JJ- my e-mail is lissa1522@msn.com. i would love to get together!! We will be here for sure!

Hes back. They were able to accomplish there goal. Hes was pissed but he got through it. Corey is better at giving medical details so he will be updating after we spend some time with Brian.

The nurse just came in to give us an update. Hes tolerating the procedure OK, and they have about another hour to go. Hes a fighter hes so strong!

Still waiting

Brian was wheeled down at 1pm. Now we wait.

Brian's had his MRI this morning. The doctors think they can help Brian's chylothorax so he has been scheduled for an angioplasty tomorrow at about 1:00. The doctor's plan is to run a line through the vein in Brian's neck and groin. They hope to work the line into the middle of the clot and balloon a hole to allow fluid to drain. The doctors will also try to place a stint to ensure the hole stays open. There are 2 big risks associated with this procedure. There is a chance the fluid or contrast injected in Brian to help the doctor's see what they're doing can trigger a pulmonary hypertensive crisis. One of the major issues with CDH babies is pulmonary hypertension. Pulmonary hypertension is already an issue for Brian. It was one of the biggest obstacles that prevented Brian for getting off ECMO. Right now the doctors are managing Brian's pulmonary hypertension with a drug called flolan. The other risk is simply that the procedure is unsuccessful. This is already the second attempt to correct the chylothorax. The longer Brian drains white blood cells from his chest tube the greater the risk of an infection that could potentially kill him. The cardiologist that talked to us about the procedure referred to it as the last option. Alyssa and I are optimistic because Brian has always pulled though at the very last minute and we are confident he will do it again.

A few days ago Alyssa and I were very excited that Brian tolerated vent decreases and wasn't as sensitive to touch. At that time these were big accomplishments because it showed us he was fighting off the infection. In the past few days we have learned that Brian's tolerance and ability to breath are affected by everything else going on and can fluctuate day to day and even hour to hour. We have learned to gage his progress by looking at the bigger picture. Unfortunately Brian has a lot of issues right now that the doctors are doing their best to manage but are not improving. The most urgent issue has become the clot in the main artery in his neck. As I have mentioned in previous updates the clot is responsible for Brian's huge head. The clot is also responsible for the fluid accumulating in his chest. If I understand correctly some of the fluid that has been unable to drain through the clotted veins have found another rout, the fluid settling in Brian's chest. The amount of fluid has been steadily increasing which is again putting Brian in a state that is very susceptible to infection. Alyssa and I talked to the cardiologists today. They gave us three options to correct the chylothorax. Brian is scheduled for an MRI tomorrow which should help them determine which option is best. Depending on the size of the clot the doctors would like to try to balloon the vein, hopefully creating the space to allow the fluid to drain properly. If the clot is to big for the balloon option they would try to place a permanent stint. There is also the possibility that the clot is to big to do anything surgically. We are not sure what the plan would be then. If surgery is scheduled for Brian it will most likely happen Wednesday or Thursday. Your continued prayers are appreciated!