When we came in this morning we found Seven sounding very coarse, "fish mouthing" and nasal flaring. We requested an X-ray and it came back showing his right lung completely whited out. We weren't sure if this was fluid retention or atelectasis (collapsed lung) so we ordered an ultrasound. At the same time, his previously ordered CBC had come back with a white blood count of 33. Last night's WBC was 15. Normal is 5-10. Seven is already on a pretty tough and broad spectrum antibiotic but it's possible something else could be simmering under the surface. Blood and urine were taken for culture. We'll keep our eye out for that... Meanwhile, back at the ranch, the ultrasound didn't show any fluid retention, which left us with atelectasis. 
"What happened," you ask? The most likely scenario was a combination of excessive sedation and maybe a mucus plug that blocked the airway. What we did about it was to put him on a machine call Vapotherm. This uses a lot of pressure to push air into Seven's lungs to help them open back up. We put him on a higher setting of pressure to be a little aggressive with it. Basically we wanted to do everything in our power to avoid reintubating. I think everyone would agree that it would just be greedy to do that again. Seven shouldn't be hogging the ventilator all the time. He needs to learn to share.
Seven learned a new parlor trick. With the amount of pressure pushing into his nose through the cannula, there was bound to be overflow. When he yawned it sounded like a leaf blower. The most amazing feat was when I noticed bubbles blowing out of his tear ducts. It was like a teeny tiny little hot tub in his eye. Oh yes, I caught a photo...
The noon X-ray showed great improvement in the lung. It was almost completely opened back up. It should continue in this manner. We're still just waiting and watching...
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