It's always tough to pick which to lead with - the good news or the bad news. Today I am going to start with the bad.
Jaisal's labs this morning showed a huge jump in his white cell count. Likely cause? Infection. Likely type of infection. Pneumonia. Ugghh! Truly, the odds were against him in avoiding an infection. He's post-surgery, immune suppressed, in the PICU, and has respiratory issues. There's no way to know if a) it is pneumonia, and b) if it is, whether it is viral or bacterial. As a precautionary measure, the docs have started Jaisal on an antibiotic. If it is bacterial pneumonia, then hopefully the antibiotics will do the trick and avoid the possibility of him becoming septic. If it's viral, well that just has to run its course, which for Jaisal likely would be a couple of weeks because of his immune suppression.We also drew blood and urine cultures to check for other sources of infection.
In a way it's a relief to have some sort of potential diagnosis to explain why Jaisal took a backward step with his respiratory issues. Of course, I am not thrilled about the potential illness and the fact that it will further prolong our stay in the hospital and creates the potential for reintubation. Kirk and I are completely freaked out by that last prospect to say the least. After a pretty rough morning breathing-wise, Jaisal did seem to settle down a bit, even managing to laugh and squeal while wearing the mask. We're hoping that even if he doesn't improve right away, he holds steady and avoids the need for intubation.
Now the good news. First and foremost, Jaisal's liver labs continue to trend in the right direction. Yay, yet unnamed liver! (By the way, we're loving the name recommendations.) Secondly, we had a cardiology consult today regarding the breathing and heart rate issues. The cardiologists don't think Jaisal's heart is the cause. Whew! We were concerned because back in July Jaisal was diagnosed with a mild heart defect, an atrial septal defect (I think that's what it's called). Basically there is a small hole in the wall separating the two atriums of his heart. Quite a few people have an ASD, but only some require surgical intervention. The docs wouldn't even consider surgery for Jaisal until he is 4 or 5, so the ASD itself is a back burner issue. Anyway, between this ASD and Jaisal's heart showing as enlarged on all of his xrays, we were concerned that the symptoms we've been seeing weren't related to Jaisal's lungs, but instead were stemming from his heart. The cardiologist put those fears to rest. Jaisal's heart is working perfectly and likely is enlarged from the earlier fluid overload. He expects it will go back to normal size over the next year. We'll have to add a few cardiologist appointments to our future medical regimen, but we kind of already knew cardiologists were going to be in our future anyway, so this isn't a big deal. Last but not least, Jaisal continues to gain weight. He's almost back to pre-transplant weight, and I can't wait to see where he'll level out. I know he's a little old for baby chunkiness now, but I secretly (okay, not so secretly) hope he gets some chubby thighs for me to squeeze.
Tomorrow Jaisal finally gets his staples out. The surgeons did a fabulous job with his scar, but it will be nice to not see the little man looking so Frankenstein-ish with staples across his belly. Kirk's already determined that Jaisal will tell people he got his scar by getting into a knife fight with monkeys in international waters. I'd prefer he say he got attacked by a great white shark while surfing off the coast of South Africa. Maybe, just maybe, we'll let Jaisal come up with his own story.
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