I arrived yesterday very hopeful.  Optimistically thinking we might have Landon home by the weekend.  But as the treatment and waiting game continues, he’s taken a step or two backward the last couple of days.

Main points:

He’s still breathing well on minimum vent settings, and is doing pretty well during his sprints.

He looks great when he’s resting.  He is comfortable, not puffy, and has been squeezing my finger with his right hand.

His x-ray has gotten worse, and an ultrasound indicates pockets of fluid that aren’t responding to treatments, and have instead gotten worse lately.  There seems to be some fluid gathering on his right pleura.  So we’re back to mentioning pleural effusion, most likely onset the last few days as a result of the pneumonia.  This is all RELATED…but it is different from the fluid IN his lungs from his pneumonia.  It is more of a fluid AROUND his lung as a result of the pneumonia.  (Any DR reading this is cringing…I’m trying).

What is pleural effusion?

Pleural effusion, sometimes referred to as “water on the lungs,” is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing. Normally, a small amount of fluid is present in the pleura.

They are starting another antibiotic, and planning on a CT scan in the morning to get a better look.

That’s enough detail for now, anything else I say may end up being incorrect or behind by the time I type it.

I’m feeling a bit negative right now, so I’m going to try to list some positives:

• Landon is comfortable
• The “home” team has been doing pretty well, and J has been successfully operating as a single father of two for the majority of the last few days.  All of my boys are tough.
• Darra is wonderful, and knowing she is keeping an eye on Nolan during the day is a huge relief.
• I am thankful for an understanding work environment, and that I have something to help keep my mind busy on other things on days like today.
• I’m thankful for reliable friends, eager helpers, good deeds, a faithful family, a kind community, you, a present God, strong coffee, soft yarn, and Landon’s long lashes.

I’m back with Landon!  It’s been a very busy few days.  Since Sunday night I’ve driven 1,000 miles.  In addition to being in 4 states, visiting familiar faces, learning new things, and trying to make the brief visits home meaningful, Nolan has been pulling some fast ones on us.

He woke up on Tuesday very cool.  It took much of the morning to warm him up to 92 degrees.  D knew what to do, and what to watch for.  Temperature regulation issues are a daily battle, but sometimes the extremes still catch us off guard. That wasn’t the only trick up his sleeve.  He also had some focal seizure activity.  It didn’t require a rescue med, and despite the seizure he went on to have a very good, smiley, alert day.  That’s just another area where we prefer no surprises.  But wait – there’s more!  Just today, Nolan held his pee for 18+ hours.  Under normal circumstances a 24 hour dry spell might merit a quick ER trip for a straight cath.  But we knew he was hydrated, and we also know the boys hold it.  So after a long dry day, we were all “relieved” when Nolan stopped the strike.  And he’s the “easy” one right now!

As for Landon, he is still improving.  It seems he is very stable, and breathing well.  He keeps passing his breathing tests with flying colors, and is passing his daily sprints.  But…the right lung still isn’t clear, and some of the junk is being stubborn.  If you’re wondering how long it will take to get that clear enough to get him home…you aren’t alone.  Today’s update was a positive one, but included no projections on timing.    I am hoping and praying we can extubate tomorrow or Friday, the get him home Saturday or Sunday.

In the meantime, I had a huge smile when I encountered these curls upon my return.

Talk about a good hair day!

A special thank you to Papaw for taking such good care of my buddy.  I love you both dearly!

Sunday evening has arrived.  So we are almost one week from the incident that we believe set all of this in motion.  Seven days in now, and Landon has made great progress, particularly since Thursday morning.  I handed the job of keeping Landon company off to my dad.  It is hard not being there, especially when I know I’m not running right back.  But if Landon can’t be in my hands, it is hard to beat Papaw’s.

Landon is on full feeds, is stable, and his secretions are getting thinner and clearer.  Now we just have to get him off of the breathing machine…or extubated.  That’s not something you rush in to, so Saturday morning, Landon started doing Extubation readiness testing (ERT).  His first test, he lasted 15 minutes before needing additional support.  Sunday morning he lasted 90 minutes.  After the 90 minute attempt, they decided during morning rounds that Landon would likely need “sprints” to help get him back up to strength.  In other words, they will “sprint” for up to two hours, challenging his lungs to see if he can handle BiPAP settings.  For this evening’s sprint, he lasted 45 minutes.

So Landon is slowly getting better, stronger.  But it is hard to predict at this time how long it will take to get him up to full strength and off of the breathing machine.  In the meantime, his settings are pretty low.

40% oxygen

5 peep (that’s a minimum setting)

rate of 8 (he’s breathing over it for an acceptable 20-40 rpm)

So it’s up to Landon to set the pace.  In the meantime, all of this running talk has me hungry, so I will support him the best way I know how – I’m carbo loading.

I’ll keep you updated as the sprinting continues.

Alert!

Found the roof top garden!