Ooey, Gooey, and Gone (for that moment, anyway)

Overall, I'd say that today was a relatively good day. Mason's right lung looked better on xray, the fever he'd spiked again last night seemed to have subsided again, and he decided at about 9:40 that it was time to wake up (the paralytics had not even been turned off yet). Once again, his paralytic holiday started off rough, but went well for quite a while. The pulmonologist came down and did another broncoscopy to get a better look at Mason's airways while he was breathing on his own. Not surprisingly, he did find that Mason does collapse his airway a little bit when he breathes, but thankfully, not too badly. Soon after entering Mason's airway, the scope came upon some ooey, gooey, slimy gunk. It was likely part of the reason that Mason's needed a bit more oxygen over the last couple of days and might be an indication of what's causing his fevers. The gunk was so bad that it actually clogged up the scope a couple of different times when the pulmonologist tried to suction it out. Really gross! Thankfully, between the scope suction and the regular suction, they got most of it out and Mason's saturations went up a bit.

The rest of the day, Mason has been bouncing back and forth between asleep and awake. Randomly, he will open his eyes and freak out just a little bit. Fortunately, he does calm to my voice reassuring him that everything's ok. He's still on the paralytic, but they've cut his Fentanyl in half to begin his wean off of the narcotic. Last night, they started him on a new medication that will help his wean off of the narcotic and sedatives as they move to waking him up - Neurontin. It is a non-narcotic pain medication that works in a different way, but still causes some sleepiness so that he will have some sedative effect. Hopefully, with the addition of this and the methadone and ativan, he can get off of the IV drips and continue his progress toward waking up and getting slowly better.

I think Mason will have his first trach tube change tomorrow. It will be a true test of how well his surgical site has healed and how secure his new airway really is. I am hoping for good healing over the last 10 days so that we can begin to challenge him more off of the paralytic. It would be great to allow him to stay awake as much as he wants instead of how much we are willing to have him awake. More awake means a whole bunch of things for him including processing food better, maybe less sedation medication, and another baby step toward that day way off in the future when we can think about returning home.