Update III

Things are starting to improve. While the chest x ray is still pretty white, the labs look good. The vent settings were reduced yesterday and Dear Son is breathing over the vent. Both the pain and the sedation meds were reduced as expected with the decrease in the vent settings. It looks like we are on our way in terms of extubating although it is probably still a few days away. He has completed two of the three antibiotics and we are on day 7 of a 14 day course on the third one. He remains on insulin for the time being. He is tolerating feeds through the g tube and the breathing treatments have been reduced a second time and are now every four hours. They have told me that we are still not out of the woods yet, but things are looking good. Dear Son opened his eyes for one second a few times yesterday but nothing yet today. Your prayers are working and are appreciated.

Interestingly enough, there was a special segment on our local news last night about MRSA. They interviewed the Section Chief here at the Big Academic Medical Center. They showed a boy who had recovered from a MRSA pneumonia last year-he was in a coma for two months and hospitalized for five months. Of the twelve cases they had here, seven died. I am a very lucky woman.

During the rounds today, I also asked about the lack of the local hospital to make an appropriate referral here. I actually initiated the referral here because I didn't feel Dear Son was improving and he was struggling really hard with his breathing at the local hospital's ICU. Since Ped Neuro Doc (who works at the Big Academic Medical Center) was on vacation, I ended up speaking the doc's nurse who was covering for him. I explained that I was very uncomfortable at the local hospital, that Dear Son's breathing was extremely labored, that he wasn't getting better, etc, etc. It was late on Friday night and she managed to find a pediatric resident who would agree to take the transfer "only" if the Ped ICU Doc would initiate the transfer. I spoke with him and he said he would agree but only if the Big Academic Medical Center had a bed available in the PICU. I gave him the pager number of the pediatric resident and 28 minutes later the Air Team arrived from the Big Academic Medical Center and saw Dear Son. They changed one of the antibiotics immediately and said he was in distress. By the time Dear Son had arrived at the Big Academic Medical Center he was in respiratory distress/failure and in septic shock. I wanted to know why the ICU at the local hospital didn't make an appropriate referral. The local hospital uses a hospitalist system; there are hospitalists in the ER and also on the Peds floor. At the local hosptial, they have a different hospitalist every twelve hours. I do not like the hospitalist system nor do I belive they are good. When I am sick or Dear Son is sick, I want "our" doctor, not someone who doesn't have any history. The attending physician answered my question by saying that a lot of the local hospitals don't think that MRSA happens in their area and think it's only an inner city issue. The area where I live is one of the wealthiest suburbs which is probably part of the problem-they probably don't think MRSA exists there. I would hope that more hospitals begin to understand MRSA so that appropriate referrals can be made. Dear Son arrived here in the nick of time and I would hope that more hospitals would understand the important health issue that MRSA has become so that this situation doesn't happen again to some other child.