Day Three Post-Glenn - Friday, May 15, 2009

" Listen to my cry for help,

my King and my God,

for to you I pray.
In the morning, O LORD, you hear my voice;

in the morning I lay my requests before you

and wait in expectation."

Psalm 5: 2-3

Another day of waiting. The settings on the ventilator were turned down a great deal overnight and it is now on one of the lowest settings possible, called CPAP mode. This basically just gives Tyson pressure support while breathing. Tyson is breathing on his own but the machine is just keeping his lungs open a little, preventing them from totally deflating so it's easier for him to take the next breath. This is the final step before extubation. However they will not be extubating in the next day or two until they can figure out why his sats remain in the low 60's.

An echocradiogram (ultrasound of his heart) was done this afternoon. They did what's called a "bubble study" which involved making bubbles in a syringe full of saline solution, and injecting these bubbles into the central line in Tyson's neck (the central line goes directly to his heart). The injected bubbles can be seen on the screen of the echo monitor. This tells the doctor where and how the blood is flowing by following where the bubbles go. The cardiologist said that from the echo report, there appears to be good "Glenn blood flow" (blood flowing from the superior vena cava to the pulmonary artery, which is what they connected during surgery) but he also said that they've been fooled by the bubble study before. Sometimes there can still be blood escaping elsewhere in the heart from another vessel, which could be causing the low sats.

The only way to know for sure if there is blood escaping where it shouldn't be going, is to do a heart catheterization. The cardiologist is a little hesitant to opt for this immediately since it is a very invasive procedure involving general anasthetic and intubation (well, he already is intubated! LOL)

So the short term plan is to wait for tomorrow's chest x-ray and see how the right lung collapse is healing. Once the right lung is 100% repaired, if the sats do not improve, then they know for sure that the low sats is NOT a lung issue but a heart issue. Then a heart cath will be done. So there will be no extubation unless the lung is 100% repaired and the sats go up. If the lung repairs but the sats remain low, Tyson will stay intubated since he would need the machine during the heart cath anyway.

Low sats are not harmful for the short term, so waiting a few days before doing a heart cath is not a big deal. However, in the long-term it can cause damage to the brain because the brain will not be getting enough oxygen. So this needs to be figured out.

So Tyson will be staying in Intensive Care for a while yet, until they can get this mystery solved.

Please keep praying that the Great Physician can help Tyson's other physicians figure out what is wrong.

Mel:)