The good news:
Jude is moving more air through his right lung. The effusion has improved some.
The bad news:
Jude has double pneumonia. It has spread to the left lung.
Jude basically went into mild respiratory distress last night about midnight. I noticed his breathing was very erratic and kept pointing it out. I told the nurse I had to lay down for a bit and she kept a close eye on him. About midnight she woke me up and said she wasn't liking his breathing and that he was working extra hard. His stats were good although his oxygen did drop some but he was just working so hard to move air. So they did a deep suction, they did a breathing treatment, and they did cpt. They also gave him some Motrin and we repositioned him several times. After about two hours he was breathing easier and he finally drifted off to sleep. Throughout the night Jude would moan in pain and it just broke my heart.
So today Jude is still sleeping again and he is very pale. So I called the nurse in. I explained I am not a panicked mom and that if Jude was a little better I would probably be standing there asking to take him home. However, with that being said (and I paused) I told her Jude is very ill. I explained I was not new to aspiration pneumonia or to effusions. I explained that in PICU before we left I pointed out that the right side of Jude's chest wasn't moving so they did an X ray and he had the effusion. Yesterday I pointed out that Jude was more lethargic and looked worse than the day before to me and then he had that attack last night. I told her I had even said I thought the pneumonia may have spread. So I said "Today he looks worse than yesterday". She asked if if he looks worse than when we decided to bring him to the ER. I replied "Most definitely! On the way to the ER I was even contemplating if I was making the right move because he was alert and happy. Although no one expected him to aspirate walking into the ER". She said "Oh my". I then showed her a picture of what Jude normally looks like and she got a concerned look on her face and said she was going to inform her charge nurse.
So here is the complicated situation for my medical friends. Jude's air movement looks better to me today! His O2 stats with 5 liters of oxygen on is running 100 percent. Last night his blood gases were good too! However he is more lethargic, moaning in pain, I can hear wheezing, and he just looks.......grey to me. I am not new to aspiration pneumonia it is a beast to get over and can take everything out of a person. However I have just never seen Jude THIS sick. I don't think there is much more that can be done except give it time but I am concerned. The fact he has had two sudden episodes that required intervention worry me. Last night the charge nurse told me Jude's lungs sound "terrible". I told his nurse today that I wonder if Jude's little body is just broken down and tired from all the fighting. She said it does take a toll. He is resting comfortable in his bed and his stats are still good. I am sitting here beside him dreading going back to work tomorrow because I will worry so much about him.
I am hoping he wakes up and he is happy today.