Zack was having a very difficult time breathing yesterday. As a side effect of pneumonia, his lungs became very stiff and developed tiny leaks that allow air to escape into his chest. The air in his chest cavity is not alarming because the body can reabsorb it...but because of the leaks, his lungs aren't able to distribute oxygen into his bloodstream. One of the many monitors he's been hooked up to shows the oxygen saturation levels in his bloodstream, "sats." Normally we should be around 100% saturation but Zack was having trouble keeping above 90%...and then above 85%. The doctors were ready to put him on a ventilation machine but I was not...I talked it over with Zack and explained the risks and he decided he wanted to be ventilated...So that procedure took place around 6pm yesterday evening.
Zack was completely sedated during the procedure and remained so afterward, as is standard. Ventilators do all the breathing and it's uncomfortable and dangerous for a child to be conscious while a machine is breathing for them. Zack seemed to be doing great on the machine all through last night.
This morning's chest x-ray showed that air was still escaping his lungs, much more so than yesterday because of the extra pressure and oxygen from the ventilator. He wasn't able to keep his sats high enough either. The docs called an emergency meeting with me and let me know that on the ventilator, his lungs were not going to be able to recover. They offered me an option called ECMO, Extracorporeal Membrane Oxygenation, which is essentially a lung bypass in which blood is taken out of his body, oxygenated, and returned to his body. The entire process takes seconds and happens in a constant stream day and night.
As I'm typing, Zack is just about to have the necessary catheters put in his veins. He will be taken off the ventilator and hooked up to a different respirator that won't exactly breathe for him but will inflate his lungs with air about 10 times per minute, keeping them open. The ECMO machine will be monitored 24/7...one of the doctors told me that he'll be more monitored than the space station. This process will give his lungs a chance to relax and get the rest they need to heal.
There are risks associated with this process but I'm focusing on the benefits and on giving Zack the help and time he needs to heal. Aside from his lungs, his body is very healthy. Luckily, he just recently finished the most intense part of his chemo. He's also receiving steroids to help his lungs and they are the same steroids that are part of his chemotherapy.
Keep sending your healing thoughts and your love. Though Zack will be sedated for the entire time he is on the ECMO machine, he will be able to hear me and I'll be reading comments and emails to him.