Monday, August 07, 2006

Night before eye test, yawn.

So it's another day-before-a-big-day for Woody; I've gotten a little used to these situations, and instead of being really nervous and excited and scared I'm almost, well, bored. Yeah, yeah, I know he's going to get his eye test and they're probably going to wind up doing surgery the day after or Thursday or whatever, and it's going to greatly influence which track of therapy he gets after that point. But on the other hand, I really don't think that anything that happens can surprise me, and it's not like whatever happens tomorrow will spin us off into the world of infinite possibilities like his last extubation attempt did, so I'm just more impatient for it to be over so we can move on to do other things.

Last week they said that his eyes were in stage 1 ROP, which doesn't sound that bad, but it is the fast-moving variant, so we're expecting him to need to be quickly treated; I'm just hoping the test won't show that he's in stage 4 or 5 or worse, because anything below that and the prognosis following surgery should be pretty darn good. After that we then will reevaluate so we know whether he gets another shot at extubation or a trach first.

And speaking of that, Woody's improvement continues on his respiration. His oxygen needs are trending farther and farther down; he spends more time in the 30s and less in the 40s and higher; we haven't seen another CO2 test yet, but I suspect that's still trending down; and he's just getting more and more feisty and alert and strong every day. The crew we saw at rounds today was generally more sanguine about his overall health than the professional pessimists* that populated his intervention last Friday, and the general tenor of it was that barring something unexpected, Woody will get another shot at extubation instead of getting the trach first.

So yeah, tomorrow is a huge milestone day and everything will hinge on it for the near term and all that stuff. Whatever. Woody will be ok regardless, I am confident.

*My current paradigm is that while I am optimistic, I don't want Woody's care decisions to be driven by my wishful thinking. That being said, the crew that met with us on Friday were, with the exception of the neonatologist, not exactly the professionals who have spent the most time with him. Following that, he's been seen by another pulmonologist twice, who is apparently of the opinion that if he maintains current trends, there is no reason why it isn't a good idea to give him another shot off the vent. After all, what's more risky-- leaving him intubated, which he has been most of the last twelve weeks, or poking a hole in his throat? I know that there are real concerns there, but let's make sure that's the right choice, please.


At 1:28 PM, Anonymous jared said...

It sees; I feel; You are.

Best wishes on your test tomorrow Woodrow. And on your house sale too Hobbses.


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