because it's asher, and nothing is ever straightforward with asher

so, once again, asher is doing what asher does.

making something simple(-ish) into something far more complicated.

hence the nickname "asher crasher."

asher has had a bit of a fever all day, and has been tachypnic (breathing fast) off and on all day. he isn't working to breathe, there is no distress, but his resps tonight are 64 to 67 breaths per minute, when his baseline is mid- to high-30s. when the doc came in to check him tonight (after the nurse went to get her), she found that air entry is decreased to the bases, which means, in real english, that when he breathes, the air isn't getting down to the bottom of his lungs. his breathing is very shallow. and that's a problem, since it means that he is not taking in as much oxygen with each breath as he should/could be, which means, predictably, that his sats are lower than they should be. mid- to high-80s, when they have usually been in the low- to mid-90s.

the cause, in my own humble opinion, is that they were a bit too aggressive with asher's chest drains today. just this morning they took the drains off suction and removed one of them. this left the only remaining drain to remove all the fluid, which is fine, but it wasn't set up to suck it out anymore, which makes it more difficult for the fluid to get out. this, you can imagine, causes fluid to build up in the chest, which takes up more room, creates pressure around the lungs, and prevents them from filling properly with air which is needed to oxygenate the blood, thereby lowering sats. when they removed the left JP today, the entire length of tubing inside was clotted. basically, a foot-long blood clot. in my opinion, this made it well nigh impossible for fluid to drain through that tube, which led them to believe that the drainage was slowing enough to remove the tube.

this evening, they have put the remaining tube back on suction, and lo and behold, more drainage! more in one hour than all day, in fact! they are currently monitoring asher's breathing, and if it does not improve (slower rate + increased air entry to bases), we will be going for a chest x-ray.

asher had been doing so well up until now. it's just a bump, but a stressful one, nonetheless. and when you figure in the fact that he does not like to move, going downstairs for a chest x-ray will be unpleasant to say the least. so please pray/think positive/send good vibes... whatever it is you do, please do it now. the doc will be reassessing at midnight, and we would all like to find better air entry and continued/increased drainage. thanks so much!