John's Weekend

John was admitted to the PICU at 3:45 am on Sunday for severe acidosis. Normal body pH should be 7.35 John's was 7.02, normal body CO2 (bicarb) should be in the lower 20's John's was 7. He scared a whole bunch of people but in the PICU began to recover rapidly and this morning he is doing great with normal numbers, even for other people not just normal John numbers. While in the PICU we also found out that he has RSV. While that can be a devastating illness in babies John seems to be handling it quite well. He has not needed any oxygen support nor other breathing helps and for all the world just sounds like he has a pretty bad cold - which is really what RSV is. He continues on the fluconazol - antifungal drug and other than that seems good. He will probably be moved out of the PICU today and back out on the floor.

The acidosis was brought on by a combination of factors but probably the biggest was being a bit too aggressive in turning down his TPN and pushing his feedings - but the aggressiveness of treatment with John's GI issues is what keeps him chugging along and developing well. The GI docs are now going to address John's feedings by divorcing the two issues 1. his need for caloric intake and 2. his need for fluids. What this means for John is that for the moment he is back on full TPN but once he is out on the floor and ready they will start his g-tube feeds again. As the g-tube feeds increase they will take the caloric things, amino acids and such out of the TPN. Of course this means that he has to have a new broviac central line put in later this week or early next week, but once the caloric things have been completely removed from the TPN his liver will start to recover and his line will be less susceptible to infections. After he is getting all of his calories through his g-tube and/or by mouth then they will start to try to wean him off the IV fluids. This of course is going to take some time and will depend heavily on what John's system can handle.

As always we thank you for keeping John and us in your prayers. We''ll try to send a pic of John out pretty soon. Thanks again, you are all such a blessing to us. In Christ's Love, Mark, Gina and John who even during all the struggles with stuff in the PICU still made the nurses smile and oh and ah.