Wednesday, October 7, 2009

Si Pap Overnight

Elias did well with the continued Si Pap overnight. They also began lowering his oxygen level which is down to 26% (21% = room air). His blood gas looked very good at 3pm yesterday which prompted the decision to let Elias continue with Si Pap. While we are all very pleased with the terrific success and amazingly quick progression Elias is making, the doctor warned us not to be too content just yet. He explained that it is possible for them to move down too quick and then suffer a set back. Hopefully this will not happen and it is for this reason they are considering slowing down a little with changes. They are going to discuss things this morning and consider what more if anything they want to do today. One thought is to just allow Elias to continue with this for another 24-36 hours before making the next adjustment. That next step is to lower the amount of pressure control to help hold his airway open. One possibility that does exist is the Elias may only need the Si Pap or other intervention at small intervals of time and not full-time. That would be a great scenario as well and is a goal we’d like to work for.

We are still awaiting a decision on the potential for a NJ tube for feeds. We probably will not hear anything on that until rounds this morning. The other key thing we are watching is Elias temperature. His normal hospital temperature is 35.3 C. They have had several now that have been over 36 C, and his white blood count from a CBC yesterday was 18, just slightly elevated. We are hoping this is not the early signs of an infection or illness brewing. We will keep you updated on any developments regarding that. Finally, this morning Elias will be heading back to the O.R. on the 14th for another bronchoscopy. They will be assessing the airway and making decisions on what trach tube the want. Hopefully, we will be switching back to the uncuffed trach tube.

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