteries in the lungs are either constricted, underdeveloped or both, creating pressure on the right side of the heart that causes a valve to open in order to relieve the pressure. The valve sends the blood around the left side of the heart. The left side of the heart needs this blood in order to maintain the blood pressure to the body. The result is that they have to control blood pressure using medicine that dilates the vessels. He is on 3 different types of medicine that do this. He's been on maximum doses of all of these until last night. As his blood pressure rises, they are slowly weaning him off these medications.
The other issue that he is having is with the mechanics of breathing. It is stressful for him to squeeze and relax his lungs. They put him on a normal ventilator but that wasn't working well. So they put his on an oscillating ventilator that gives him 720 small breaths per minute. Additionally, the ventilator gives a constant stream of air that works to keep his lungs more open than a traditional ventilator. This is needed to keep his lungs from collapsing. His lungs want to collapse because the air sacs in the lungs (alveoli, 250 million of them) don't have enough surfactant due to the fact that he is premature and not producing this chemical yet. The ventilator was set to 100% oxygen. I believe this is largely due to low blood pressure. When the blood pressure gets low, the brain gets preferential treatment. The result is that the amount of oxygen measured at the left toe may be significantly lower than that measured at the right hand. By putting 100% oxygen in the lungs they can help keep oxygen to the extremities. Currently they have weaned the oxygen 65%.
We're putting the heart "tumors" on the back burner until we have dealt with the more immediate issues.
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