Pee, Pee, Pee...

Still working on peeing off fluid. He is peeing well, just needs to keep it up. If he diureses well this morning, they may try to lift the paralytic this afternoon and see what happens. The big issue is that when we lift the paralytic his blood pressure must stay down and his LA pressure (left atrium pressure, this is our biggest number to watch) must also stay below 20. He is sitting around 13-15 on the paralytic, but shoots up when someone touches him or moves him...even while being paralyzed. They have increased his morphine and versed drips in preparation for this afternoon and also started him on some methadone. My suspision is that we will lift the paralytic, his numbers are going to shoot up, reparalyze him and come up with a new plan. I don't mean to be negative, but sedation is always our biggest issue and waking up calm and quietly has never happen with him before. Also, when he is not paralyzed he hates morphine, it makes him itch and very irritable, so finding another medicine that is strong enough to replace the morphine is tricky. I am sure we will try some other drugs to get us through, but this next step of turning off the paralytic and then evetually extubating will be a very hard task to do without causing a big disturbance in his numbers. Usually for extubation we turn off the paralytic and sedation drugs and literally hold him down until he is awake enough to pull the tube (he has also pulled it himself in the past!) That kind of stuff cannot happen after this type of surgery. Please pray for our team of doctors and surgeons to find the right balance of medications and timing to complete all these tasks with ease.
Here are a couple of pictures from late last night and this morning.

Pink little lips :)

Still has some puffy legs!