Day 19 - Sunday

Dawn and I got up walked the dogs, grabbed some food for lunch (provided by our loving friends) and went out for breakfast at one of our favorite local places. We usually go out to breakfast with Daniel and this was the first time Dawn and I had been out at all really. A nice quick departure from our "new normal" and back to our "normal normal". 👍

But reality rang back in during breakfast when we got a call from the hospital asking for consent to perform another bronchoscopy. They wanted to do a third one as the x-ray for today showed more fluid build-up. By the time we breezed into the burn ward they were prepping him for the procedure. For some reason the scope was not showing a good image so in short order the respiration tech produced a new one. And we're ready to go. Jamie arrived just in time to observe.

Dr. Br. performed the procedure again, but this time it was harder to get a good angle so Team Daniel moved the bed away from the wall, lowered the head of the bed a bit and the doctor climbed up on the bed-head and aimed at Dan's mouth from above. (Anything to get Daniel what he needs!).

They began the procedure and immediately started getting gunk out of his throat. Then a bit further down and schlooop! Something big, icky, and thick got sucked up. We examined it on his bed when they ejected it from the sucker. I'll just describe it as ewwww and leave it there. Moving down further we got more gunk out. You could see some redness from where we'd probed the two prior days since lungs and bronchial tubes aren't used to getting camera probes shoved down them. But we were getting a lot of really "good stuff" out. The x-ray showed a big improvement. The concern is that we don't want to keep doing daily bronchoscopies as it's hard on Dan. We need him to cough up the gunk and get it out of his lungs.

We discussed other strategies:

• Tilting Daniel to his right to let gravity do a little of the work. Reading back from even the first few days I wrote about how Daniel seemed to lean his head to the left some. What we've been noticing lately is that he seems to be holding his body in a way that might be contributing to the fluid build-up in his left lung only. 
• Keep the new uber-bed moving side-to-side to swish him around.
• Dr. Br. checked with his pulmonary doctor colleague pals and they confirmed with him that it would be clever to treat him like a patient with Cystic Fibrosis since he's similar (not even close) to such a patient in his current chest-burned condition. So Team Daniel called up some medication that will cause him to cough more deeply and that will help to work up the stuff and get his chest clear. 
• Try to get Daniel to stand - but all the procedures needed for a burn patient (wound-care and what-not) take a lot of energy out of him so he may not be strong enough today to do so. Maybe tomorrow though.
• Step up his mouth care - brushing his teeth and mouth will help keep him healthy and knock out any bugs wishing to settle there like a squatter.
• Chest compression - not even an option to try since he has burns all over his chest and back.

At any rate as of mid-afternoon Daniel is doing some good coughing on his own and the mama-bear (aka Dawn) is helping to suck it up and get it all out of his mouth and throat.

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One of the residents Dr. C. (a favorite of ours) here at the burn unit ICU stopped in to say she had completed her 4-week rotation on the burn floor and had to move on to the next stop in her rotation: trauma floor. She wanted to ask if it was okay to stop-in still and check on Daniel's progress - isn't that cool? We are sad to see her go - she's awesome, super competent, and very upbeat. Dr. C. expresses in all her actions and words that she cares! We showed her the link to this blog and she seemed thrilled to have a way to follow along - I hope she's reading this post - maybe it will make her blush a little and know how much she is appreciated. ❤
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Today Daniel visited the tub room and for the first time since his arms were grafted on Tuesday. They took a peek at his arms and cleaned and bandaged them. What they reported was that his arms looked great. His surgeon was vacationing in Hawaii, but he wanted to know how they looked. The burn techs sent photos to his surgeon Dr. Wi. and he too was pleased with the photos.