The shots above are from yesterday, when Avery was having a pretty good day. I didn't have it in me to take more photos of him after he went back on the ventilator today. We've had enough of those! Here's a better shot (below) as a filler. This was taken just after Mason and Avery turned a year old on a rare occasion that they were dressed alike. They look like such good pals.

3.23.06: too much too soon

Yesterday morning it looked as if Avery may have finally made it over the hump after nearly 3 days off of the ventilator. He was still working pretty hard when he went to bed Tuesday night, but had a reasonably good night. Overnight, Avery was still very dependent on his blow-by O2 Dixie cup to keep his saturation levels in an acceptable range. However, in the early morning hours yesterday, his sats were on the rise and we were able to set the extra oxygen aside most of the time and his saturation levels stayed above 90%, occasionally reaching close to 100%. By noon, we had taken the extra oxygen away completely. His saturation levels didn’t even drop while sucking on his bottle of Pedialite. Avery’s CO2 levels dropped to 61, well within the acceptable range.

When the doctor made his rounds late last evening he confirmed that Avery’s lungs sounded better and that his numbers were in a range he wanted to see. However, he felt concerned that Avery still had an audible strider and felt it may be necessary to do a bronchial scope and see if there was anything more than just swelling obstructing his upper airways. He just wanted to confer with the pulmonoligist in the morning.

Avery’s overnight last night was OK, although there were moments he needed some extra blow by O2 and they decided to increase his heliox (the 70% helium/30% O2 mixture he’s receiving through his cannula) from 4 to 6 liters. There was a little activity in the middle of the night also, as Avery was bumped from his private room to a shared room down the hall to make room for a child with more intensive care needs. It was assumed that Avery was doing well and on the road to recovery.

As we’ve experienced before, things change quickly. Avery was still stable in the morning and when the pulmonoligist made his rounds he agreed that he’d like to scope his upper airways. His blood gas this morning showed the CO2 levels went up slightly and his Ph level dropped slightly. Otherwise, there didn’t seem to be any big concerns. No sooner did Mama Mary leave to go work on her grad school final paper (due Saturday), did Avery hit a wall. His effort to breathe was increasing and he was not looking too good. He simply pooped out. The doctor didn’t hesitate to make the decision to reintubate.

It just breaks our hearts in the biggest way to see Avery go through all this all over again, back to being sedated and needing morphine to handle the pain and discomfort. As for the bronchial scope, it’s no longer necessary. When the doctor went to intubate he could see very clearly down Avery’s throat and could tell there was extreme swelling, which is what they initially assumed was the problem. For now, they will assume there’s nothing more than that. The swelling was so much that they used an ET tube that was 3 sizes smaller than the one he had last time (from a 4.5 to a 3.0). It’s quite a big difference! The one he has now is about the size of the one he had while in the NICU.

For now, we’re not even going to try and predict how long Avery will stay in the PICU. We’re back to just looking at things one day at a time. Fortunately (depending on how you look at it), we’re back in the private room down the hall.