Quick update cause I am drained today. Basically, I fired his doctor cause she is a fucktard and wanted to put my dad down like a lame horse cause “he is too old and this will most likely happen again”. Well she can suck my poorly wiped asshole. After talking to the Pulmonolgist we decided to instead do a bronchial wipe, essentially they stick a scope down the throat and remove any mucus plugs or obstructions (pulled another liter of gunk out). The procedure went well and the response was immediate as his oxygen level topped 100% very rapidly with only 30% assistance from the vent.  There was some apnea issues afterward that almost made me shit myself. I’ll tell you right now, when you have been studying someones every breath for almost two weeks and they stop breathing you jump the fuck up real quick. Quick enough that your knee does not realize it is positioned within direct contact of what will be hence forth named “THE RAIL OF DEATH”.  I will tell you what else, you let loose a stream of profanities that would make Mad Max go to church the subject in question will also jump up and start breathing again. You know what else? The nurse will throw some shit and come running too. Anyway I digress, so for today, things are better.

Tomorrow they are going another Thoracentesis to try to drain off more fluid from the lungs. As of now he is back on the vent, however the Pulmonolgist was very open and honest about his prognosis.  The short hairs is this, he is weak, he is in poor health and he has been through hell, however everything he has is treatable. He thinks that he will be able to come off the ventilator again, and that it’s a matter of clearing the lungs and healing the infections. After that it all depends on how well my father takes care of himself. He was very honest that if anything else happened, stroke, heart attack , ulcer, athletes feet, hang nail etc dad would not be able to make it. So for how we fight till either he gives up or his body does.

Below is more info on what is going on.

Sometimes pneumonia can lead to additional complications. Complications are more frequently associated with bacterial pneumonia than with viral pneumonia. The most important complications include:

Respiratory and circulatory failure

Because pneumonia affects the lungs, often people with pneumonia have difficulty breathing, and it may not be possible for them to breathe well enough to stay alive without support. Non-invasive breathing assistance may be helpful, such as with a bi-level positive airway pressure machine. In other cases, placement of an endotracheal tube (breathing tube) may be necessary, and a ventilator may be used to help the person breathe.

Pneumonia can also cause respiratory failure by triggering acute respiratory distress syndrome (ARDS), which results from a combination of infection and inflammatory response. The lungs quickly fill with fluid and become very stiff. This stiffness, combined with severe difficulties extracting oxygen due to the alveolar fluid, create a need for mechanical ventilation.

Pleural effusion. Chest x-ray showing a pleural effusion. The A arrow indicates “fluid layering” in the right chest. The B arrow indicates the width of the right lung. The volume of useful lung is reduced because of the collection of fluid around the lung.

Sepsis and septic shock are potential complications of pneumonia. Sepsis occurs when microorganisms enter the bloodstream and the immune system responds by secreting cytokines. Sepsis most often occurs with bacterial pneumonia; Streptococcus pneumoniae is the most common cause. Individuals with sepsis or septic shock need hospitalization in an intensive care unit. They often require intravenous fluids and medications to help keep their blood pressure from dropping too low. Sepsis can cause liver, kidney, and heart damage, among other problems, and it often causes death.

Pleural effusion, empyema, and abscess

Occasionally, microorganisms infecting the lung will cause fluid (a pleural effusion) to build up in the space that surrounds the lung (the pleural cavity). If the microorganisms themselves are present in the pleural cavity, the fluid collection is called an empyema. When pleural fluid is present in a person with pneumonia, the fluid can often be collected with a needle (thoracentesis) and examined. Depending on the results of this examination, complete drainage of the fluid may be necessary, often requiring a chest tube. In severe cases of empyema, surgery may be needed. If the fluid is not drained, the infection may persist, because antibiotics do not penetrate well into the pleural cavity.

Rarely, bacteria in the lung will form a pocket of infected fluid called an abscess. Lung abscesses can usually be seen with a chest x-ray or chest CT scan. Abscesses typically occur in aspiration pneumonia and often contain several types of bacteria. Antibiotics are usually adequate to treat a lung abscess, but sometimes the abscess must be drained by a surgeon or radiologist.