Thursday, July 24, 2014

annual tests

Lex had his annual pulmonary function test and ct's of his sinuses and chest today.  Last year he did not do well with the Chloral Hydrate they used to make him sleep, so I thought they were going to put him under general anesthesia.  I was happy to find out this was not so.  They gave him Propofol and Versed through an IV because they needed him to be able to breathe on his own without a breathing tube.  It was definitely a fight to get the IV in, and he was pretty angry for a little while , but he calmed down fairly quickly and did ok with it.  Much better than the fight he put up last year with the Chloral Hydrate!

                                                         Pre sedation selfie

They did his pft's first.  This is how they measure his lung capacity.  Because he can't yet do the "blow as hard as you can" type of pft, it is much more complicated.  I'll try to explain the best I can.  He is put into a sealed plastic chamber and his lungs are filled by a machine and then the air is forced out of his lungs.  The chamber measures the amount of air coming out, thus determining his lung capacity.
                                                This is Lex in the pft chamber

Next we went to get his ct's.  We had to wait a little while for them to be ready for us, so when we got into the room, he started to wake up.  The sedation team gave him a little more meds and I rocked him and sang to him for a few minutes as he fought it, but he went out again pretty quickly.  During the CT they had to "breathe for him" a little bit, which was scary for me, but they said they did it purposefully to get him to, essentially, hold his breath as the pictures were taken.

When this was done, they did a few small procedures like a throat culture and body mass as he was waking up.  He woke up pretty pissed off and really wanting his IV and all the other monitors off.  He calmed down as they were able to unplug him from everything.  He was super cute and funny as he was waking up fully.  He ate some fruit loops, and they let us go.

Before we left, Dr. Thompson  pulled me aside to let me know he got a look at the ct's and his sinuses were terrible.  He said he was going to make sure we saw the ent at our next clinic vist, and that we should prepare for the fact that they will probably do surgery in the very near future.  He said if ent decides to do the sinus procedure, then they will also do a brochoscopy.  He said since it has been about a year and a half since he has been admitted, he is due for a "tune up", so we should plan on a full 2 week admission for a course of IV antiobiotics and the full shebang.

He just called me after having a chance to look everything over.  He said his lung function is basically the same as last year, so this is good news.  His lungs also haven't changed much since last year, which is a big relief.  I was worried about this after the Pseudomonas.  He said there looks like a a few small mucus plugs and a little thickening of the lining, but nothing significant.  So, then we discussed the sinus issue.  His exact words were "serious sinus disease".  He said that Lex's sinuses are completely filled with scar tissue and mucus.  There is no open space for air to get through at all.  He said it is most likely causing him pain, and he probably can't smell, taste, or breathe through his nose.  He thinks this may be a reason he doesn't eat well.

In the mean time, he is prescribing an appetite stimulant in the hopes Lex will eat a little better and gain some weight.  We go to clinic again on Aug. 14 and will get to ask the ent more questions and find out for sure if she will want to do surgery, and exactly when.  Dr. Thompson said to expect it to take about 4-6 weeks to schedule, so I guess we'd be looking at sometime around the middle to end of Sept.  I will definitely keep everyone posted as I learn more.

1 comment:

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