In the hospital and some vent changes.

 Joey had some increased oxygen needs a few days ago-he went from a couple of liters to requiring 6 liters of flow. We called the ambulance and rode into the hospital emergency room.  The last time I rode the ambulance, I was pregnant with Joey.  His inflammation marker for his CRP was elevated some to 19 or 20, showing some inflammation. Sometimes our bodies react to infection with inflammation.  All the viral panels and infection markers did not show anything concerning.  He is finishing his course of bactrum though just as a precautionary. We did find that when we put him on the hospital servo vent, he had very minimal secretions. When we switched him to his home trilogy vent, the secretions started back up again. The pulmonology team seems to think that he needs more pressure to keep his airway open so that he will have less irritation.  I'm not sure what I think about that, but okay, I'll go with it. They increased his peek pressure from 15-27 to 19-27, but his average pip is actually 17, and prior to that, it was more like 13-14.  I think they are confused as to why the machine is not delivering what is being requested, so they want the DME to investigate the matter. Pulmonology also suggested trying pulmicort to see if any of Joey's issues are allergy related. It's an inhaled steroid. I'm willing to see if this helps keep him more clear.

He has been vomiting more, so we are going to try another reflux medication-maybe Prilosec to see if it helps. It addresses the acid in his stomach.  We are going to trial the complete food mix to see if it helps his tummy hold things down. I just know that vomiting after ever meal is not fun. This could be contributing to the inflammation that is showing up on his markers.

On another note, the PICU is such a weird place-it's very different from the NICU.  You see many big kids, and it's hard to see them and their parents have to walk this path. I literally saw a parent crying outside of his child's hospital room with a lot of medical staff in the patient's room. If I were a nurse or a doctor, I think it takes courage to have to step into a situation like this. I have a whole new appreciation for those who choose to take those steps out of their comfort zone to experience the highs and lows daily.