Thursday, November 19, 2015

What if We're Chasing the Wrong Dog?

We're starting to wonder on this one.  He did grow out strep bacteria in his lungs. That part is real, but we're treating it and have been since Saturday evening.

You know how after 24-48 hours on antibiotics you're doing much better?  Yeah, well, not this time.

But his lungs sound good, really good.  All that nasty garbage that pneumonia creates in the lungs?  That's supposed to be suctioned out, except we're not getting anything.  Maybe a little bit of white stuff, but nothing special.

Oxygen is high.  Someone brought up in rounds that maybe we're chasing the wrong dog.  What if it's not his lungs?  What if it's his heart?  What if it's the pulmonary hypertension?

And then the trach whisperer showed up in my door and asked the same question.

We're maxed out on pulmonary hypertensive meds already.  There are no new ones to give him that he can stay on.

This could be a longer haul than we planned on.  We've done this before, waited and waited for massive amounts of oxygen to do their magic and bring his pressures down to where we can manage it at home.  It takes time, sometimes quite a bit of time.

But as I was going over protocols, I remembered, he's been higher.  We've had to use nitric oxide before when he's been on the hospital vent, using much higher amounts of oxygen, and still not satting well.  We're still a long ways from that.

FYI, nitric oxide is very different from nitrous oxide (laughing gas).  One you get at the dentist, it makes you feel good, they turn it off, and you go home.  The other, nitric oxide, is only used under special circumstances, closely monitored, and weaned very, very carefully.

So I guess I get to practice patience.  I'm not very good at it yet.  I'm grateful that we've been working on strengthening his heart and lungs by spending time off the vent.  I'm pretty sure that's helped keep us down where we are.  And I'm very grateful we're still worried about this, working on it.  There's only one way to guarantee we don't deal with it anymore.

And I'm not even going there.

How poor are they that have not patience!
What wound did ever heal but by degrees?
~William Shakespeare

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