Looks like today is our "one step back" day. Micah's sedation medications had been stepped down starting on Friday, hoping to take him off the ventilator yesterday. But on Saturday morning he was still having lung secretions. They could have extubated him, but then they would rely on him to cough. Micah doesn't have the most productive cough on a good day (could it be due to low muscle tone? don't know). So they opted to delay extubation until today. His white cell count came back high yesterday (33, if anyone cares... it was 19 last Saturday morning and fluctuated greatly after he arrived at the hospital). It's still 33 today.
* The Infectious Disease doc was just here and she said that it's likely C-diff, a bacteria that takes over the gut when other "good" bacteria are destroyed by antibiotics. She's not really worried about the 33 number, but she doesn't want to see it spike up.
And... today he has a partial collapse of his right upper lung. He'll be getting some treatments for that today and he'll hopefully get off the ventilator tomorrow.
They started him on slow-drip feeds through his tube yesterday. But he had a high residual today (meaning, lots in his stomach that hadn't gone through). His belly is distended and the x-ray shows a lot of gas. The GI doc thinks he's just not ready for feeds yet so we're stopping them. Side note: the GI doc "on service" the past four days has actually been Micah's regular GI doc. It's been great having someone here who knows him. She was here on Friday when Micah's pediatrician was here and the three of us were able to discuss what to do with Micah the next time he gets sick. Short summary: The next time Micah gets something resembling a GI bug with diarrhea, we will bring him to the hospital for an outpatient treatment of IV fluids in order to give his gut a break.
We were really hoping that Micah could get off the ventilator today. I miss my melting Micah snuggles. And we're tired emotionally. The first couple of days were so crazy: it's taken a while to really get my mind around everything that happened those days. For example, I've been following Chrissie's story on her mom's blog. Chrissie is on ECMO. Reading about her being on ECMO (a MUCH bigger deal than Micah's situation) reminds me that the doc here in the PICU had an ECMO conversation with us the first night Micah was here. And I remember hearing her talk about him not having a pulse in his right arm for hours. And how his pressures dropped so much during intubation that they were concerned about brain damage.
Micah's wonderful cardiologist in WI called me Friday. Micah has been so well cared for by doctors here. And he's clearly made an impact on those who he no longer sees. Dr. S made mention of how great it was that we were so close to a major children's hospital when this happened. If we had taken Micah to our local hospital back in WI (which happens to be a satellite of Children's in Milwaukee), he would have been life-flighted to Milwaukee... one more step in what was already a difficult Saturday. He might not have made it through one more step. We truly believe that God had His hand on everyone who touched Micah on Saturday and are forever grateful for those who cared for our son.
From across the hall, I hear a baby crying. Oh, how I wish that was Micah. I long to hear him say, "Dada." Please pray that when we do hear him say it, that there would be no raspiness in his voice. Because Micah's intubation was an emergency and there were a lot of other things going on (i.e. puking and very low blood pressure), I'm concerned about potential damage to his vocal folds.
Please pray that Micah can be extubated tomorrow. And that his gut would start working well. And that he wouldn't get any additional infections.