Ian's overnight update:
Ian is not doing well overnight. Overnight is typically worse, but seeing as though his case is diagnosed as severe, it makes it so much harder. He is back up to 4 liters of O2 and is still having a moderate amount of trouble. His chest x-rays showed partial atelectasis, partial collapsed lung, in both lungs.... Making it even harder for him to breath.
He has a lot of secretions and exacerbates them by his hypersensitive vagus nerve and all the coughing. He doesn't expectorate the secretions because of the dysphasia sensation and oral aversion, so he ends up swallowing them. With the dysphasia, this usually induces more coughing. Thankfully, the x-rays did not show fluid buildup in the lungs.... So, at this point he seems to be holding off from the pneumonia. RSV is one of the most common causes of pediatric pneumonia.
The respiratory therapist is doing an easy-pap treatment to try and help open the collapsed parts of his lungs. If he reaches 5 liters and is unable to respond to the easy-pap or other therapies (which are unknown to us at this point) they consider intubation.
Ian still seems very uncomfortable and sickly. For Ian, this is rare even when he is sick. This is the sickest we have seen him and he seems to be really struggling. Yesterday during the day was better, but we were told that sometimes they get worse, and then usually improve. Ian's allergy tests for immunity have not returned yet. They were drawn on Tuesday of last week. Hopefully, we can get those results soon and the doctors can assess he needs based in his level of immunodeficiency.
Thank you again for all the thoughts and prayers. With Ian's previous prematurity, chronic lung disease and the reactive airway disease-asthma, we are certainly not falling into a fantastic category. Most children do not need to be admitted for RSV. Of those admitted, only a little less than half really need to have oxygen. Ian is on a pretty high dose right now and we are praying that it is an overnight-sleeping exacerbation.