The results came back from Maddy's CT scan and it has us worried! She has pneumonia in the upper lobe of her left lung and her right lung is partially collapsed, which means there is air in her chest cavity. They have to put her on antibiotics for the pneumonia, obviously, but for the air in her chest cavity they have to put in a chest tube. They will leave the chest tube in with suction on it for a few days to make sure her lung opens all the way up and she can breathe again.
This is really crappy news in one respect but the doctor says on the other hand it's positive. He said if the only reason her lung functions have taken this big a dive were rejection there is not much chance for full recovery of lung function after treatment. Having these other two issues as a possible cause for the drop in lung function increases her chance of having a full recovery. Basically the air and pneumonia are more quickly treated and have better recovery statistics than a full on rejection episode.
Dr. Floreth is very optimistic that Maddy will be feeling much more like herself in a few days. Then after a week or so of treatment her lung functions should be back to where they were. He also said it makes sense that it took three different things to knock a tough girl like Maddy down! She don't mess around!
Maddy went down for her central lines and chest tube at around 4. It was 6:30 before she came back. She is still a little groggy but seems to have wethered the procedure well. They said she tolerated the central lines and chest tube well.
Just as I was writing the above all hell broke loose. The nurse hooked up the suction for her chest tube and Maddy suddenly couldn't breathe. It took us about 20 or 30 minutes to get her breathing again. She was in a lot of pain and couldn't catch her breath. They had her on 3 leters of O2 through a nasal cannula but she said she couldn't get enough breath from her nose. We called in the respiratory tech real quick and she set up a mask so she could gulp air through her mouth. That got her O2 sats up above 90 again. It never dropped below 80 so we knew she was not in trouble. But she was having trouble understanding that she was ok so she started having a bit of a panic attack on too of it all. We finally got everything under control and the doc called the nurse back. He said when they put suction on the chest tube it probably expanded her collapsed lung quickly, causing an imbalance that lowered her sats and made her feel like she couldn't breathe. After all was calm again she was able to tell us she could feel it crackling and expanding a little.
Now that all that is over and she is stable again they were able to start her first IV antibiotic. We are waiting for the dialysis team to come up here for the first round of plasma pheresis. As I typed it they showed up! (Now that's service)
The above pic is of Maddy's central lines. The top line goes in at her neck and if the the pheresis. The bottom lines go in at her collar bone and is used for antibiotics and they will draw her blood work from there as well. So no more sticks! (We hope)
Here is the machine they will use for the plasma pheresis. A quick refresher on pheresis. They take her blood out. Spin her blood to seperate the plasma from the blood. The antibodies they are trying to get rid of are in the plasma so that goes right out the window. Not literally. Then they add albumin to the blood cells and put it back in her body. She will make more plasma but it takes too long to make albumin so they need to add it.
Things are going well with the pheresis so far. Maddy still has not eaten but I'm about to run down and get her some McDonalds. Hooray! I'll update again tomorrow. Thanks for all the prayers. I hope I didn't leave anything out.
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