One Year Ago Today: 12/19/2012 - A Collapsed Lung that get's BiPAP'd in the Night

(12/18/2012, Wednesday) Evie had another echocardiogram which showed her heart function is excellent and has not changed. An x-ray early in the morning (which I'd alluded to in yesterday's update) has shown that she had a "consolidation" (junk) in the bottom portion of her right lung. Throughout the day, Evie's inhale/exhale ability did not improve. She enjoyed having Grandma & Grandpa visit for a few hours and we put together a gingerbread house (We tried to make our friends the Lowe family proud!) -- Evie acted as the architect and grandma and I were the general contractors. Evie got really tired, and had to catch a nap once we were done.

 
Evie enjoyed Skyping with her sisters and little brother in the evening, and enjoyed a special treat of getting to Skype with Aunt Angela & her kids. Both calls did a lot to buoy up her spirits. I was particularly encouraged by how loud Evie tried to talk while on Skype -- the last couple weeks she's been rather non-communicative, and nearly inaudible when she does talk, but she perked right up to talk to cousins.

We originally were going to go to bed around 2030, but between various respiratory therapy checks, she was no longer sleepy, so we stayed up a bit later. She'd had a low fever began to climb, and Tylenol didn't have any impact. At about 2300 we ended up giving her another sponge bath to help her body cool off -- this time she also got her hair washed, and styled with french-braided pig tails like Laura Ingalls. We finished around midnight, and her fever broke.

By 0200 her blood oxygenation was dropping, and her breathing was getting laborious. By 0300 we'd had another chest x-ray to discover her right lung was fully consolidated (full of junk) and had collapsed (note: this is not the same as punctured, and due to TV you may have watched may have an overly negative connotation in your mind. It isn't good, but it isn't as bad as you may think.) To deal with this new predicament, we did a few things:

• Additional medication to break apart the junk in her lung
• Additional antiobiotics, specialized for the infection we're dealing with
• Nebulizer treatment to widen the breathing passages
• "Percussion/Pulmonary Therapy" -- Essentially getting a thumping on your back for 5-15 minutes to encourage the junk to get coughed out.
• Increased the air pressure via a BiPAP (Bi-level Positive Airway Pressure) machine, which pressurizes the air to help someone in Evie's predicament to get more movement of air in the lungs. Typically the starting pressures are 10/5, but in Evie's case, we began and are currently holding at 13/8. She began at 40% oxygen, but it has since been dialed back to 35% oxygen.
  
  

Unfortunately, this means that she's back to dinner in a bag (TPN) but at least that means her pancreatitis will give her a break:

DISCLAIMER: Posts Labeled "One Year Ago Today" are a record of what transpired when Evie first became ill.  The slightly edited text comes from emails which we sent to family to let them know what was happening, and to keep them updated.  These posts are usually long, but if you want to truly understand what life was like for us, and what led to this point, it makes for great "light" reading.