Rise and fall, turn the wheel...

Cause all life is,

Is really just a circle.

--Big Head Todd and the Monsters, "Circle"

With anything in the ICU, it can be two steps forward and one step back. Or three steps forward and two sideways hops. An occasional swing your partner do-si-do. All night dance party in CICU room 10! But we're having one of those side steps, going in circles kind of days.

Last night, Derek went back to the house for some MUCH needed rest. He has not slept in a big boy bed since Jay's surgery on 8/11. That's a lot of nights on a couch or sharing a tiny cot with me. I took hospital duty last night, and I now realize why that's usually Derek's job. He handles that kind of thing far better than I do.

Nothing horrible has happened, but we're not exactly making forward progress either. After coming off the vent, Jay went onto a high flow nasal cannula (which you could see in the picture posted yesterday). Last night, he seemed to be having a little trouble breathing, so they switched him to a CPAP machine, which helps to force a little more air into his lungs.

No one seems willing to commit to a particular diagnosis beyond "junky lungs." I swear, if they can't come up with some crazy technical sounding term, they just pull a random word out. (When Jay was having v-tach episodes, the doctor described his heart as "sparky." I couldn't make this stuff up.) Some think the junky lungs are from ventilator-associated pneumonia, some call it roving atelectasis (similar to a collapsed lung), some believe it to be bruising from the trauma of 90 minutes of chest compressions during CPR. Whatever the root cause, the treatments are the same - lots of pounding on his back to loosen the junk, forcing more air in to open up those little alveoli, and lots of moving around to keep junk from sticking in one spot too long. He is not really a fan of any of these.

The jury is still out on the central line infection as well. He hasn't had any further fever, but there is discussion of keeping him on heavy duty antibiotics (vancomycin) for six weeks (yes, I said SIX). No taking the pink stuff home in a bottle, folks. Six weeks of IV antibiotics. In the hospital. You're freakin' kidding me! Nothing is certain yet, but that's on the table. We just don't want any infection latching onto his snazzy new heart valve.

Speaking of the snazzy valve, we're working on switching him from one blood thinner (heparin) to what he'll be on when he goes home (coumadin). Coumadin is only taken orally, so we've got to get him eating to be able to get it into his belly. And no one wants him aspirating anything, so they don't want him taking food by mouth. Do we crush it up and send it down his NG tube?! Regulating his levels of heparin has been a roller coaster ride - tiny tweaks in his dosage mean giant swings in his bloodwork results. So, if we're going to ride the Coumadin Coaster, might as well start now.

Sorry if I'm a little less upbeat than I have been - things aren't all bad. In the good news department, Jay was able to sit up with support and was holding his head up very well on his own. He's tried to say "Daddy!" which appeared to mean "Daddy, make them stop doing this stuff to me!" He's becoming more alert and nodding/shaking his head. So we're getting little glimpses of our old Jay, and that does a heart good. A mom's heart, anyway.