Roscoe had another great day yesterday. He made good progress toward less breathing support and didn't have any desaturations. As you can see from the picture below, he's now on 60% oxygen with 20ppm of nitric oxide. The doctors are now free to use nitric oxide to help his chronic lung disease, because it will hopefully no longer cause fluid retention due to his narrowed (now stented) pulmonary vein.
His oxygen support has decreased across the board on the ventilator:
Immediately after his surgery, the numbers across the bottom row in the screenshot above were 50, 125, 0.60, 10, 8, 0.6, and 100%. By last night, just about all of them have been decreased by ~40% within a mere 48 hours. This is very encouraging news. His saturations and heart rate have remained about the same (or better) through the whole process:
In the reflection, you can see a team practicing an emergency
situation on a plastic baby in the room across the hall
The doctors have been gradually increasing Roscoe's remodulin doses, to get him up to the full dosage that will adequately treat his chronic lung disease. An unfortunate side effect of remodulin is vomiting, so unfortunately Roscoe spit up 5-6 times the day after his surgery and another 4-5 times yesterday. Thankfully, Roscoe didn't seem to know he'd vomited at all since he'd look around and stare (no grimacing) after it happened. In response, the doctors have slowed the increases in his remodulin dosage and have cancelled his iloprost (which may contribute to vomiting as well). He is still on the following medications which are constantly being fed through his IV:
You may have been curious what the things were strapped across his head. Right now they look like an 80's headband, but they are actually measuring the oxygen in the blood that's returning to his heart. This number should be about 25 lower than his oxygenation (which has been staying around 95). These two sensors measure oxygen on the left and right side:
The last piece of great news is that doctors have done an x-ray on his lungs each day and have seen some level of improvement each day, even in the presence of decreasing his breathing support. We have heard from a few of the doctors and nurses that this is very good news and shows that he's responding well to the treatments. In the x-ray below (taken yesterday) you can see his lungs as the patchy blobs to the left and right of his spine in the center of the picture. By the way, if you read this blog you should know where lungs are by now. If you started looking near his armpit, you might want to take a biology class.
Today Roscoe will get another perfusion scan ("lung scan") to see how much the delivery of blood to his lungs has changed. Normal delivery is 60% to the right lung and 40% to the left. His previous scan showed 70% to the right lung and 30% to the left (which indicated that his chronic lung disease was a major factor in his struggles). They will continue to wean his breathing support as he tolerates it.
The next major milestone will be the extremely dangerous surgery sometime next week. That surgery will be the point where God grants us a miracle or where God decides that Roscoe's story should not continue. Please pray for a miracle.