Wow, what a morning!

Phil is stable now, but its been a long morning. Early this morning he started coughing and his saturations went down. They had to increase his FiO2 to 90% again. They got a call for a liver, but due to his lungs they turned it down. We totally believe this was a God thing because he was doing well and then started coughing and his saturations went down. God didn't want him to get this liver. Earlier in the week we prayed that the surgeons wouldn't make the decisions, but that God would make the decision for them.


Beth and I were in the room and he started grimacing and his saturations went down into the 70's. They increased his FiO2 to 100% which is the most you can have and he was still desaturating to the 70's. Alarms were going off and not being dealt with, which was really frustrating. His nurse is the charge nurse today and they have a shortage of nurses so she is running around into other rooms and not able to pay as much attention to Phil. I had to go and tell them that he was desaturating and to give him more pain meds. The nurse just decided to increase his propofol(sedation which causes low blood pressure) from 40 to 200 (he has never been over 50) and she didn't see his blood pressure starting to drop. As soon as I told her, she turned it back to 40. Please pray for her, Lindy, as you can tell she is overwhelmed and stressed. God sent Dr. Koje by and he saw what was going on and he is now in the room with Phil. They paged the lung doctor again. Dr. Koje just said he happened to walk by. We know that is not the case. They have now called in another nurse to stay with Phil 1 on 1 today. Her name is Tammy.

Please pray for Phil's lungs. We had an extensive talk with the lung doctor today and they feel that all of this is due to his lung shunting from the liver disease (hepatopulmonary syndrome). This is where the blood vessels around the air sacks (alveoli) are expanded and blood passes by but cannot pick up the oxygen. They do not understand how this happens but they think there is something the liver makes or clears and the lack of it or excess of it causes the blood vessels in the lungs to dilate like this. The only thing that fixes it is a new liver and even with a good liver it takes time to reverse the shunting. They said his chest x-ray looks good today so they don't think pneumonia is the cause of all of this or fluid on his lungs. They are going to give him a higher dose of steroids to help his lungs which will also help with rejection of the liver. Pray against infection because steroids increase the risk of infection. They are also going to do a sonogram of his legs to check for blood clots they could have gone to his lungs. They just want to rule out all causes of what could be making his lungs have trouble. They don't think this is what happened because his blood is already so thin. They want to do a CT scan of his abdomen just to check and make sure no other infection is going on, but with his lungs like they are, they don't want to take him down stairs to radiology. They are going to do a sonogram instead which they can do in the room. The surgeons have now decided to paralyze Phil today so that he can't move in hopes of allowing his lungs to heal and recover. They will also be giving him sedation and pain medication. Please pray for God to heal Phil's lungs- that He would reverse this shunt and allow his blood to pick up the oxygen that it needs to.

Praise God that the liver function is improving. His INR is down to 1.5 on its own (with no added plasma) and his billirubin actually dropped to 4.4. Dr. Ruiz actually stated that can't tell the future but that this liver is kind of functioning and that "maybe he will actually walk out of here with this liver" - this is the first time he has admitted that this liver might work out. It gave us a chance to remind him that we have been asking God to heal this liver. Pray that God will use this to show Dr. Ruiz that He is real. We also praise God because maybe He is using these lung issues to keep the surgeons from taking Phil back to the operating room for a new liver when maybe God wants to heal this one.

They decided to take him off of dialysis today and they are going to remove the catheter they use to do the dialysis because it can cause infection. Continue to pray that God would heal his kidneys and that they would be able to clean the toxins out of his blood.

We had a neat moment with Phil. While they were waiting on the paralyzing medication to come from Pharmacy, they decreased his sedation. He was the most awake we had ever seen. He was blinking his eyes and he looked at Beth with open eyes for a prolonged time. We were able to tell him to relax and explained some of the tubes to him.

We are so thankful for all of your prayers. Please continue to pray for Phil. We praise God for how he continues to work out His purposes in all of this.