Growing up

Happy 21 Months Old Isaac!  Below, you will find some photos from today of our wonderful boy - Isaac Kenneth Russell Faulkner.  Thanks to Facetime I was able to see him this morning and this evening.  He's growing up so fast! 

Josiah has been NPO since 6 AM yesterday.  I thought NPO stood for "nothing passes orally" which is the correct meaning but according to Wikipedia it actually stands for "nil per os" which is Latin for "nothing by mouth."

I can't remember if I wrote about this previously but according to the care map for chylothorax (which he developed due to his lymph system being nicked in his first surgery), if Josiah's chest drainage increases with feeds, he should be NPO for five days.  This morning the staff physician decided that Josiah should do this so he'll only get lipids and TPN (total parenteral nutrition) into his veins for five to six days.  This may have had something to do with why his blood pressure was up today.  I think he would prefer to have some food in his tummy.

They will stop Josiah's heparin around 5:00 AM tomorrow morning so he'll be ready to get his PICC line at 9:00 AM.  They will take out his pacing wires tomorrow and probably start his shots of enoxparin tomorrow around 6:00 PM.  It continues to amaze me that I can find out so much information with a few strokes of the keyboard - apparently enoxparin is derived from the intestinal mucosa of pigs.  Interesting.   

Josiah had two rounds of physio today and should have three rounds tomorrow.  It is helping to loosen his secretions.  The x-ray this morning showed that both upper lobes (right and left) had collapsed a little.  The fellow told me this morning that Josiah is on a lot of breathing support.  She said there are four levels of support: 1) Intubation - breathing tube; 2) BiPAP - Bilevel Positive Airway Pressure; 3) CPAP; and 4) Oxygen.  Josiah is receiving BiPAP so he has pressure keeping his lungs somewhat open and when he initiates breathing, there is additional pressure.  It's something like that anyway.  He can't go to the ward unless he's only on oxygen or just breathing air. 

Neurology came and started to assess Josiah.  They will recommend an MRI which will need to be approved by the cardiologist but I don't think that will be a problem.  They seemed to see good signs in that all of Josiah's limbs are moving and his eyes are tracking and he has good reflexes - however, they can't do a good assessment until he's fully off of the morphine (he's at 32 today and should go down to 25 at noon tomorrow).  It sounds like they will be following up regularly.     

I've saved the best news for last:  I held Josiah today!  It's been four weeks since he's been held (the night before his first surgery).  That's sad.  He was quite restless and agitated while being held and when he was in a vibrating chair.  I've been thinking that it's a good sign that I haven't seen him trying to cry but then the nurse said it's almost like he doesn't try to cry because he knows it doesn't do anything (perhaps from trying to cry when he was on the ventilator).  That's sad too.

One of the grandmothers staying at RMH gave me some Bible verses today so it was nice to discover that she and her family are Christians.

I'll end with a line from Keith Green's song, If You Love The Lord: "If you love the Lord you will love his will for you.  Instead of questions why, there will be praise for all he brings you through."   

We praise the Lord for all He's done and continues to do.  Thanks for your support and prayers! 

Blessings,

Elizabeth