About 4:00pm today, the resident on-call, Dr. Caban, came to replace Ella’s right chest tube. We have not spoken to Dr. Kays, so we are not sure about his thinking on just replacing the right chest tube.

We called in tonight to check on her and she went through the chest tube replacement procedure fine. Dr. Caban removed the existing right chest tube and inserted a new chest tube on the right side of her chest.

Approximately 6 hours later, Ella’s chest fluid output had increased dramatically. Already her right chest tube has output 59 and her left chest tube has output 18, for a total of 87. This is good news!

The nurse tonight mentioned that Ella was awake for her and seemed comfortable (not fussy). This is the same nurse that took care of her last night, so that is good that she can tell a difference.

Ella’s last blood gas at 8pm was cO2=64, pO2=74. She will have another one performed at 4am.

We will wait and see how she does overnight and into tomorrow morning. Please pray for her chest fluid to continue to flow out of her chest cavity, for the fluid issue to resolve completely and for Ella’s strength to be increased as each day passes.

Psalm 27:14
14 Wait for the LORD;
be strong and take heart
and wait for the LORD.

Unfortunately, Ella’s stats have progressed in the wrong direction.

Her blood gas at 4am was cO2=70, pO2=84. The blood gas at noon was cO2=84, pO2=77 (ideally cO2 around 40-50 and pO2 above 100 is what we would like right now). They made adjustments to the vent to see if that would improve the situation. They changed the vent to 40% oxygen and 44 assisted breaths per minute.

Then, they took another blood gas at 2:15pm. The situation was not better, cO2=86, pO2=90.

In addition to all this, the fluid situation did not improve. The chest tube fluid output yesterday was 9 total. The last time the right side drained was at 3pm and the last time the left drained was yesterday at 8am; both by 1cc. No chest fluid draining would be great news if she had clear chest x-rays, but she doesn’t. She is also getting puffy.

They paged Dr. Kays with the latest information. He called back at 2:30pm and ordered a chest x-ray and for her right chest tube to be replaced.

Since we did not have a chance to talk to him, we are a bit confused with the overall plan. We are not sure why he is choosing to replace only the right chest tube, considering that neither of them are draining fluids. Also, he will not be performing the procedure, a resident on duty will be doing it.

On top of everything else, our least favorite nurse out of all nurses, is taking care of Ella today.

All of this and yet, He is in control. He knows exactly what the fluid situation is about and knows just what needs to happen…in His perfect timing.

Please pray for our strength and patience. Also, for sweet little Ella. She is not feeling well with all this fluid and is working very hard.

Psalm 25:4-5
4 Show me your ways, O LORD,
teach me your paths;

5 guide me in your truth and teach me,
for you are God my Savior,
and my hope is in you all day long.

p.s. The Gators will be working hard at trying to defeat Tennessee in about an hour from now. Go Gators!