Monday, May 22, 2006

All about the lungs, baby

Babies are not supposed to be born at 23 weeks, 2 days. Most of their life support systems are not ready to go, but the primary issue is the lungs. As noted yesterday, Woody has been having recurrent issues with his lungs, which makes it difficult to move him up farther on the imaginary flow chart that it takes to make a preemie more healthy. When you see his chest x-rays, instead of nice dark areas within the lungs, he has had "haze" in the lungs, which isn't so great. Now we're up to "white-out" in the lungs, as they say, and that's bad.

So what can cause lung white-out, you say? Here are our options.

  • Infection. This is possible although not necessarily likely. The doctors have ordered blood cultures to see if he has bacteria running around in there, and as a precaution they're starting him on antibiotics. If I had my choice, this is the one I'd like him to have, frankly, because at least you can treat it right away.

  • Chronic Lung Disease. This, as mentioned before, is probably close to inevitable with a kid his size and age, but it's a little early yet to make a diagnosis of this. As the name implies, it's a chronic condition and about all you can do is keep him comfortable and with as much oxygen as possible and hope that he can get strong enough to build new lung tissue and fight off the damage.

  • "Wet lungs". This disgusting term is what the doctors call a scenario where he's retaining fluid in the lungs, making it more difficult to keep his lungs fully inflated and exchanging oxygen and carbon dioxide. This appears to be the most likely of the possibilities, based on his response to the oscillator versus the normal ventilator; the oscillator does a little better job forcing his lung pockets open and keeping them that way. To deal with possible wet lung, Woody's getting a round of Lasix, the diuretic used famously on race horses to mask steroids. Which means he may, yes, need to piss like a race horse.

  • The ductus again. The medical team doesn't think this is likely, but if the ductus is periodically popping open and shut, it can allow fluid or even blood to backflow into the lungs. Which wouldn't be so great. If this is the issue, it's not playing very fair with us, because the echo shows it's closed and the characteristic murmur hasn't been heard since the last round of the drug used to close it. However, these things can flap open and shut with little warning, and the oscillator is so loud it makes it more difficult to hear the murmur. So it's back to watching and waiting again.


As the nurse told me yesterday, this just is his life right now, and we're in for a long summer. Oy.

2 Comments:

At 12:31 PM, Anonymous Grammie said...

I never really knew the meaning of "pray without ceasing" until you were born, precious little Woody. I find myself waking up in the night praying for you and your mama and daddy. You are not without invisible means of support.

Love,
Grammie

 
At 3:02 PM, Anonymous jared said...

Wow, what a choice of evils regarding the lungs...

Hopefully Woodrow's thoroughbred genetics and legions of fans pull him through, a la Seattle Slew.

 

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