There seems to be some confusion as to what's going on with Colby. That's probably my fault, sorry. I'm not exactly hitting on all cylinders lately. So let's see if I can provide clarification. Read below and pay attention.
Saturday afternoon we went via ambulance to Kosair, the local children's hospital. There they did a chest x-ray, nasal swab to test for viral illnesses, a trach aspiration test to test for other things and drew blood work. Then we were taken via the Kosair transport team to Cincinnati Children's, late Saturday night. It always takes lab results at least 24 hours to complete, if not 36-48 hours. So it doesn't do me any good to start asking what the lab reports are until 24-36 hours after they were taken. X-ray showed small amount of pneumonia on Colby's lower left lobe. Well of course it did. Does Colby get sick without getting pneumonia?! Apparently if the pneumonia is "streaky" that indicates viral. If it is a "patch/spot" usually means bacterial. Who knew? So they started him on IV Clindamyacin (probably spelled incorrectly.)
That's really all I knew until this morning. In rounds we discussed everything going on with Colby. His CBC looked good. His renal panel was normal. His PCR is negative. That's the viral panel they run. The attending doctor here said Kosair said they test for about 20 viruses including flu, rhinovirus, etc. His nasal sample shows no nasty growth. However, keep in mind there are about 150 nasty viruses out there, and they only test for about 20 of them. His trach sample is growing gram negative. What does that mean? Probably means he has pseudomonas (probably spelled incorrectly.) Great, super, fantastic. Guess this will be Colby's arch nemesis. We have to wait for sure for the gram negative result to keep "growing" to further define what he has. They will probably keep him on his current antibiotic and add another one to treat the pseudomonas if that is in fact what Colby has. So, as of now, Colby's official diagnosis is bronchitis and pneumonia. We're going to try some hypertonic saline and maybe some Xopenex (spelling?) to try and break up the gunk in his lungs. Colby is on 30% oxygen, room air is 21%. So as he starts to improve, we will wean his oxygen down as he tolerates.
Colby does not have the Enterovirus everyone keeps asking about. Here's some helpful info. The pulmonologist said 2-3 weeks ago they were swamped in the TCC with patients testing positive for it. He said it was so bad he felt schools should have been closed down. He said it's not that bad right now. I do know there is another patient on our unit that has it, but this patient is down another hallway, thank goodness.
What's the plan for Colby? Wait to see what else the trach culture grows. Treat accordingly, maybe add another antibiotic. Continue cough treatments every 4-6 hours for airway clearance, trying to finally get his lungs clear. Maybe use hypertonic saline or Xopenex to help with that. Colby is feeling better I think. He got lots of good sleep last night, more than in the last several days. His heart rate if finally down where it should be. We gave him a bath last night. He was needing one really badly. Stinky Poo! Hadn't had a bath in several days.
That's the plan, Stan. Hold tight. Watch for Colby to improve. Wait for further culture results. Give Colby kisses and hugs and more kisses and more hugs.
And don't forget!! The Origami Owl jewelry fundraiser is still a GO. We're still having it!! I know you were just thinking this morning, man, I need some new, uniquely designed and original jewelry. I just know you were thinking that! Taking orders from now until Tuesday (tomorrow) at noon.
I'll update when I know more. Colby is amazing! How in the world do you battle bronchitis when you have no cough?! He's such a trooper! What a strong-willed young man he is. Gooooo Colby! Kick some bronchitis/pseudomonas/pneumonia ass.
Awesome. sounds like they are on top of things - and where they drop the ball, you are there to pick it up and hurl it back at their heads! I'm connivence doctors wouldn't be as good if it wasn't for the mom's who step up, become educated about what's going on with their kiddos, and keep the doctor's in line. On the other hand, I'm amazed doctor remember so much from visit to visit when they don't see some kids that often. i can't tell you what I had for dinner last night, let alone the name of someone I met 3 months ago.
ReplyDeleteKeep up the awesome work. Every rock star has someone behind them believing in them and helping them. Colby wouldn't be who he is, where he is, without you. Rock on sister!!