CJ update...

This is CJ getting ready for his cat scan this morning. He is feeling rough and very nervous for the upcoming procedure. 

This is Wes, our favorite radiology technicianThis is the radiologist looking over his cat scan. Notice all the white areas of his lungs. Those areas should be black. The cloudy white stuff is fluid and infection. You can see that there is A LOT of it. After reviewing the films they decide that he definitely needs intervention today. He REALLY didn't want surgery so the specialist opted for a less invasive procedure. They put a small tube through his back and into the space around his lungs and drain the plural effusions (pockets of infection). The hope is that this will get rid of enough infection that the antibiotics will do the rest.

I got to stay in the room with him while they inserted the drainage tube. They make a small incision on his back and insert a long skewer type needle through his scapula, between his ribs, and into the area just out side his lungs. They used ultra sound to make sure they didn't hit a rib or puncture a lung. He has a lot of muscle so they had to be pretty aggressive with poking the skewer through. That was the only point that I felt faint. He wasn't feeling anything because they had him all doped up but it was still unsettling to watch the 12" very thick needle being crammed into him. He is feeling better because there is some relief from the pressure out side his lungs, but they are disappointed with the amount of fluid being drained. His white cell count is still on the rise and the fluid outtake is falling. They think that there are loculations (thick pockets of infected goop) in the space around his lungs that can't be drained from the tube they placed today. He has another cat scan scheduled for 1st thing tomorrow morning to see if he really has loculations and how advanced they are. That will determine how invasive a surgery they have to do. The danger with pleuritic effusions is that the fluid gets thicker and thicker and the loculations attach themselves to his lungs. If that happens they will have to open up his chest and scrap away the infection, potentially damaging his lungs and putting him at a higher risk for respiratory failure.

 The pulmonary specialist currently caring for him is very competent and aggressive in his approach. He said that this is just bad luck. It started out as pneumonia and only 5% of people with pneumonia get pleural effusions and an even smaller percentage of those patients get the loculations. CJ is always the exception to the rule.