"Not out of the woods yet"

These are not the worst words you can hear from a doctor, but they're not the best either. Turns out that Will is sicker than originally advertised. With hydration (or maybe progression, but the theory is that it is at least partially hydration-related, he was pretty badly dehydrated on admission) his lungs became noticeably worse on imaging and they are now calling what he has a parainfluenza pneumonia with secondary bacterial and possibly fungal infections. He had a rough night last night, his oxygen saturation went way down and apparently this morning they were having trouble keeping him saturated above 90% on any amount of oxygen. When I got there around 9:30 he was on 10 L of oxygen delivered through a face mask and that was keeping him saturated at about 92%.

Parainfluenza is, near as I can tell, part of a series of viruses that causes colds and croup among other processes. It is most common in young children. (Thank you, Liam's new school!) There is no proven treatment, but there are some anti-virals they might try if Will's condition worsens. In the meantime they are "aggressively treating" everything else they find -- which means IV antibiotics (ceftazine), inhaled antibiotics (colistin), and an anti-fungal drug (voreconezole). I think I spelled most of those right, or close, I don't feel like dragging out the Merak manual to check spelling right now. The hope is that Will will start to feel better in the next few days. They'll be watching is oxygen saturation closely, since it sounds like that is one of their main indicators of whether he is improving or not. This is all made very complicated because Will's immune system is purposefully suppressed to maintain his lung transplant. So, things that aren't a big problem for most people can turn out to be really big problems for him.

When I left this evening he was tired but feeling better and his oxygen saturation was up at 95% or so on 8 L at 60% delivered by face mask. He had eaten some lunch earlier in the day, opened some of his weather-delayed Christmas presents from L (Key monster things---a surprise big hit!) and said he would try to eat some dinner. (The hospital kitchen will deliver meals to order until 7:30 PM, it's really a much better system than the previous, "whatever we've happened to cook coming to you on a tray whenever we happen to bring it" approach.) The pulmonary service checked Will right before I had to leave and proclaimed: "You're not out of the woods yet; but I'm less worried than I was this morning."

Thanks to Grandpa DH and GG for taking such good care of Liam all day today so I could be with Will, and for taking care of him tomorrow so I can work, and generally for all their help juggling so many things including my short, stressed-out temper. We hope and pray that the other virus panels come back clean and that he doesn't have a cytomegalovirous infection on top of all of this.