Slowly...

That's the magic word of the week. They respiratory therapists are attempting once again to move Rob's ventilator settings down to keep trying to get him off the vent. He is at a PEEP level of 8 and an oxygen level of 40%. This combination is the lowest attempt so far. So we're praying that he handles it well and is able to keep moving down. He's still a little agitated, as I'm sure anyone would be who has had a tube down their throat for 2 weeks. They are trying not to give him anymore sedation medication than absolutely necessary. So today will probably be a little tough on everyone, including him. They have to find the "sweet spot" for the right balance of Ativan (his sedation medication) and his lower ventilator settings. And that can be a tricky thing to manage.

Over the next 3 days they will slowly switch his pain medication from morphine by IV to methadone by oral tablets. They will start the methadone today and slowly increase that and decrease the morphine IV at the same time until they are able to remove the morphine IV. Which means one less machine and tube for Rob! Anytime they can remove a line from him is a great step ahead for him.

Rob's breathing difficulties are due to a condition that he has developed stemming from the pancreatitis. It is called ARDS, or Adult Respiratory Distress Syndrome. The doctors and nurses tell me that patients can recover relatively quickly after developing ARDS or they may take up to a year to get back to normal breathing functions. Some patients can deal with it for the rest of their lives and it can be life threatening for some. But we're praying that this is short lived for Rob and that he can bounce back quickly with the help of his young age and otherwise good health.

The following link will take you to a website about ARDS and explain a little about the common treatments used for this condition. It also explains what the PEEP level is that I keep talking about concerning Rob's ventilator settings.

http://www.ards.org/learnaboutards/whatisards/faq/faq5.html

I am in no way smart about all these medical terms that are being tossed at us so I tend to use the Internet to find out a little more about them. Although, using the Internet can be frustrating at times too because it describes the overall condition and is not specific to Rob's case. So what you learn online may not be exactly what Rob is experiencing. I've found that the online descriptions sometimes sound much worse that the doctors describe so don't be alarmed if you read the words "death" or "mortality" more than once on some of those sites. We're praying constantly that Rob's condition isn't anywhere near that level and so far, he's looking very good.

So, today could be a rougher one for Rob due to the changes in medication and finding the "sweet spot" in the balancing act of vent settings and sedation medication. I can only pray that he is as comfortable as possible and I let him know what is happening and why it is happening. I keep reminding him that he needs to get better so we can go home soon and prepare for our new arrival, which is coming sooner than I can even imagine. We have less than 14 weeks left now until our due date. I told him that he needs to keep looking forward to getting home, finishing the nursery, finalizing baby names, and actually getting to purchase the new rocker/recliners we were shopping for when this all started. We started shopping for a rocker for me for when the baby comes and Rob then thought we should see what kind of deal we could get on 2 and have a matching set. I think he has an ulterior motive to getting a good deal. Probably the fact that the one we were going to buy for me was much more comfortable than the one he has at home already. :) Although, after all this, I think he deserves a big comfy chair to relax in. I know I could sure use one. So off to McGregor's we'll go to get our chairs once we return home. It's so important to focus on the future in a case like this. As long as Rob can keep hearing about what he has to look forward to in the future, he'll have to urge to fight his condition even more.

Focusing on the future...

Kelly