Ella had a restful night, but unfortunately, her blood gases were worse. The one at 4am was cO2=70, pO2=90. They did a repeat blood gas shortly after and her cO2 went the wrong direction, cO2=80, pO2=124. She had 69ccs of total chest fluid output for yesterday’s total (6 left, 63 right).
 
Dr. Kays reviewed her chest x-ray this morning. It looks worse on the right and left hand side.
 
Oddly when we visited Ella, she still seems comfortable. She is not extra fussy, so we have really enjoyed our time with her.
 
Her blood gases during the day have been slightly better, but not good enough. The next gas at 8am was cO2=62, pO2=79. The one at 4pm was cO2=66, pO2=77. Her chest fluid output has been 10ccs total so far today (0 left, 10 right).
 
Here is the game plan: Dr. Kays is going to replace her left chest tube this afternoon/early evening. We are not sure what time, but he is planning to do it before he leaves the hospital for the day.
 
He has been hesitant to mess with the chest tube since it increases the risk for infection (on the same side as the patch for her diaphragm). But this is his last try at giving her body a chance to resolve the issue on its own.
 
Tomorrow, they are planning to transport Ella in her bed with all the drips and ventilator down to radiology. He has ordered a CT scan of her entire chest area, to gain a better understanding of the fluid problem and to check and see if her superior vena cava is still collapsed.
 
He is not doing any interventions tomorrow related to the her chest fluid issue or the SVC syndrome; he simply wants to diagnose the chest fluid problem with more precision and take the opportunity to look at the SVC during the same CT scan.
 
He is not real confident that Ella is going to have a major turnaround within the next ~48 hours. Therefore, he has also scheduled Ella for her surgery on Wednesday.
 
When we asked, he did mention that he would look to do this thoracoscopically or with minor incisions on one or both side of her chest (near where the chest tube incisions exist). Admittedly, this made us feel better that they would not be making a large incision across her chest.
 
Please continue to pray for Ella – – for the Lord’s will to be done. We would love for her to have a miraculous turnaround in the next 48 hours, which God could certainly decide to do.
 
But if that is not His will, that we will continue to trust and cling tight to His promises. We keep hearing the Lord asking us to trust Him and to continue to focus on Him.
 
As we have experienced so far, each time we keep our focus on Him, we gain a peace that is beyond all understanding.
 
Psalm 25:4-8
Show me your ways, O LORD,
teach me your paths;
guide me in your truth and teach me,
for you are God my Savior,
and my hope is in you all day long.