We did “the walk” again this morning as Rudy had to go down to the Cath Lab for a fluoroscopy. Rudy looked like a child emperor in his carriage as a half dozen people wheeled him and all his gear down to the elevator in his big crib. Trish and I made like we were helpful, moving chairs or pushing a door button here ore there, but it was hard to divert our attention from the respiratory therapist’s hand regularly squeezing the inflator that they use to help him breathe when he’s off the machine. Hard to believe it’s been almost six weeks since the last time he was out of this room.
The Cathertization Lab is a high-tech room filled with gear one can’t even imagine. We watched from the control room as they put him on a table with a huge bank of eight flat-panel displays behind it. When things were ready, Dr. Dan, Dr. Lee and the RT put on full body wraps of lead armor to protect themselves from whatever invisible thing this machine does. Lying there on the table, Rudy’s defense was limited to little more than a clean diaper.
All of this was to give the team a very clear image of what’s happening with Rudy’s chest when he tries to breathe—a “video Xray” of sorts. For all the time it took to transport Rudy and get him positioned, it’s startling that they needed to look for only 15 seconds at what was going on to make their assessment. There is no sign of paralysis, detachment or extensive nerve damage affecting the muscles of his left diaphragm. It just isn’t moving with the vigor it should.
The good news is that this is not something that requires a surgical fix. The bad news is that the main remedy for this is time; time for Rudy’s nutrition to take effect and for the muscles to get strong. Perhaps there is some minor nerve damage, but attention is focusing back on his chylothorax issue. The fluid leaking from his chest is draining the protein he needs to get strong. Without fixing this, we can’t begin feeding him into his stomach which would really further nutrition. So, though we haven’t heard definitively yet from Dr. Reemtsen, word is that Rudy will be placed on the surgery schedule for Monday and will only be removed if there is zero output from the chest tubes. We appreciate having a team that isn’t too quick to operate, but there also comes a point where waiting things out has run its course.
That’s the update for now. Still praying for peace and protection to all of you back home in Santa Barbara.
Rudy's Beat 
Seems like the good news is always tempered by something. It’s as if having reached the top of a mountain after an arduous climb that the view is simply more mountain peaks that must be traversed. It is definitely an up and down battle, one that is tiring from my distant observation point; how much more so for you who are right there climbing with Rudy.
I can only hope that my prayers – and those of so many others – are helping to give you strength as you keep climbing!
I suppose it’s good to know what’s keeping Rudy from cresting the mountain… we’ll keep praying for full lung function.