ARDS Improving

10/05/2009

Journal, Blood - 10/05/2009

8:30 AM

Since the dramatic turn-around of his lungs yesterday Jaymun has continued to improve.
In 24 hours his vent settings are down to 45% oxygen (from 100%) and Pip down to 34 (instead of 44).
The staff here seems amazed ...this is not a typical response for patients with ARDS.

Jaym is getting his Vitamin E dose under his tongue every 8 hours. We have discovered that within a minute of putting the (roughly 300iu) Vitamin E dose under his tongue his cystolic blood pressure jumps 20 points up and holds for hours. The nurses are using that to concurrently schedule his dose of Atavan (which would otherwise depress his blood pressure).

There are much larger challenges here, and it is hard to see a way forward more than weeks, but at least Jaymun's siblings got to go home last night with some good news. Hope is a great thing, and in these situations we take what God gives us each day as a gift worthy of celebration!

(After watching Jaymun suffer the past week, I'm also grateful for the unfortunate mice in the control and LPS group in the study :) http://www.ncbi.nlm.nih.gov/pubmed/19484962
The effects of vitamin E and dexamethasone on inflammation of acute lung injury and expression of myosin light chain kinase
"...extensive lung inflammation were seen in the LPS group ...accompanied by marked pulmonary edema and hemorrhage."
"...the inflammation and hemorrhage in the 2 treatment groups were significantly improved ...attenuation of pulmonary edema and inflammation...")

4:30 PM

Jaymun is slowly progressing, it is hard to be patient. The nurses keep reminding us that for an ARDS kid he is already four days ahead of normal, and I am afraid to keep pushing our luck with Vitamin E because of this study:
http://www.ncbi.nlm.nih.gov/pubmed/10575906
Vitamin E, a modifier of platelet function: rationale and use in cardiovascular and cerebrovascular disease.

Please keep praying. Even though Jaymun is not the "sickest on the unit" any more, his disease is insiduous.
We will need many more miracles to make it through.

9:30 PM

One of the miracles we need is to have a surviving and functioning immune system after dexamethasone.
One of the immune stimulaters I use is Spirulena (to activate NK cells) (http://www.ncbi.nlm.nih.gov/pubmed/11962722)
But here again dexamethasone has a contraindication for NK cell activators (http://www.ncbi.nlm.nih.gov/pubmed/2417957)

I've heard more than one surprised comment about Jaymun's metabolic alkalosis ...it has given them more room for CO2 management (protecting his brain). Most patients with this intensive ARDS support by this time have developed metabolic acidosis. However, the above mentioned Spirulena (along with Aloe Vera and Chlorophyl) are all alkalyting agents. So even though every few hours I am swapping the 30 to 60 cc's of herbal meds in his stomach (unsure how much coming out is stomach fluids and how much is actually going into his paralyzed intestines) SOMETHING must be going in, because of the alkalosis and also his blood albumin which has been staying up "all by itself".