No more surprises!

All of the bad test results that necessitated the move back to the ventilator seem to be reversing themselves now. His bicarb, which was 45, is now down to 36 (not great, but much better). His blood gas CO₂ is now in the low 70s (we'd like to see it lower, too, but that's not a big deal). The chlorides, which really precipitated the whole crisis on Thursday when they dropped to 89, are now back up to 98 (100 to 105 is normal). Nothing else seems to be looking too bad now. Well, except...

I managed to make rounds this morning, and wound up giving a short speech to the collected health care professionals that amounted to "we felt surprised with how quickly things went south last week. I worry that it was because the doctors and nurses sugar-coated what was going on. I don't want to feel like that again, so now is your chance to tell me anything else that's worrying you that I don't know about."

This gave them the opportunity to tell me for the first time that Woody's echocardiogram revealed something odd. You know, that echo that was taken on Friday to see whether he had evidence that the right side of this heart was being overworked. Yeah, the one that they told me showed good news. Anyway, so there is evidence of an odd blood vessel going from his aorta toward his left lung. It could well be nothing, but there is also a chance that it could be diverting excessive flow from his aorta towards his lungs, which could be the explanation for why his lungs aren't healing up as quick as we would like. They didn't say this, but it could also help explain some of his CO₂ purging issues too, as I understand how the circulatory system works. So the next step is that the pulmonologist and the cardiologist will be ordering more tests and we will see if this is a big deal. Of course, the only way to address it is surgical, so it will need to be a fairly thorough evaluation first. On the other hand, I am not too worried about this for two reasons. First, Woody is now approaching five pounds, and is far bigger and stronger than he was when we were discussing PDA surgery, back in the first through third weeks. Second, I am in favor of addressing any major health obstacle that he has, and am in some ways hoping (perversely, maybe) that this is the problem, just so there is a single large factor that we can focus on. We will see.

Speaking of focus, Woody's eye exam today reveals that he has stage I Retinopathy of Prematurity (ROP), in zone 2. This is apparently a fast moving version of the disease, and may require surgery later. He will be re-evaluated next week. So anyway, more stuff to worry about, but he is doing well overall, and is starting to wake up and be feisty again, which I like.