Mikie really has had a pretty good day. I did notice when I got home from work that he had quite a rattle in his chest but Lorraine said he had maintained about  an oxygen saturation level between 90-95 all day.  However, he had some trouble around 5 PM and it dropped to the mid to high 80’s.  I tried suctioning him but it was just too deep to get too and though he would cough it just wouldn’t come up.  We tried sitting him up and got him to cough like that but it just got worse.  Finally we laid him back down and rolled him on his bad side.  We call it that because for years if we rolled him on that side it would make him cough and it made him very difficult to breath.  Several months prior to this last hospital stay we noticed that most of Mikie’s respirator problems disappeared, including the left side cough.  But I noticed since he has been home and suffering from some respiratory problems that the left side cough came back.  Since that’s one way to make him cough, we put him on his left side for a few minutes and then brought him back over and suctioned him as deep as I could through his throat with a soft tube.  Then I remembered we had a nebulizer and some Albuterol Sulfate solution that we used to use in past.  We dusted it off, washed the breathing apparatus part up and cranked the thing up, putting the mask on him for about 5-10 minutes.  I saw his Oxygen level increase from 90 to 92 in minutes, and within 30 minutes of the treatment it was up to 98-99, the highest we have seen it since we got him, or for that matter, since he has been off the ventilator.

Now that I think of it, we never had a pulse oximeter when we used the nebulizer before so we never knew what Mikie’s actual oxygen saturation levels were before or after.

Here’s a pretty good article that describes what I have been concerned about since Mikie’s respiratory distress incident last week in the hospital, the one that sent him back to ICU.  

http://www.merck.com/mmhe/sec04/ch055/ch055a.html

This is from the site:

Low oxygen levels in the blood cause a bluish coloration (cyanosis), and high carbon dioxide levels and increasing acidity of the blood cause confusion and sleepiness. The body tries to rid itself of carbon dioxide by deep, rapid breathing, but if the lungs cannot function normally, this breathing pattern may not help. Eventually low levels of oxygen make the brain and heart malfunction, resulting in deteriorating consciousness or unconsciousness and abnormal heart rhythms (arrhythmias), which can lead to death.

Otherwise, Mikie has had a pretty good day.  He’s been awake and alert, seems to be in no pain requiring no more than a little Motrin and even less than his normal dose of seizure meds.  His urine is very clear and light colored now and he is tolerating his feedings at 75 ml per hour with no problem.

I just checked in on him and his heart rate is now below 100, at times in the high 80's, and yet the oxygen levels are still high.  I suspected that the reason it had been so fast was because of the low oxygen levels, the heart trying to make up for it by moving more blood.  Now that his bronchial passages have opened up a bit the heart rate is slowing down.  That doesn’t explain why his heart rate remained fast while in ICU, unless it was just the stay in ICU itself that was causing it.  They certainly had his oxygen levels up while on the vent.  Yeah, I suppose if someone shoved a tube down my throat my heart would be pounding too.