Wednesday, August 02, 2006

Urine luck!

We now know that Woody's little sickness is either a urinary tract or bladder infection, based on the urine cultures they took prior to starting the antibiotics on Monday. The good news is that his blood cultures have come back negative, which suggests that it's not anything more serious than that, and the culture shows that the bacteria causing the infection is the sort that is handled by the antibiotics he is currently getting, so he ought to be cured by his current treatment.

In other good news, his followup echocardiogram shows that while he does have a collateral bronchial vessel (an extra blood vessel running from his aorta to his left lung), it's not serious enough to do anything more than just re-check shortly before he is discharged. As it was explained to me, kids develop a number of blood vessels in utero that are ordinarily either re-absorbed into the body or otherwise unused by the time they get to term, and preemies often have some artifact vessels that go in odd places leftover from ending their gestation early.

As alluded to earlier, we are looking at the future now, and there is a basic split in approach to where we will be going in the next month. Track I is that we'd try again to extubate Woody around week 36 (one week from today) with the idea that if he was unable to make it on that attempt, we'd have another chance to try prior to term (week 40) before giving in and getting the tracheostomy. Track II would involve us waiting a while longer before making the extubation attempt, with the goal of letting him gather as much strength and build as much new lung tissue as possible prior to the extubation, in order to give him as much of a chance of success as possible. Of course, if this extubation attempt would fail it would mean almost certainly that he would be going home on a trach*.

However, we may not be able to actually choose which track we want-- if Woody has to have eye surgery next week, we will be more or less forced onto Track II, as he would need to be intubated for the surgery, and he would need time to recover afterwards before doing another extubation. Since we wouldn't really have time to make another attempt before week 40, we'd probably just delay until around week 37 or 38 to give him the best chance to make it as possible.

Let me make a comment, peripherally, about the trach. One of the reasons that I was so sad about Woody's reintubation was the fear that we would have to deal with this over the next year or however long it would be. Both I and Grammie have noticed that some people do not have much patience for talking about our fears on this issue. "Well, if that's what you have to do, suck it up" or something seems to be the gist. I understand this sentiment-- hey, I understand that after a while compassion fatigue sets in. I also agree with the underlying point. Of course, if that's what we have to do, we'll suck it up and deal with it. On the other hand, I think it's okay to point out that something just sucks once in a while, so if you're hearing me say that, the correct answer is something along the lines of "there, there," not "would you rather he just die?" Also, please remember that we have banned the phrase "it's a roller coaster ride." "You expected ups and downs, didn't you?" is also more or less right out.

I still have great confidence that all will be well in the long run, but it's hard to get an idea of what it will take to get us to this mythical and long-promised 'long run', and I am impatient for it.

*I have noticed that some people write this common nickname as "trake", but this seems a bit silly to me, even though I can't really explain why. "Mike" short for "microphone" also irritates me a little. It's a mic!


At 1:11 PM, Anonymous Grammie said...

Bad pun, GREAT post.

Love you!

At 1:54 PM, Anonymous Angie Theisen said...

Could you explain why Woody would be on a trach for so long- if he came home with one? And what exactly do they do in this eye surgery and is it a pretty common one? Should I be in a different blogging area to ask these q's? (I'm really dumb with computer, techy stuff)

Wishing all the best, all day, everyday

At 2:00 PM, Anonymous jared said...

There is something to be said for phonetic abbreves...

Good luck on the Tracks, the Trake, and those beautiful blue peepers.

At 7:26 PM, Blogger Bill Hooker said...

I agree, "mike" and "trake" are abominations.

Nice catch on the infection, Papa! But that pun... *makes norm a sammich*

At 2:02 PM, Blogger minx said...

your pun made me smile!

just going through the old posts, thinking about how cool it is that woody's such a healthy happy little guy now.


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