Another Day

Last night there was a possibility that Jayson would have to go through dialysis today because his lab work indicated there was an increase in the nitrogen level.  This can mean his kidneys are not functioning well. A nephrologist (kidney doctor) came by and physically examined Jayson.  She explained the different factors she looked at before deciding if dialysis should be done.  She had to first determine if the increase in the nitrogen was due to improper kidney function or if it was due some other factors. She explained that chemotherapy and blood products can affect the nitrogen level. She said that since his urine output was good, she thought his kidneys were doing their job, maybe not 100%, but they were working.  She felt that his kidneys were slowly recovering.   Another factor to determine if dialysis should be done was the risks associated with it.  For one thing, there are risks in transporting a patient. NMCSD did not have the personnel to do the dialysis here. Jayson would have to be transported to Rady's Children Hospital.  Also, there are side effects associated with dialysis.  After reviewing all factors, she determined that the risks associated with dialysis was greater than the benefits it would provide. She recommended giving his kidneys a chance to work. Therefore, she recommended not to do dialysis at this time.

I met with Jayson's team of doctors, nurses and staff members around 10 a.m. as they were doing their rounds. They discussed Jayson's treatment for today.  The doctors opted to hold off on the MRI.  They felt it would be easier to do the MRI when he's awake. Based on his condition and the fact that dialysis was not going to be done, they decided to try to wake him up today.

At about 10:30 a.m., the paralytic medication dose was reduced and we began seeing some movement from him. He was slowly weaned off the sedation medication.  After about an hour, he began to cough and he slowly opened his eyes a few times.  His nurse, grandma and I talked to him and asked him to squeeze my hand, but he didn't respond.  He closed his eyes again.  I was just so happy to look into his eyes once more.

We waited patiently for him to open his eyes again and when he did, we gave him simple commands. When he showed some signs of responding the plugs in his nose were removed and his nasals were cleared. Afterwards an attempt to have him breathe on his own began.  He was slowly weaned off the breathing machine and he was able to breathe on his own. Next, they removed the breathing tube and began suctioning out fluids.  By this time, his entire team of oncologists, nurses and other doctors not involved in the actual procedure were standing outside watching everything unfold along with his dad and grandma. I was at his bedside, holding his hand and saying some prayers throughout the entire time.  We urged Jayson to cough. This was to help remove the fluids in his lungs. As he coughed, the respiratory therapist suctioned the fluid and blood that came up.  It was easy at first, but then there was a clot obstructing the airway that could not be suctioned out. So, it was quickly decided that they could not complete the task and a new breathing tube was rapidly put in. Jayson was not quite ready.

He is resting now. He is comfortable and stable.  I thank God that he is still with us and we have another chance to try again.  God is Good. Praise the Lord!