Today was both good and bad. Pat appears to have stabilized his lactic acid levels - his dialysis brought the levels down to 9 (the scale ends at 20, and he was above that last night), when they turned off the dialysis and since then his levels have been ever so slowly decreasing - they are now 7.5, or thereabouts. Also, his heart appears to be regaining some strength: the beats per minute and the strength of the beats are improving. Finally, a Doppler ultrasound of his intestines showed good blood flow down there.
Unhappily, the C/T scan and the ultrasound show that there is some minor bleeding in his brain, his brain is showing signs of swelling, and there is an area in the ultrasound that some people seem to think is an area that was damaged last Saturday night when he crashed. Others don't seem to think that the images mean that. Also, his kidneys are still not working. The doctors say that is not unexpected, and that they think dialysis can be used to carry the load for the kidneys until they can get a chance to recover themselves.
So why is all of this damage showing up now, days after he crashed? Apparently, when they cooled Pat down after putting him on the ECMO, it gave him a head start on the healing. Now that he is back to 36C, the swelling and other problems are becoming apparent.
It's a little hard to see our little boy, laying still and all swollen with the fluids he's been pumped up with. He looks like a very fat little baby. Very fat. but it's all fluid. They stopped the paralyzing medicine earlier today, but with his poor renal function and dialysis only running a little, it will be "some time" before he starts to move a little. We don't want him to move much - not with two tubes sticking out of his chest cycling all of the blood into and out of his body.
It was quite a performance earlier this evening, when we watched the nurses change shifts. Nurse Ann (whom we really like) spent almost 40 minutes reviewing all of the history, current thinking, every trace, medicine, blood chemistry, test results, IVs, and ECMO with her night-shift replacement. I was actually a bit surprised at how well I was able to follow things: I have unwillingly learned a heck of a lot these last 11 days.
All in all, he seems to be doing better now than he was yesterday. Pat is a very sick little boy, but at least he isn't an urgently very sick little boy. At the moment.
Pui and I are now getting ready for bed, and hopefully some sleep.
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I hope that you feel that the good outweighs the bad today. Did they say what they felt happened yesterday? Was the ECMO Machine not working properly?
ReplyDeleteI hope that Pat's swelling goes down steadily - it is great news that his heart is showing signs of recovery - and that the optimistic doctors are right about the brain imaging.
Hugs and all our warmest thoughts for Pat.
Hi Shannon - the lactic acid increase and subsequent drop is still a complete mystery. They have no idea why it strated or what change is making it go away. At least they aren't trying to make up explinations. "Um... Leprechauns did it!"
ReplyDeleteDear Pui and Rob, we at Unilever Thailand are following your blog everyday. P'Thip and P'Air also send their thoughts and good wishes. P'Air said สู้ สู้ , we are all behind you. my personal hope/belief is the baby body will adjust, life will find its way. have a good rest.
ReplyDeleteMoo, P'Air, P'Thip
sending hugs well wishes and prayers for Pat to heal and stay strong!
ReplyDeletewyndi steven and Izzy