Aspiration pneumonia

So, things took a few steps back. For the last few days Wyatt hasn't been eating as well as he was post-surgery. We had complained to the resident over the last weekend that he was coughing. She seemed unconcerned and said she hadn't heard him cough. I wish I would have yelled at her. I need to stop trying to rein Rus in.

Today during rounds he coughed while the nurse was feeding him and made a wet sound. Dr. Alexander was immediately concerned. So, they did an x-ray and saw that his right lung looked different then it did immediately after the surgery. They told us he has aspiration pneumonia. Some fluid was getting in to his lungs either from bottle feeding, stomach contents from reflux, or possibly drainage from the cyst site. Dr. Jennis told us that in the worst case of reflux, there are surgical solutions. They called for gastroenterology and pulmonology consults.

A gastroenterologist (Dr. Mow) came by to see us first. He told us his suspicion is that bottle feeding was causing the problem. I asked if maybe we started feeding him before he was ready. He said that might be it. He told us a number of tests that could be done. He said he would not recommend surgery at this time. It was actually hard to get him to recommend anything at first. Eventually, after prodding from the pulmonologist who showed up later, they decided on a saliva study. The gastroenterologist also wanted to do an extensive imaging to make sure there are no abnormalities with his stomach or intestine.

The pulmonologist said that Wyatt should be started on bronchodilaters. He would put him on albuterol and Pulmicort. I happen to take albuterol and a similar drug to Pulmicort for my asthma interestingly. It's ironic that I had to ask about bronchodilaters this morning during rounds, but sort of forgot. These drugs would be administered by nebulizer.

They were able to get the imaging done today. Nurse Rachel gave us a preliminary report that everything was fine, but we should have a better idea at the family conference tomorrow. They were not able to do the saliva test yet. They have already started Wyatt on Pulmicort and albuterol. His breathing didn't sound so great when we got there, but hopefully we should see an improvement tomorrow. He is being fed by feeding tube again.

I really took this set back hard. One, because if it is a result of feeding him by bottle, how are we going to feed him? By tube? I think that the pulmonologist said with the drugs, we might be able to stay ahead of the issue. We just need to get his lungs cleared up and see if it happens again. We should also work with Amelia to make sure he is being fed correctly. I also have to wonder if we did this to him. I wish they would take us more seriously when we tell them something is wrong with him. I wish Pat was back. I have to think that if she was here this could have been headed off.

I also just feel really, really bad for Wyatt. He is so small and so sweet when he is feeling well. He doesn't deserve to suffer through so much.

Right now I feel like by the time I get him home I will be back to work.