A Reasonable First Full Day

Today was Mason's first full day on the ventilator. He had some ups and some downs, but generally tolerated the ventilator well with some heavy sedation. The doctors changed things up a little bit including how the vent. delivered the air, how much/little Mason was able to move his body, and his nutrition.

One of the doctors today talked about how the vent. was delivering air to Mason. The way they set it up gave a constant pressure for lung inflation. They did not think that Mason's lungs would be able to receive a constant volume of air, so they decided not to set it up like that. However, once he was intubated, he surprised them. They found that Mason's lungs were not nearly as stiff as they thought by xray, so they could be pushed with a constant volume inflation. They also theorized that Mason's major desaturations were possibly due to a decrease in volume when he woke up because he would bear down and get really stiff. So, if the vent. delivered a constant volume, it might be able to help him avoid those major desaturations. The good news is that during the day, when he had some paralyzing medication in him, but wasn't fully paralyzed, he would wake and not desaturate! A really good sign! Unfortunately, when they stopped the paralyzing medication all together, he was not as successful. He had 1 more major desaturation. They were able to bring him back up fairly easily and he's now resting comfortably on 85% oxygen/15% air with his heart rate around 100 beats/minute and oxygen saturation of 94%. Pretty good for him! Our goal is ~60% oxygen/40% air and saturation above 95%.

As far as how awake he is, the doctors are trying really hard to allow him to be awake and able to move, but really, really sedated. The more he is able to move on his own, the more he is able to keep his joints moving and avoid fluid buildup in his body. It is also good to allow him to be awake enough to cough. When you're flat on your back with a breathing tube in, congestion tends to set in. If he is awake enough to cough, he can sort of avoid that. Unfortunately, we haven't been successful at allowing him to be that awake, but he did have quite a bit of time today when he could move some, but kept his saturations up. It gave me good hope that this might work after all. Once the paralytic was completely taken away, though, his awoke a little too much and his saturations dropped. Apparently, we all needed to be reminded once again that we need to have patience and take baby steps.

They were also able to start feeding him again. We've fed him overnight just about every night this week, but because of his major desaturations before getting the breathing tube, they would stop his feedings just in case. Because his lung healing all hinges on his growth, it's really great to see him tolerating his food well. Hopefully this trend continues and we can do some other things that will allow him to resume growing.

Well, I continue to be pretty pooped with all that we've been through. I'm going to sign off for now. I'll keep you all posted on our progress. Please continue to pray for healing for Mason's lungs. It is going to take pretty much nothing short of God's Hand to help him get through this.