Wet lungs

When I arrived at the hospital this morning Josiah was off oxygen and looking good.  He even had his chest physio with suctioning and maintained his sats.  At around 10:00 AM his amazing nurse and I took Josiah (in his crib) to the second floor to have an ultrasound.  While we were waiting in the hallway, Josiah gagged and spit up.  During the ultrasound Josiah was quite irritable but his sats were good.  The nurse was concerned about his colour as he became very pale.  He started to desat right when we were ready to leave so she put the oxygen mask by his face.  This nurse worked in the CCCU for a year but prefers the ward as she can be silly with the children and have more of a relationship with the families.  She did say she picked up great skills in the CCCU, especially learning how and what to think when children deteriorate quickly.  

Back in the room, his sats wouldn't stay up so he ended up being put on 1.5 L/min of oxygen which he remained on for the rest of the day.  He threw up again around 3:00 PM for no apparent reason.  The nurse was surprised as it had been three hours since his previous feed.  When he had physio in the afternoon, the PT was able to get out quite a lot of thick secretions, including a large plug.  The fellow called for an x-ray which showed that Josiah has very wet lungs.  He'll get more lasix tonight and they are monitoring him very closely.  If he gets a fever, they will start antibiotics as they will assume he has pneumonia.

His echo from yesterday showed no changes from his previous imaging.  The ultrasound of his right groin showed that the previous clot hadn't changed.  I actually found out that there are two clots there but only one is an occluded clot.

Josiah's picc line was TPA'd again as they couldn't pull back blood.  One lumin was done and then they both worked beautifully and blood was sent to the lab and in less than an hour the lumins didn't work again.  The other lumin was then TPA'd and I didn't hear if that worked.  (Update: I just spoke with the night nurse and she wasn't able to draw back anything but then another nurse worked on it for a while and was able to draw back so it's clearly very finicky which isn't surprising given that the end is inside a clot.)

The nurse practitioner said she would need a full day to read through his entire history.  She told me she's staying on her tiptoes for a while.

We weren't able to attempt any oral feeds or developmental physio today but our new physiotherapist said that Josiah will be on a mat tomorrow (as long as he is stable).  His PT isn't on the floor on Wednesdays but he did come down to do Josiah's afternoon session.  He is very kind and really seems to care for Josiah, telling him what a brave boy he is and commenting on his cuteness.  Josiah usually doesn't like getting the vibes on his chest and hates the suctioning down the back of his nose but the catheter goes in his mouth after that and he calms down right away.  He bites on the catheter and we think he likes the feeling of the suction on his tongue and his right cheek.  That's his treat.   

Two phrases I hear a lot are "it's a balancing act" and "he doesn't have any reserve." 

Grandma and Grandpa L. were able to visit this afternoon and they both pushed Josiah in the stroller.  Even though Josiah wasn't overly stable today, he would go from being mad to giving a beautiful smile. 

Isaac had a wonderful playdate with a friend from church this morning and later in the afternoon he had a Daddy date, getting his hair cut, looking at animals at Petcetera, going to the library and then out to dinner. 

One of the staff members at RMH told me that she brought in ten new families last night and two tonight.  There are room for 80 families here and they have only one or two more spaces available, though there are often people leaving as well.   

Apart from asking for healing for Josiah, I often don't know what to pray for or what to ask you to pray for so that's part of the reason that I let you know what's been going on so you can decide what to pray.  We really appreciate your prayers for Josiah and our family.  We are blessed indeed!

Blessings,

Elizabeth