PICU Day 4: Failed

 Isaac is very sick.  That is what the doctors say.  When the goal to wean him off ventilation and extubate him failed, it was determined that he would undergo MedaNeb treatments in an effort to open and inflate his left lung.  By 6:00 that night, it was decided that he failed the MedaNeb treatments.  It is always discouraging to hear the word "failed."  A new, more invasive ventilator was started.  This machine uses percussion, vibration, and pressure to break loose the infection inside of the lung.  It is uncomfortable, looks frightening, and sounds like something from a bad 1980's sci-fi film: "Servolator Percussionator Monotron Wave Form Analyzer." Yikes.  There are concerns that such rigorous therapy could be harmful to his relatively healthy right lung, which is why they didn't try this type of ventilation earlier.  (Thanks, Rasch Family, for the super snuggly puppy!!)

 Isaac is still under heavy sedation.  This allows him to be restful and relaxed during the painful and uncomfortable therapy.  Occasionally his eyelids will flutter but he makes no eye contact.  In these rare moments he tries to lift his hand to his face, but his hands are tied to the bed so he doesn't pull out any of the 147 tubes attached to his body.  The other 23.8 hours throughout each day he is completely non-responsive.  I talk to him and tell him what is going on.  I read to him and tell him about the get well cards on his wall.  The professionals working with him introduce themselves and explain what they are doing.  He doesn't respond to any of it.  His sick little body lays in bed bouncing mechanically from the machines he is attached to.

 I look closely at the xrays they take each day as the nurses explain them to me.  You can see a feeding tube, a chest tube, and a PICC line.  The xrays show that the new ventilator seems to be helping.  The top xrays show more shadows on the left side than the bottom image, which was taken earlier.  Shadows and dark space indicate air, which is good.

When you watch the machine breathe for Isaac, it is easy to see that his left lung is non functional.  The right side of his chest rises and falls with each mechanical breath.  The left side remains motionless.  The doctor explained that when there is a pleural empyema this severe, the bacteria is difficult to reach.  It is as though the disease walls itself off.  The various procedures and medications they are trying are methods to break down these walls.  The empyema is outside of the left lung, so the treatment measures for the empyema are in addition to those implemented to treat the pneumonia inside the lung.

 As for me, I had a sweet visit from one of very best friends yesterday.  She brought me a skirt in case I get the chance to ride TRAX down to the temple.  She brought me homemade soup and snacks.  She brought a letter of love and a Christmas card for Isaac's wall.  She brought her own 4-year-old whom Isaac was in preschool with.  When it was time for them to go, I asked little Ally for a hug.  When that little girl wrapped her arms around my neck, it was the first time I really broke down and sobbed.  I couldn't hold it back.  Feeling that tiny squeeze and that little body within my own arms was more than I was prepared for. 

By some miracle (I'm sure a result of all the prayers being offered in our behalf,) I was assigned a sleep room again last night.  For some reason, I couldn't sleep.  I tried and tried.  I even used all the relaxation and breathing techniques I learned in natural childbirth.  No luck.  So I came back down to Isaac's room where his nurse helped me lay next to him for the first time.  I untied his arm restraints and just held his hand and felt his body next to mine.  It felt so good to be so close to him. 

Today is Friday.  This has been the longest week of my entire life.  As long as it seems to be working, Isaac will remain on the sci-fi ventilator for a few days.  After that, he will move to a regular ventilator for a few days.  When he is well enough to breathe on his own, they will take him off the ventilator and prepare to extubate him and move him from the Pediatric Intensive Care Unit to the Medical Floor, where he will continue treatment until he is well enough to go home.  Until then, I am taking one day at a time.  I try not to worry about the things I can not control.  I try to do as many of the daily routine things that I can here (which unfortunately does not include Zumba...dang!)  I shower and get ready each morning.  Isaac and I have morning scripture study together.  We have bedtime stories and prayers.  I try to focus on the positive things and the tiny miracles and blessings, of which there have been many.  I know my son will get better.  I know we will make it through this.