June 8

 Brian has had some improvement in some areas and a few things that are being closely monitored. First, there is some marked improvement in his Tidal Volumes. At some point last night as Brian was comfortably sleeping, his Tidal Volume was measured at 150 ML!!!! Remember, on Saturday he was hanging out around 17 ML. His doctor said that this morning he watched his Tidal Volume fluctuate between 70-80 ML. That sounds like a very positive step in the right direction for his lungs! His physician is planning on doing another Bronchoscopy tomorrow to see if there is any blockage he can remove to help with further improvement. He is doing well with his blood-thinning medication. The plan for tomorrow is to try and lower his sedation a little more to see how his heart rate and oxygen levels adjust. All really good stuff!! 

Two areas that are being closely monitored are his nutrition intake and his bilirubin level. Brian is currently on total IV nutrition. He was not able to digest the nutrition that was given to him through a feeding tube. IV nutrition is not considered ideal, but in Brian's case, his doctor has emphasized that he really needs it to avoid malnutrition. The second concern is Brian's bilirubin level. A normal adult bilirubin would generally be around 1.2 mg/dL. Two weeks ago, when Brian came to Santa Clara, his level was 2 mg/dL. This would be considered slightly on the higher side of normal and not concerning. Yesterday, it was at 7 mg/dL and today it is at 8 mg/dL. With Brian being as sick as he has been for a month, cellular breakdown that causes an increased bilirubin level is not surprising. Hopefully, this will just be something that is closely monitored and not the beginning of a trend to higher numbers.