Down to Ten!

Trish and I have both been in Santa Barbara today to be with Grandma and Grandpa and get the kids back off to school. Had lunch out on the pier and enjoyed that “only in Santa Barbara” view.  We’ve been checking in down at UCLA by phone and are very encouraged by Rudy’s steady progress.  Two more steps down on his ventilator rate mean he just came down to 10 breaths per minute this evening and seems to be tolerating things well.  The team will likely continue to step down the rate, but will also start to turn down the pressure with which each breath comes from the ventilator.  In my check-in with Dr. Lee this evening, he mentioned that Rudy’s prealbumin, which is an indicator of nutrition, is now at 29!  The last time they tried to extubate him, it was less than 10.  With good nourishment, they hoped to maintain a level of 20 so it’s great to have Rudy well above that.  The prayers for nutrition are clearly being answered and he now has lots of energy for breathing.  Go, Rudy, Go!!

Trish will be heading back to UCLA tomorrow and we’re excited that one of us can be with Rudy during this encouraging swing.  While the team is keeping an eye on some very small fluid pockets on his lungs, these haven’t grown significantly over the last week so we can continue to hold him–and something tells me that’s what Trish will be doing most of the next few days.

In addition to your prayers, we also have a minor logistical request for those who are so inclined.  A few people who called Trish today might have wondered if it sounded like she was whitewater rafting.  Actually, in a fit of efficiency this weekend, Trish laundered her cell phone–she might just be taking the whole hygiene around Rudy thing a bit too far.  It’s now downy fresh and static-free but doesn’t actually send and receive calls.  We did set her up with a new one (Dante overlooked a 10th circle of Hell–the cell phone store).  Unfortunately her contacts didn’t transfer so if you speak with Trish regularly by cell phone, she would appreciate you calling hers sometime in the next few days so she can capture your number–or send it to her by e-mail.  Pat me on the back for restraining myself…there are just too many jokes to make here.

The Plan for this Weekend

Trish went back to SB for the weekend, so I’m here hanging with Rudy.  The 4pm Doctor Parade just came by (OK, they call them “rounds” but it always feels like the former as I step out on our front “porch” and wave as they go by).

After looking at the flourscope study, Dr. Reemtsen feels there is no damage to the diaphragm, making the key concern nutrition and conditioning.  Nutritional status can be determined by checking prealbumin levels.  Rudy’s level is 9; it should be 20.  This confirms the plan of action determined with his chylothorax.  If we can stop the leak, Rudy can retain the protein and nutrients he needs to breathe on his own. 

The only way we will avoid surgery on Monday is if the chest tube output stops completely.  It just dawned on me that Rudy might be a bit of a troublemaker.  They put Rudy on Monday’s surgery calendar three hours ago and since then, wouldn’t you know, the chest drain output has gone down to pretty close to nothing.  Reemtsen is a cool customer, but he wonders if Rudy is trying to drive him crazy.

Turnabout is fair play, so Brian got the last word by sending Rudy on a two hour sprint.  Just because the timeline got extended a bit they aren’t giving Rudy the weekend off.  He’ll be doing three a day as he seems to tolerate these well and every little bit of conditioning helps.

So, I’m looking forward to a weekend watching the tube!