Sunday, June 7, 2009

Day 3 Update

Last night was a relatively peaceful night. Cain rested well for the most part. His blood pressure stabilized for most of the night. His O2 was decreased to .5 L as his oxygen saturations started to stabilize, they adjusted his pain meds for optimal control, and continued periodic suctioning to clear mucus from the breathways that had developed in response to inflammation from being on a ventilator. Additionally, his temperature stopped spiking. They removed his cerebral O2 monitor, so we are seeing more and more of his face again.

Cain's new sign for his room that Curry (one of the nurses) made for him.

This is a view of Cain's room from out in the hall.

The majority of the morning went well. His chest x-ray this morning did not show much improvement since yesterday and his lung fields continue to look "wet", so one of today's objectives was to continue to get some of the fluid off of Cain's lungs, making it easier for him to breath. Dr. Glenn, a member of Dr. Bichell's surgical team, came to look at Cain and they removed one of his chest tubes since it was no longer draining. Cain also finally had some "food" today. He took about 50 mls of Pedialyte.

They informed us today that some of the pain Cain is having may be related to the way his blood now passively flows to the lungs from the upper body. It meets resistance in the lungs and can cause an increased back pressure that pushes back to the head causing migraine like symptoms. Unfortunately, the pain medications do not help much for this and it will take a few days for the body to adjust to its new anatomy and the venous blood flow to adapt and then the migraine like symptoms should subside.

I took this picture as we were walking back from lunch. It was too pretty to not share with you.

Since all was going well, we walked across the street to get some lunch, but when we returned things were not so rosey as Cain appears to have hit another speed bump in his road to recovery.
His blood pressure continues to spike and his O2 saturations dropped. His IV BP meds were increased and they increased the amount of oxygen he is receiving, but this did not improve his situation very much. After listening to his chest with a stethoscope they noticed that the left lung sounds were diminished which caused concern that his lung may have collapsed. Another chest xray was performed and fortunately it had not; however, the chest x-ray did reveal a small area of atelectasis (lung not fully inflated) in the left lung behind the heart. Possible reasons discussed included Cain's heart currently being enlarged and pressing on this area of the lung combined with his breathing shallow breaths because this may be painful for him to take deeper breaths. A new machine was brought in called the Vapotherm which provides oxygen in a molecular vapor with nearly 100% humidity at body temperature. This warmth and humidity allows Cain to receive oxygen at a much higher pressure and flow rate. Additionally, they continue to give him additional breathing treatments and periodic suctioning to keep his airways open.

There were times today when Cain looked like this....resting peacefully!

But a lot of the time the poor guy had this expression. Throughout the day he would let out a whimper and make a face where you could tell he was not comfortable at all. It just broke my heart to see him like this.

Little man is having a tough day, but there is nothing going on that they have not seen before. Although these hiccups are not expected, they are not necessarily unexpected. Cain is a tough little guy, but overall progress is still positive.


Tiffany Lockette said...

Oh my goodness, what a precious, precious little boy. Keep fighting Cain!! I will pray for these hiccups to subside and for Cain's recovery. He is beautiful..or should I say handsome. Keep being strong and keep the faith.

Tina said...

Greg and I have been thinking about you guys. I am so glad you are keeping your blog updated. I have been checking it all the time. I don't want to bother you with phone calls, you have enough on your plate and I am sure your phone is ringing off the hook. I do want to bring you some dinner soon. We are keeping Cain in out thoughts and prayers. He is a tough guy and I can't wait to introduce him to Luke. :) Hugs!!

Katherine said...

We are praying for you and hoping for a speedy return home! Katherine


I was at Vandy today in the burn center and I went to get lunch and saw the childrens hospital and stopped and said I special pray for your little man