Wednesday 31 October 2007

ICU

As I know you are waiting to hear how things went today I am hear to convey only what we know at this time, which doesn't seem to be a whole lot. 
 
We went into this Lavage with a different perspective then the last one.  Last time we were hoping for a cure, this time we were hoping for some answers.  So with that in mind it's hard to say whether there was any sucess.  Only time will tell us whether there are any answers, right now we just pray for stability in James' condition.
 
As we were told, this Lavage involved more risk then the last ones.  In the end they had to abort the procedure because James was deSATing and no longer stable.  They put 1100 ml in and were only able to get 60% of it out, leaving 440ml in his lungs.  From what we were told they got the same milky substance out of his lungs as previously, but it was thicker then the last lavages.  It's hard to say if this is for medical reasons or because of the technique they were using this time.  What they did remove from his lungs has been sent off for further testing, this time also looking at the lipids (fats) to try help determine the source of these.  Once again we are told that the substance removed from his lungs does not have the "classic" appearance of PAP.  This is not to say they do not believe he has PAP, we are confident he does, we are just unsure what else is going on in his lungs and how it all works together, if it does.
 
The endoscopy was also done and we were disappointed to hear that they did not find anything abnormal.  I suppose that's not the right thing to say.  It's good to hear that things appear normal, but unfortunately there was not an excess amount of mucas as we have been seeing, so we may not be getting any answers.  They did do biopsies and there is always the hope that this will provide some answers..  We were told that he only appeared to have very mild esophagitis (inflammation in the esophagus) which we would expect to be worse if he indeed had aspiration or even given his daily vomitting episodes.  The one thing they did note was that his stomach was oddly shaped and so they would like an ultrasound done to look at the surrounding body parts to see if that explains the different shape.  This could possibly just be because of his enlarged liver and spleen and they don't really see it as a concern.
 
They were unable to extubate James and so he was moved to ICU to be closer monitored and extubated (remove the ventilation tubes) when ready.  Upon first seeing him he appeared very relaxed, calm and comfortable ... much better then the time I seen him at Mac that way.  This did not last ...we were just going to head out to get some lunch when all that changed.  He began to cough and in turned deSATed badly and he would wake and fight the tubes.  It seemed something was blocking his tube and they worked hard to suction and stabalize him for some time, but his CO2 levels remained unstable.  It's amazing to see the quick response when needed.  At one point the nurse simply called out one name "Anne-Marie" and within seconds five people came flooding in the room, and then one says "Anne-Marie's on her way"  Two more people arrived before Anne-Marie (the doctor) did.  You get this feeling like you're watching a TV show as they all surround the bed and you're off to the side watching and unable to do anything.  But with time they were able to clear his airway and stabalize him again and  so far he's remained that way.  Once again they were shocked at how much profofol (aneasthetic) was needed to keep James asleep, he kept waking and they kept giving him shots of it and slowly increasing the consistant dosage.  The doctor said we (as in normal adults) would be sleeping sounding on this amount.  That's our James.
 
So at this time he is once again "stable" and we have to play the waiting game again.  In situations like this there is no way to estimate how long it will take before they can extubate him.  Patience is required!

11 comments:

Anonymous said...

Rob and Steph,
We are keeping James and you all in our prayers. May God bless what was done today, and may He continue to give you peace and assurance of His loving care.
Gerald and Carmen JALMEWBGT

Anonymous said...

Praying for you all specially for James.

Anonymous said...

My heart is breaking...I don't even know what to say! We pray that our heavenly Father will surround you with strenght, and carry James close to His heart!
Much Love
Steve and Karen Mans

Anonymous said...

Prayers for all of you. Is James just building up a tolerance because he's had so much anesthestic in his short life time? We pray for answers soon, and much patience as you deal with this all.
Brad and Deb Alkema

Anonymous said...

Rob and Steph,
We are praying!!

Rich and Tracey Stam

Anonymous said...

We join the others in praying for all of you. May the Lord bless the work of the doctors, surgeons, and other health-care personnel and may He give them insight into James' condition and, hopefully, some answers.

Arend and Willa Dale

Anonymous said...

Rob and Steph,
We are keeping you all in our prayers. James is quite a trooper,we pray that the Lord will continue to give you all the strength that you need. We pray that answers will come.
Ps.145 vs. 17 & 18
The Lord is righteous in all his ways, Gracious in all His works.The Lord is near to all who call upon Him, to all who call upon Him in truth.Keep leaning on our Father, for he is our Rock. Wait on the Lord be of good courage, and he shall strenthen your heart; wait I say on the Lord! Ps.27:14.All our love and prayers to you all.
John and Martha and the gang

Anonymous said...

We will join the many many others who are continuing to pray not only for you and James but also that the LORD will grant the doctors nurses and many other medical personnal the knowledge, ability and hands to help James.
With much prayer and love
Nathan, Aileen, Taryn and Aiden

Anonymous said...

Rob & Steph,
God's throne is surrounded by prayers for James and you all. God hears every one of those prayers. May you continue to receive much strength for each day, and peace knowing that God's plan is perfect albeit beyond our understanding.

With all our love,
Ike & Heather & kids

Anonymous said...

Rob, Steph and family:
We continue to bring your needs before the Father's Throne in prayer. May He continue to grant all things necessary for James and you in this incredibly uncertain and stressful time.
Love,
Jay, Tara, Rachel and Sheldon

Anonymous said...

Thinking of all of you, and praying for you. I see your little girls almost everyday, Wow what troppers they are. You can see the sadness in their eyes, as they talk about James, and long for there family to be back together. Wishing you all God's strength and comfort as you all must deal with this situation as best you can. We will keep you in our prayers and ask God to bless all the work the doctors are doing.