I heard from a few subscribers today about no update going out last night. Sorry about that–we didn’t get the post up before the automated send deadline. Thanks for your dedicated reading. I noticed today on our stats site that Rudy’s Beat crossed over 25,000 hits today. Wow, that’s amazing! The support and interest in our little warrior is overwhelming.
We had decided not to mention the possibility of extubating Rudy this morning as I’m not sure how many nights we’ve left with that being the plan only to have a change in course overnight. Unfortunately, that was the case again. Rudy had a great day yesterday–alert with consistent numbers where they all should be–so they were going to steadily dial down the vent overnight to see if they could get to 8 bpm by 6am. A routine chest Xray at 4am (if there is anything routine about an Xray at 4am) showed a plural effusion on his right side–fluid on his lungs. The drain on that side had fallen out yesterday and the team decided not to replace it, but took the course of monitoring things closely.
The good news is that the accumlating fluid was detected quickly before other signs of distress kicked in. The ventilator was bumped back up and he underwent a procedure this morning to install a new drain (more generic bears again). All of the numbers have held fairly well during the day, so the main issues we had to overcome were the sedation that knocked him out most of the day and the always closely-monitored flow of urine. We’re still waiting for the latter to come back where it needs to be to let us know his kidneys are OK, but we’re glad that Rudy woke up and joined us again about an hour ago–the good kind of awake, where he can focus and looks at me with quiet, patient but questioning eyes. We can drive ourselves crazy if we focus too much on getting that horrible tube out of his mouth. Tomorrow!? Tomorrow!? Tomorrow!? Dr. Harrison came on today and like everyone else, he’s optimistic but wisely non-committal as to a timeline. I was able to extract a promise from him that it’ll certainly be out by Rudy’s first day of kindergarten.
We’ve noticed a respectful debate emerging between the Cardiology and the ICU docs regarding Rudy and the ventilator. The former would want a quicker wean while the latter argue for a more gradual process (Note–if Reemtsen ever teaches swimming lessons, verify that his pool has a shallow end before you sign up your kids). I am grateful that multiple minds, each holding their own perspectives, are involved in this key discussion.
UPDATE–THIS JUST IN!!! As I’ve been typing Dr. Mary (pronounced as the French–”Marie”) came in and discovered 10ml in the pee tube. Yahoo! She also reported that Dr. Harrison feels that Rudy is far enough out of the woods on any intestinal issues that they can start some powerful medication for his chylothorax (the liquid that keeps collecting on his chest). This will hopefully stop the fluid from collecting over the next few days so we can get rid of the drains and reduce the risk of infection from them.
We said goodbye to Robin and “Papa”, her baby boy, today. They arrived just a few days after us from Lompoc and were part of our temporary community that formed here over the last month in the ICU. We feel a bit like year-round residents in a resort community of some kind. The neighbors come and go every few days, but we’re still here. We wave to them from the front porch as they drive away. Blessings, peace and health to you, Robin and Papa!