what to call it?
Well it is kind of like government spending, is a reduction in the rate of increase really a cut? So it was with Becca's breathing last night. She had been doing much better and was being challenged and pushed by the Docs tweaking her vent settings. Overnight she began to struggle with keeping her saturation up and a chest x-ray showed the she was derecruiting somewhat [collapse of the aveoli (little air sacs in the lungs)]. The PEEP pressure that I have mentioned in the past is what keeps those sacs open during exhalation in a kiddo that is struggling like Becca. For normal lungs, this is done by the ambient air pressure. So lowering her PEEP closer and closer to normal air pressure is necessary to get her off the vent, but every tick down gives her less support. So I will call this a slight and specific decrease in the gross rate of increase, she is still getting better, just a bit more slowly. It looks like the oncology folks are going to restart her chemo today or tomorrow. At first, it will just be the Hydroxy Urea... remember that compound from a hundred years ago when we were first admitted? Begin digression... admitted? Jeez it sounds like a red velvet rope barrier should be involved, digression over. The Oncology team is currently discussing how to proceed with her dosing, specifically whether or not to lighten the dosages and extend the time or to use the tried and true sledgehammer approach. A rise in her white blood cell count, that dropped so precipitously, has begun to come back up rapidly along with her ANC. The small gift that this timing may bring is that she may be sedated for the worst of the symptoms following the administration. Something that just popped into my mind...I really hope she does not wake up bald. Father's fears of failing follicles force foreboding flights of fancy. Sorry I just needed to get some "f-words" out.