June 26

 Doctors decided today to start incrementally decreasing the amount of blood flow that is going through the AV ECMO machine to his heart. This is a more subtle approach to try and take Brian off of the ECMO machine that is supporting his heart. As of this morning, he had 3 liters of blood flowing through this particular machine. After reviewing how his body was doing with the blood thinner, Heparin, and seeing that it has a good consistency, a heart surgeon and his team decided to lower the blood flow to 2.5 liters. If he does well, then they will lower it again tomorrow to 2 liters. On Monday, Brian will go through CT scans to look at his brain, chest, and abdominal area. They will do as much testing as they can with ultrasound and any other resources available, to then decide if they can safely remove him from the AV ECMO machine. 

Through dialysis, extra fluid continues to be removed from Brian's body. The less swelling and puffiness he has, the easier it will be for his heart to come off of the AV ECMO machine and function properly.  Brian's bilirubin count was at 16.4 earlier today. His skin looks very jaundice but is in good condition. He had a lot of flakey skin (particularly around his hands and feet) for the past few weeks that I was thinking was maybe just part of the process of everything he has been going through. His nurse, on Friday, let me know it wasn't part of the process and suggested I get him some really good ointment. I brought back some Aquaphor and began applying it. There was a huge difference almost instantly! We discussed his skin and I asked about bedsores since he can barely be moved without machines going off indicating that Brian is struggling. His nurse said that although bedsores are often an issue for ECMO patients due to their lack of mobility, Brian is, remarkably, without any. He then told me he would make sure and put Aquaphore on his back whenever possible to assist with prevention. I anticipate that tomorrow will be an uneventful day as Monday appears to be the big day of potential progress for Brian.