Good morning,
The weekend was rough. Ruby had her big spell on Saturday then yesterday afternoon was looking good and then she had another bad spell in the evening. We thought we were going to lose her. Thank God she got through it and stabilized again. The doctor and nurses were doing anything they could, but Ruby doesn't respond much to what they are able to do. They did test her C02 levels in her blood and they were at a good level, which indicated that pulmonary hypertension wasn't the only cause of the spell and that her lungs were involved too. Basically part of her left lung isn't in great shape. The doctor said it isn't too bad, but it and her pulmonary hypertension are both factors in these spells. She still has some wetness in her lungs and her treatment is still focused on reducing her fluids.
The new drug they gave her yesterday seems to be doing it's job. When her lungs aren't giving her trouble she is sitting around 91% oxygen saturation. Her internal temperature went a bit high yesterday afternoon, so she got some tylenol and during her spell last night they took a bunch of different samples to be sent off and tested for viruses and bacteria. The virus test came back negative for everything and we are still waiting for the bacteria test, it takes longer. She is on broad-spectrum antibiotics anyways just in case there is something, if they get a positive result then they will switch to a targeted antibiotic.
They are still planning to take her to do a "cath lab" to test her lungs and try to see how bad her pulmonary hypertension is. It is something that is done in an operating room (They put catheters into her blood vessels) and she is on a list to get it done when there is time (there are other scheduled labs that happen). The original intention was to wait until that test before putting her on the stronger meds they put her on yesterday, but the situation was such that they didn't want to wait.
We are still in a very slow period where they just have to keep adjusting the balances of her meds, making sure she has what she needs for her little body to heal. Her heart is still improving, the cardiologist said it looks a bit better than on Saturday (we don't expect it to improve quickly, especially not in just two days). That is encouraging. She is also on less muscle relaxants (paralytics) so she is allowed to wiggle around a bit, which she is tolerating. She even opens her eyes a crack, but she is still heavily sedated so it isn't like she is waking up or anything. Things are looking nice this morning, but we know that everything can be looking good right up until the moment she has a spell and nothing looks good. It's stressful.
We also just discovered that they saw a small clot in her heart. It's stable for now, but if it breaks off it could be really bad. They have her on more anticoagulants to treat it and will monitor it until it's fully reabsorbed. Where it is it could go to her brain or to the rest of her body and cause some serious problem. Hoping the treatment works and praying it won't break off. They said it is something they are going to monitor and could be two or more weeks before it is gone.
Please keep praying for our little Ruby, her lungs need to heal, she just needs to get better.
