June 15 - Father's Day

Max' ABG (arterial blood gas) came back PCO₂ = 54 mmHg today. This seems to confirm that the diuretic (Plavix) is helping his ability to out-gas CO₂ by keeping fluid out of his lungs. They'll probably continue Plavix until Tuesday, then skip a dose or two to see if blood gas PCO₂ goes back up. If so, then the'll be fairly certain the two are cause-effect and go back on the Plavix.

Max also had another echocardiogram today. Shortly after, I met with the cardiologist to interpret the results. Although we had a long conversation, it essentially boils down to...

• Max' high PCO₂ is making his heart worse (beginnings of heart failure)
  
• High PCO₂ is caused 50/50 by his PDA and lung damage from the CMV
  
• Max' heart will eventually require an "invasive intervention" (i.e. surgery). Today's scan showed that his PDA is still very large and although may get smaller, will never close enough on its own to be healthy in the long term.
  
• Keeping the lungs fluid free (via diuretic) is so far keeping his PCO₂ lower - allowing the lungs to heal and buying time for the heart
  

The cardiologist said that she would like Max to be at least one year old before he has another heart surgery. Right now, he's too small to perform some of the procedures that have the best potential outcome. He's also still got low platelet counts which make spontaneous bleeding a risk during a surgery. Keeping him off of breathing assistance is the best path to avoiding an earlier heart surgery. She wants to see a monthly echocardiogram for the first year to monitor his heart in case an issue forces our hand before then.

There are some additional minor details today (bottle feeding status, secondary c.diff infection status, etc.), but I'll catch up on them here up tomorrow. I'm tired and already hit the important cardiac topics. Zzzzz.