Sorry for the lack of a post for a while. It has been hard to know what to write because even Will's doctors are stumped at the moment.
They tried unsuccessfully to tap him yesterday, getting only a tiny bit of real thick fluid. His x-rays still weren't looking good and he wasn't oxygenating very well, however, so they took another look and saw that there indeed was fluid there. So, they tapped him again last night late (10:30 or 11) and got 45cc off. They think when they tried earlier they weren't in the right place, or were in a pocket that has formed because of scar tissue that didn't really have much of anything in it. His x-ray after that improved a little, but not like they'd hoped. They looked again this morning and it looks like he has even more fluid there already. They don't know why, but it seems to be getting worse now, not better. That might just be because the fluid flows at different rates, sometimes more, sometimes less, and that last night's tap came coincidentally before a point where it was going to flow more.
So, right now they are tapping him again. They've outlined a course for today where they are going to try to be more aggressive about tapping him before he needs it (much like they've done before), increasing his dopamine again (they had been trying to wean it a bit) to get his blood pressure up to get him peeing more (only 10cc in the past 24 hours) and might try him on a different ventilator, a conventional one that might inflate that left lung a bit better. If that works, great. If not, they'll look tomorrow at the possibility of putting the chest tube in after all and of increasing the octreotide. We're not crazy about either idea, but have told Dr. Colaizy that she needs to do for him what she thinks is best to get him well.
On top of all that, they're putting an IV line in his head right now because the veins in his arms are too damaged from all of the other IVs to allow them to put one there. He needs a blood transfusion to get his hemoglobin levels up, and that's the only place to put it. It's fairly routine, they say, but we still don't like the idea of them doing it. It'll just be in one of the veins in his scalp, and they'll keep it in as long as it stays good.
So, another day of waiting and hoping that all of this stuff they're throwing at him will work. We've been here before and Will has responded, so we can only hope that will be the case again. That said, if you hadn't seen his x-ray or heard from a doctor that the fluid was reaccumulating and that they were concerned, you'd think he was doing OK. Despite it all, his oxygen needs aren't much higher than in the past few days, his blood pressure is pretty good, his heart rate is good and he seems to be handling this well. It's sad to say, but this is normal for Will, and he has proved to be a tough little guy who just rolls with the punches.
They tried unsuccessfully to tap him yesterday, getting only a tiny bit of real thick fluid. His x-rays still weren't looking good and he wasn't oxygenating very well, however, so they took another look and saw that there indeed was fluid there. So, they tapped him again last night late (10:30 or 11) and got 45cc off. They think when they tried earlier they weren't in the right place, or were in a pocket that has formed because of scar tissue that didn't really have much of anything in it. His x-ray after that improved a little, but not like they'd hoped. They looked again this morning and it looks like he has even more fluid there already. They don't know why, but it seems to be getting worse now, not better. That might just be because the fluid flows at different rates, sometimes more, sometimes less, and that last night's tap came coincidentally before a point where it was going to flow more.
So, right now they are tapping him again. They've outlined a course for today where they are going to try to be more aggressive about tapping him before he needs it (much like they've done before), increasing his dopamine again (they had been trying to wean it a bit) to get his blood pressure up to get him peeing more (only 10cc in the past 24 hours) and might try him on a different ventilator, a conventional one that might inflate that left lung a bit better. If that works, great. If not, they'll look tomorrow at the possibility of putting the chest tube in after all and of increasing the octreotide. We're not crazy about either idea, but have told Dr. Colaizy that she needs to do for him what she thinks is best to get him well.
On top of all that, they're putting an IV line in his head right now because the veins in his arms are too damaged from all of the other IVs to allow them to put one there. He needs a blood transfusion to get his hemoglobin levels up, and that's the only place to put it. It's fairly routine, they say, but we still don't like the idea of them doing it. It'll just be in one of the veins in his scalp, and they'll keep it in as long as it stays good.
So, another day of waiting and hoping that all of this stuff they're throwing at him will work. We've been here before and Will has responded, so we can only hope that will be the case again. That said, if you hadn't seen his x-ray or heard from a doctor that the fluid was reaccumulating and that they were concerned, you'd think he was doing OK. Despite it all, his oxygen needs aren't much higher than in the past few days, his blood pressure is pretty good, his heart rate is good and he seems to be handling this well. It's sad to say, but this is normal for Will, and he has proved to be a tough little guy who just rolls with the punches.
posted by John Kenyon at 1:50 PM
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