Well the good news is Elias continues to be episode free, but there is still no explanation for why he stopped breathing so many times the other day. The EEG done by neurology was normal and showed no indicators for seizures. That doesn’t rule them completely out it just means it is much less likely. Today they are doing an MRI. This was a planned test before this admission, they are just moving it up a week. The head portion of the MRI might give neurology more to work with so we will see. While down there they are doing MRI’s of the head/brain, spine, sacrum, ears, and pituitary glands. It is expected to take several hours to complete and will be under sedation.
The passy-muir valve trials went fine and much to the surprise of the ENT team after drilling a few tiny holes to relieve some pressure Elias seemed more comfortable. The only thing I was not completely comfortable with was when Elias needs to coughs while wearing this. He really seems to struggle a bit to actually cough. There were several times when I had to jump up to pull it off him because he was trying to cough and clear secretions. The hope from pulmonology was that the type of pressure this valve is designed to create would be a natural Si-Pap if you will, obviously much less pressure, but still hopefully provide the same results. There was much more activity, but mostly discussion with TONS of people from various specialties.
This morning Elias had one of the coughing spells that we had been seeing where we find blood in the trach when we suction. we have not seen that since Wednesday. It will be interesting to see if now that this has returned we start seeing the stop breathing episodes. While we do not think the two are related it is something that disappeared the same time, so let’s see if they reappear together. Just something to take note of.
We are waiting on rounds to see if there is anything they plan to do over the weekend. It is not likely. We will probably just sit here and wait for Monday’s surgery with the bronchoscopy and be observed. We will update later with any new developments.