My heart is smiling!!!!

This morning I woke up totally out of fuel and just plain exhausted.  I have not even had an opportunity to recover from my surgery before being thrown into a major crisis.  But Avery turned it all around for me today.  Around 10am the nurse was changing his diaper (he of course gave her a shower) and his eyes opened wide.  I sprung from the chair and he looked at me and gave momma a big smile.  I had tears of joy.   He is offically all personalilty today.  Crying when mommy leaves and eying drs who approach him.   That's my boy.  One of my biggest worries through all of this is that he would recover but lose all of his personality.  That is the only thing that this horrible disease has not taken from him and I cannot imagine him without it.  So today I am sooo thankful and blessed to have my little man back.

WARNING INTENSE MEDICAL JARGON BELOW!!!!!!
Of course we are not out of the woods yet.  He has alot of obstacles to overcome.  The first is he is growing a highly unusual fungus that is hard to treat (true to Avery fashion).  Surgery and Infectious Disease want the line pulled as soon as possible but both myself and the ICU team know it is not realistic.  Avery literrally needs about 10 lines right now and he has only 2 peripheral IV (one is on its last leg) and his double lumen broviac they want to pull.  Problem being is he is currently getting 4 IV antibiotics, 2 IV sedation meds, TPN and IV potassium plus blood products.  So the math does not add up, right?  Where he is medically stable right now we don't feel the need to rush pulling it until they know he has the bug in both lumen of his central line and his blood stream (which would have caused him to be so sick due to being septic).  Unfortunately, fungus is a very slow growing bug and this is not good for us.  We basically need to find the species of the bug (for proper antibiotic coverage) and have negative results before they can put a new central line back in.  As it stands we only have the first round of postive fungus from Sund. night.  Nothing is back from Mond, or Tues.  so you see we need these to show us what is going on before a decision to pull his line is made. 

Second big issue is when to extubate him from the vent.  A few things affect this as well.  The main issue is the poor kid is so fluid overloaded and bloated beyond belief.  This poses a huge problem b/c if he is bloated on the outside, then what must his airway look like.  His vent setting have been weaned significantly which is great news.  But if we extubate too early  and he is not ready then he will have to be reintubated.  His stomach is huge right now which is a problem b/c he needs his stomach muscles to help him breath effectively.  Also they will not extubate until a decision is made about a new central line b/c he will still need to the vent for the procedure.

On a good note, Avery's bleeding from his g tube has slowed enough that the platelets they are giving him are keeping his number in a reasonable area.  He has gotten a total of 3 platelet transfusions and one red blood transf. and so far has not needed another one today.

Your head is probably spinning with medical overload.  So I will end it here.  Slow and steady wins the race.  I will be going home tonight to finally sleep in my own bed.  Avery's favorite nurse is on tomorrow and the nurses he has had have been great so I feel it is time to take care of me now.  Thanks again for all the love, prayers and good thoughts.