Just a quick update…slowly but surely Rudy is making progress since my last post.  I sent a text out to about two dozen people and asked them to pray for Rudy to start peeing and then started to pray myself.  About ten minutes later there was a clear answer in that tube!  Still not out of the woods, but an encouraging sign.  He also had a pretty significant stool which is also a positive sign as it removes the concern that blood isn’t circulating properly in the abdomen.  For now, Dr. Abel will be satisfied with 3ml of urine every hour and for the last two he’s surpassed that.  Please pray that he keeps it up.  Not only for Rudy’s health, but so that I can direct my focus somewhere else.  Nurse Carol is getting concerned about my fixation…

I stayed with Rudy late into the night last night as there was concern about his kidneys kicking back in.  About 12:30am it seemed like one  of the meds was helping him as he started to pee, so I went to a friend’s home to bed.  Unfortunately, he didn’t keep this up and when I arrived this morning during rounds the team was confounded and concerned that there’s been virtually no output to speak of.  What confounds them is the fact that all of the other numbers that typically impact kidney function (blood pressure, labs counts, etc) are right where they should be.  An ultrasound shows good blood, but for some reason they aren’t kicking in.  What concerns them is that Rudy’s belly is getting quite large as none of the fluids they are putting into him have any means of coming off.  We are waiting for Nephrology to come and take a look as kidneys are their specialty.

I told Rudy that if he’s being ornery, he needs to stop.  When Wilson was potty training he got upset at us and decided to take things out by not going to the bathroom for days, so exceptional bladder control runs in our family and it’s been used in protest.  I raised this during rounds and added that I’m getting a sense that Rudy might not like the doctors very much and not peeing is his way of showing it.  Dr. Rick did not argue with this and said, “He doesn’t need to like us.  He just needs to pee.”

A little levity keeps us positive, but we are concerned.  Please pray.

While the trip to the cath lab was supposed to be a relatively straightforward procedure late on a Friday afternoon, it’s gotten a bit more involved.  The line they were investigating in his right arm apparently had come out of the vein somewhere down the line and needed to be removed.  The team tried to start another one but immediately saw Rudy bruise up and decided that it was unwise to keep trying there, so they’re starting a groin line.  As they were doing imaging on that side of the body, they also noticed a significant effusion on the left side of his chest (the pleurodesis was on the right), so they’re going to insert a drain there too.  Dr. Brian said he saw some fluid there when he did the pleurodesis and wouldn’t be suprised that some would collect there in the wake of such a procedure, so please pray that’s all it is and that it will clear up quickly with the drain.

I’ll post something when Rudy gets back in the room.  Those loops just seem to keep coming.

Our Fridays tend to be frenzied days on this journey.  I had a good week in SB and actually felt an ability to focus on some work stuff even while being very concerned about all that’s been going on at UCLA–quite a few nights I hit a second wind and was able to work from 9pm until after midnight.  It’s good to feel a bit more on top things.

Today has had it’s high points:  a fantastic breakfast with great company (thanks, Will), a drive down the coast next to a Pacific smooth as glass (just screaming to be paddled), getting to see my wife and have lunch with her, getting to see my baby boy and rest my forehead on top of his, a sweet attempt by Nurses Sara, Heather and Dr. Andy to surprise us with a Christmas gift (I’ll let Trish tell that story), and….a visit from a surprise guest (check back for pics soon–he’s HUGE!).  It’s also had it’s lows:  having to say goodbye to the kids, not being able to kayak out into that ocean, getting such a short time with my wife, and seeing my baby boy in a significant amount of pain.

As Trish mentioned, pleurodesis is a very painful procedure.  As the object is to fuse the pleura (lung lining) to the chest wall by creating scar tissue, it means using surgical instruments to rough up the sides of the chest cavity and then putting substances there to create even more inflammation.  Must feel kind of like getting scraped with sandpaper and then rubbing alcohol into it.  That searing pain means it’s working.  So, Rudy has been uncomfortable and his heart rate was very high most of the night (180 to 210 bpm).  By the time I got here today he was much more relaxed thanks to medication (140 to 160 bpm).  Too early to say if it’s working, but I was glad to see very little coming out of his chest tube.

Nurse Anita tried to put in a pic line yesterday and it’s got a kink of some sort in it.  The team hasn’t been very happy with the way the lines have looked on that side the whole time, so Rudy’s just been taken down to the cath lab by Dr. Dan for an angiograph so they will have a better idea of where those veins are going.  So, I’m sitting here in his room alone since Trish just left.  It’s weird to be in here without him–the room is remarkably big when his rig isn’t parked in the middle of it.  I’m looking forward to him getting back and just having some quiet hours back sitting with him.  Our prayer is that he would have a calm night and a weekend of rest.  Even though he’s usually lying in the same crib, transports and the procedures that require them are tiring on him.  So once we have him settled in we’ll try for as much calm over the next few days as we can.

That’s it for now, but keep checking back as I know you’re dying to see who the mystery guest today was!  (HUGE–I mean it!  So great to live in Hollywood.)

Trish called about an hour ago and said that unfortunately the team was unable to perform the lymphangiogram.  They were unable to find a line in Rudy’s little feet to inject through.  He’s returned to the room and is probably going to be knocked out for the rest of the day.  Obviously not the news we wanted to hear.  As much as we try to keep our expectations in check that any one step will mark a turnaround, it’s hard not to be disappointed.  From here, they will do a pleurodesis surgery on Thursday which seals the pleural cavity thereby making it impossible for fluid to collect there.

Thanks for praying with us through the day.  Wish I could close with a thoughtful statement that puts everything in perspective, but I’ve got little.  We remain hopeful, just so long as it doesn’t need to be a happy jumping-around kind of hope; just a resolve that God will get us through.  In the meantime, I’m very sad that my son needs to go through all of this.

Trish got a call at 10am en route to UCLA to give consent for the team to start the Lymphangiogram.  We understand that this could be a long procedure, so we don’t have an idea when Rudy will emerge from it.  Please join us in praying for Rudy’s safety, the skill of the doctors and that it would give some clear indication of how treatment on his chest leak should procede.

On another front, please continue to pray for Rudy’s nutrition.  The team had to stop feeds to his stomach overnight as his stomach was getting a bit big.  They’re hoping that a bit of a break and some meds for his kidneys will start processings again.

More when we know it.