So much for symmetry...

Since the last post Charlie's right lung has continued to heal and is looking "great" per Dr. Martin's evaluation of the x-rays. The overinflation in the left lung was on the decline previously, but the most recent x-ray shows that it has again expanded and become even more overinflated than before. Dr. martin explained the problem of overinflation to us in more detail. The growth in size of Charlie's left lung is caused by air seeping in to areas of the lung that are not supposed to contain air. The pressure from the ventilator that pushes air into Charlie's lungs causes this air to break into these areas and create the problem that once inside, the air does not come back out as quickly. The air has to be slowly absorbed, for lack of a better word, out of these pockets. In the meantime, while Charlie's right lung is ready for action, there has become a simple problem of space inside the chest. Also, there is the problem that the ventilator must operate via the one tube that is Charlie's airway and cannot control where the air goes once inside. They have been tilting Charlie toward his left side or turning him on it completely in an attempt to use gravity, but the effectiveness has been limited.

Earlier in the week, Dr. Martin had mentioned the possibility of only ventilating Charlie's right lung once he was convinced that it was healthy and strong. It seems like that would be a good option now, but with Charlie's supersized left lung, fully inflating the right lung would decrease the room that the heart needs and effectivelty squeeze the heart, which is obviously a bad idea. So, despite Charlie's previous attempts at symmetry it seems he is now oddly imbalanced. Going back to the discussion of progress, Dr. Martin relayed that although we have seen even dramatic improvement in the right lung over the course of this week, the uncooperativeness of Charlie's left side is again putting us in a non-ideal scenario, creating a situation in which it is difficult to exploit the gains made on right side. This is again a pretty immediate problem and Dr. Martin hopes to make some progress on getting the left lung to deflate within the next 12-24 hours. So, I will post again tomorrow night with the results.