It was a bad night and rough morning for Gabe. Last night everything was going well and then after having one of his routine breathing treatments, he didn't recover like he normally does. His oxygen saturation's took longer to come up and he was acting very uncomfortable. He started breathing faster and his CO2 levels started rising and they got pretty high. During rounds this morning they discussed Gabe's respiratory issues and changed his ventilator setting back to were the ventilator is doing all the work, instead of him initiated the breathing. This seemed to make him more comfortable. The other issue that Gabe is facing is the fact that he has put on a significant amount of edema and got even puffier than last night when I left him. So today they are trying super hard to get all this fluid off. They have also increased his Lasix to every 6 hours instead of every 12 hours, this should hopefully get the fluid off a little quicker.
Unfortunately today they have had a hard time getting vascular access in the form of an arterial line to give Gabe the necessary blood products like the albumen and whole blood. They also need this line for labs and blood work. They have poked Gabe so many times they are having an increasingly difficult time getting the necessary lines. Today they had an anesthesiologist come up with a mini ultrasound machine to place an arterial line. She was able to get the line in however there was a problem. It wasn't working that great, but the bigger issue was the fact that there are only two arteries and they can be damaged. What this means is that we have already used one of those arteries heavily and it stopped working which could mean a damaged artery. If it is damaged it will heal over time and is not permanent. However, they stuck the new art line in his other artery and it is not working that well. This means we could cause damage if we leave it in and if both arteries are damaged then no blood can get to the hand and then he could lose his hand. Not something we want to even take a chance with, so the art line was removed to keep his hand safe. Fortunately we were just able to get an IV in his left leg and he is able to get the blood that he needs. Hopefully it will continue to work because Gabe is notorious for IV's going bad. They are trying to get surgery to come back up and try and place an arterial line in one of his femoral arteries. However, they don't seem too hopeful of these sights and they have mentioned the possibility of what called a "cut down". It's just like it sounds, they cut into him to get to a suitable artery. Not fun to say the least, but at this point we will take anything we can get to help Gabe. We really don't care as long as they have what they need to give him what he needs to keep him alive.
Shannon came back this afternoon after dropping Kayla off at Grandma and Grandpa's house and was just in time to meet with Oncology, the cancer people. They were there to review the CT preliminary results with us and we had some good and bad news. The good news is that the tumors or masses don't look like anything they are used to seeing that are cancerous type tumors. However, they cannot give us a definite answer until they have a more complete biopsy result. To us this is good news since it doesn't look like cancer. The other good news is that the CT of his lungs looked good, so to speak. There are still areas of collapse and he still has fluid around his lungs, all which we already knew. The good news was that structurely there are no obvious deformities to his lungs which would present a larger problem. The respiratory doctor came down and said that his lungs are smaller, but that could be because he has so much edema and swelling that it hasn't given his lungs much room, even before he was born. They said they could only tell the extent of the smaller lungs only after his swelling is down and he is off the ventilator.
The bad news is that there are actually eight tumors instead of the two we previously thought. They are on both his left and right lobes of his liver, with the largest one being on his right lobe. This is scary news for us, since everything seems uncertain and we have no definite answers. We are not going to jump to any conclusions and take things one step at time. I will update you later tonight on what happens during the rest of the day. I just wanted to get this all down before I become too tired to remember.