Tuesday, June 05, 2007

Pneumonia Update

Dear Son is doing better. Since I last wrote, they continued to have issues controlling his fevers and when the fever rose, his oxygen saturation deteriorated and he had great difficulty breathing. My concern was that if the antibiotics were effective in controlling the infection, then I shouldn't be seeing the fever spikes and hence the difficulty breathing. They consulted with Infectious Diseases and they looked at where the pneumonia presented itself in the lungs and then the types of bacteria associated or rather that present in that location. There was some discussion with changing his antibiotics from Ceftriaxone and Vancomycin, to the next level antibiotic that is typically used for Vancomycin Resistant Pneumonias, however they decided against it. Instead, they changed his antibiotic to Zithromycin (this is a much lower level antibiotic). They determined that he had an atypical pneumonia and probably not an aspiration pneumonia, although they can't really rule it out. (This is good news and it was probably community based which essentially means it's a less serious pneumonia than say a MRSA.)



Once he was on Zithromycin, he began to wake up and open his eyes at times. He improved on that but continued to have issues with oxygen saturation; yesterday they changed the antibiotics again to one that covered a broader based spectrum. In addition, they took him off the mouth tent (he was at 100%) and put him on a nasal cannula at 5 liters. Dear Son ran into oxygen saturation issues again at around 2:15 a.m. this morning and his oxygen saturation had dropped to 84%-87%. They made some changes again and it's becoming more stable, and is now in the early nineties. (Dear Son is a mouth breather and that makes the nasal cannula a little less effective for him (in my opinion) and makes him work a little bit harder.) We have yet to get through the night without any issues. He is experiencing some slight issues with vomiting in the last twenty four hours which make it more difficult since it increases the risk of aspiration. Normally, Dear Son is unable to roll over and chokes on his saliva when he is on his back. He is having a more difficult time now since he is weaker and can't manage many changes in position (like for diaper changes) without heaving. I have yet to meet with the ENT. Prior to the pneumonia, we had experimented with some drying agents prior to surgery and I had been in contact with the ENT. Our next step will most likely be a Nissen (to control reflux) and botox injections into the saliva glands.


Today, they'll do another chest xray today and are re-evaluating his oxygen needs as well as increasing his respiratory treatments. Overall, not a serious pneumonia like he has had previously.


As you are aware, Dear Son has MRSA, which he most likely acquired from his multiple hospital stays (versus community based). While he does have MRSA, this is not a MRSA pneumonia-it would only be considered a MRSA pneumonia if he had MRSA in his lungs (that's where it presented last year). In addition, they shared with me that patients like Dear Son who have had "two" MRSA pneumonias, have much weaker lungs than others. They also indicated, that although he had an atypical pneumonia, it could turn into a MRSA pneumonia. At the present time, I am not concerned about this happening since I think he is fairly stable.


In summary, an atypical pneumonia. I spoke with our Pediatrician today and he will remain here until he can sleep through the night and breathe room air. We have a ways to go before we get there since he doesn't seem to be able to manage decreases in the oxygen just yet. His normal baseline is fairly weak to begin with so I suspect we'll be here a few more days since I don't see that happening in the next day or so.


Thank you for your concern and your thoughts and prayers.

12 comments:

hlkennedy said...

Glad there has been some improvement....keeping you both in my thoughts.

girlfriday said...

We are pulling for your dear son.
Praying you get some rest too.

Lois Grebowski said...

HUGS... continuing to keep you two in my thoughts and prayers

zoe said...

Thinking about you and Dear Son a lot and praying for his recovery. Hang in there Dream Mom.

Midlife Midwife said...

I'm glad he is doing a little bit better. My thoughts and prayers are with you. Please let us all know if there is anything we can do to help.

Anonymous said...

I just wanted to send many positive thoughts to you and your beautiful Dear Son. I know hospital stays are not very comfortable, but it sounds like he is being watched quite well. There are a lot of people out here who care about you both very much.

Sincerely,

Jamie from Portland Oregon

Anonymous said...

Keeping both you and Dear Son in prayers.
Janet

Summer said...

I'm glad your son is improving. I will continue to keep you in my thoughts.

jennifergg said...

Sending prayers of strength, for both of you.

Karen said...

Glad to hear that Dear Son is improving a little. Take care of yourself.

Sam's mom said...

Dream Mom,

I'm so sorry to hear that Dear Son is in the hospital with pneumonia. He will remain in my thoughts and prayers, and I'll keep watching for updates.

As you and I have talked about in the past, my Sammy is scheduled for surgery on Monday, June 11 to have the VNS implanted, so I've been thinking of you and Dear Son quite often in recent days. His neuro wants to turn it on while he's being monitored in the hospital, so we will be in the hospital for a few days.

By this time next week, hopefully your Dear Son and mine will both be back home resting comfortably.

jbbzmom said...

Thinking of you and your son and keeping you all in my prayers. (((hugs to you both)))

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