June 13

 Brian remains stable through heavy sedation. His Tidal Volume is looking better. While I was there in the early afternoon, the range was from 70 -120 ML! 

The big obstacle that doctors are focusing on overcoming right now has to do with his heart. I mentioned a few days ago that he has a blood clot affecting the right side of his heart. The right ventricle is under strain from this clot and it doesn't look like it is dissolving. Normally, doctors would give patients like Brian a super-powered blood thinner to break up the clot. It is called a TPA and referred to as a "clot buster". I have discussed this as something that doctors were considering before, but due to the high risk of excessive bleeding, and the fact that excessive bleeding has been an issue before without Brian having a medication of this sort, it is something the doctors would rather not do. It would entail 24 hours of multiple blood transfusions and the possibility of uncontrollable bleeding. His doctor then presented another option that many specialists felt would be a safer option. This procedure has not been attempted on a patient like Brian in this hospital before. It has, however, been successfully executed elsewhere and his team of specialists feel this is the best option for him. There is a group of Interventional Radiologigists who use x-rays, CT, MRI or other imaging guidance to navigate small instruments, like catheters and needles, through blood vessels and organs to treat a variety of diseases. They want to use a catheter, guided by x-rays to go into the heart and suck out the blood clot. There is a chance that the blood clot could move but as long as it goes into less vital blood vessels, this would be ok.  Of course, there are risks to this option, too. There is a possibility of the clot going into the left side of his heart or his brain. The specialists feel confident that they will be able to retrieve or guide the clot to a less critical area. They feel that this procedure has the best chance of success.

In order for Brian to have the chance at progressing towards getting better, this clot has to be removed from its location. He is not stable enough to be assessed neurologically, as when sedation is lowered, his oxygen levels decrease and his heart rate increases to dangerous levels. Our hope and prayers are that the procedure is successful and Brian will be able to continue on a path towards recovery.