our son's journey: Chest Problems-11

On September 17th, Nana came to stay with Jeremy at the hospital for awhile so that Brent and I could go out and celebrate my birthday. Jeremy seemed fine all day, but when Brent and I came back from our day out we noticed that Jeremy was having an increase in his work of breathing. He seemed to be trying harder and his respiration rate was much higher than usual. They did a chest X-ray, and also took cultures from his PICC line and the back of his throat (this is common practise to rule out infection) and without waiting the 48 hours it takes for the cultures to come back conclusive, they started Jeremy on antibiotics. Within a day they had determined that Jeremy had pneumonia. His respiration rate continued to increase, and Jeremy was really working and struggling to breathe, they were watching him closely. They did another chest X-ray and after close observation determined that Jeremy did not infact have pneumonia but a pneumothorax in his right lung! His lung had collapsed because there was an accumulation of air in the pleural space, meaning in the space between his lung and his chest wall. They couldn't give us a reason as to why this occurred, sometimes there isn't a reason, but they did want to do surgery to correct it and make it easier on him.

In order to correct the pneumothorax, they had to insert a tube into the right side of Jeremy's chest. This tube would remove any excess air or fluid that was in his pleural space. Before Jeremy went in for the surgery his respiration rate was in the mid 80's and his heart rate was in the 170's. After the chest tube was in his respiration rate decreased to 28-32 breathes per minute and his heart rate came down to 115-132 beats per minute. Poor little guy was working really hard!!

Not only was Jeremy dealing with a pneumothorax, but the effects of chemo were starting to take a toll. The little amount of hair that he had was falling out and his blood was also dropping leaving him lethargic and really out of it after chemo. In order to correct this, Jeremy had blood drawn daily and if anything was too low, then he would get this replenished so that his body could keep fighting. This meant that it was the norm for Jeremy to get platelets (a component of blood that helps in the formation of blood clots, without these, one could bleed out) and red blood cells to increase his hemoglobin. This became quite the common occurrence, which was really making me realize how vital blood donating really was.

Jeremy continued to get daily chest X-rays so they could watch the pneumothorax closely. Within a few days it had improved markedly but there was still a small air leak. Jeremy would have to keep the chest tube until everything cleared up perfectly. The way the chest tube worked, was a tube went from Jeremy's chest to a collection container that sat on the floor, or somewhere that was lower than Jeremy's chest so that the drainage could flow by gravity to this container. Then there was another tube that ran from the collection container to the wall of the hospital that was hooked up to suction. This helped to remove any air or drainage that was not able to flow freely from Jeremy's chest. Having said this, this meant that Jeremy was no longer able to leave his room because he always had to be connected to the wall.

This was very difficult, having Jeremy stuck in his hospital room day in, day out, all day long. Not to mention he wasn't able to change positions very much because of the chest tube and the pneumothorax, they are both quite painful. Jeremy was just a little baby who did not complain much, I really felt for the parents and older patients that are stuck in their hospital rooms for days on end because they are on isolation. I didn't like it, but Jeremy didn't mind too much.

By September 25th they decided it was okay to turn off the suction. And on the 26th they clamped chest tube in the morning and removed the tube in the evening. By September 28th we were home free for nine glorious days before we would have to be back at the hospital for a third round of chemo. This was our first release from the hospital since July 31st, it felt like Christmas!!!