I talked to Dr. Tita, pulmonologist and critical care doctor, this morning.  He was the Dr. who saw Ron last Sat. and Sun. March 14 and 15, and said his numbers looked good, and he was progressing, when his lung was actually collapsed.  I asked how that happened.  He said his lung is pretty much like swiss cheese, and it sounded the same when it was collapsed as it did when not.  He said in retrospect, it makes sense that when he thought he pulled a muscle, it was his lung collapsing, but nothing in the vent or CO2 monitor numbers indicated a problem.  Only a chest x-ray or CT would have shown the collapse, and of 100 people on a vent, only 1 will have a pneumo thorax, so it does not make sense to do a daily chest x-ray and expose him to all that radiation.
 
He said the secondary infection that he got has caused much more damage than they originally thought.  His sputum culture shows that that Acinetobacter disease is still active.  His lung has much more damage than strep pneumonia generally has.  It looks almost like a staff infection (like the boils you get on skin) is on his lung. There are no more bubbles coming out through the tube, so it looks like the hole has healed, but he wants a CT scan done today.  The x-rays are not as clear as he would like. 
 
Dr. Maaieh, cardiologist, was in at about 11:15.  He said his heart recovery from the tachycardia was "quick", which is good.  He said sometimes it takes days to convert to a regular pattern.  He said it indicates a healthy heart.  He said the heart is such a sensitive organ, that the displacement and/or the lung disease could set it off.  It could happen again...  Ron is still very sick and at risk for tachycardia.  Dr. Maaieh wanted to know if the pulmonologist had said when they plan to remove the chest tube.  He ordered the Cardizem drip reduced by half.
 
Dr. Tita had said it needs to stay for maybe a couple more days.  The CT scan will tell him more.  When they are convinced the pnuemothorax is gone, they will cap off the tube, wait a couple hours, and see what the lung does.  If it starts to collapse again, they will uncap and leave the tube in longer.  If it looks OK, they can remove the tube.
 
Dr. Tita also has ordered the tube feeding turned off during the day -- just on at night -- so Ron will have room to eat regular food.  I don't think his stomach is tolerating the tube food very well.
 
Dr. Jauregi, the Infectious Disease Center doctor wants his door kept shut.  He also wants to see how the pneumonia looks on the CT scan.  He is concerned about the acinetobacter. This strain of it is relatively new to this area -- showed up here about 2 years ago, apparently from the Far East.
 
We are not as far through the woods as we thought last week...  It is still pretty scary!
 
Thanks for your continued prayers and good wishes!  The support is SO appreciated!!  Ron enjoys reading your messages!
 
Love,
EJ