Glacial progress?

I had typed up the first part of this post earlier today, but Blogger went and had a massage, and I was unable to post it. But a funny thing happened on the way to the publishing...

Woody's progress seems to be glacial to me. I made rounds today and the doctor told me that he continues to not exactly make huge improvement in various things; i.e., his CO₂ is better but not TOO much better; his O₂ needs are down but not MUCH down; he seems to not be any worse with his BPD (chronic lung disease), but he's not any better either; and in general it seems that every day is beginning to melt into the day before and after it, as the routine piles up as do the days.

The only comfort I really have is the continual reminding myself of how bad things could be. He could be making negative progress. He could have brain bleeds and the neurological problems inherent with them. He could have necrotizing (tubeguts-itis) colitis. He could have already been re-intubated. On the other hand, there are also continuous reminders of how much easier others seem to have it. I had a conversation with a woman yesterday about her grandkid. She looked tired, and so first I buttered her up by asking her if her child was in the unit, which she thought was a great compliment. She told me that her grandchild had been here since last Thursday, and she just wanted to be able to take him home. This, of course, is the point that she asked me how long my kid had been here, and when I told her "seventy three days" she just looked horrified. "Oh, you poor dear," she said.

Don't get me wrong, I am not complaining. The first couple of weeks, when things seemed like they were so scary, Maggie and I would talk to each other on the way into the hospital about how all we wanted was for things to be the same. "Just not any worse!" we would say to each other. So, yeah, we want things to get better, but as long as he's gaining weight and is still extubated, he's doing well.

***

So, Maggie and I were out at dinner tonight, and decided to stop by to see Woody (and nurse S, who we hadn't seen in awhile), and an incredible shock met us at his room-- Woody's off the CPAP. And he's not ON the ventilator, either. Woody abruptly graduated to the 'high flow' nasal cannula, which is an even less invasive breathing assist than the CPAP.



Apparently, nurse M₂ switched him over to a regular cannula while doing cares this afternoon, just to give his face a break from the CPAP straps, and he was doing so well that she asked if he could just switch permanently. No, was the reply, as he is still in need of respiratory support, but they were willing to try the high flow varient, which provides an EEP of ~4 (compared to his order of 7 for the CPAP). Even though his O₂ needs are up compared with where he was on the CPAP (he's hovering around 70), you also have to take into account the fact that he's not getting the full EEP, and he's also breathing in some extra room air, so who knows how much O₂ is actually hitting his lungs. It's another giant leap forward, is what it is, and it utterly makes a mockery of my earlier complaints. Well, I'll take it!