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Hello friends. I apologize for the delayed update. The last week has been a whirlwind of adjustments and changes - mostly good. Gus is doing really well. His meds have been weaned considerably, his second chest tube removed (woohoo!), and he is breathing room air! The kidneys remain a major obstacle to his progression. His renal scan (to follow up on that for you all) verified that his kidneys were indeed damaged, but they are still perfusing blood, which was encouraging. It means the possibility for recovery is still there. However, his urine output is still minimal, and the kidneys haven't responded to diuretics. Our nephrology team is optimistic, but for now all we can do is give the kidneys the ideal conditions for recovery, wait, and pray. He's still on peritoneal dialysis with hourly passes. Ideally, we'd like to see the kidneys recover to the point where such frequent dialysis is not needed - or not needed at all. 137 days with Gus at the hospital. God has been kind to us. Every day with Gus is a gift. Thank you for continuing to follow our story and pray for us.

Hello, friends. Gus had a stable night and a good day today. Positively, his blood pressure has been better and his right lung is much improved. Still of concern, his kidney output has declined, he's still draining a lot from the chest, and we have a cath procedure tomorrow. Here's an overview: Most importantly, Gus is going to have a catheter procedure tomorrow. Historically (pre-transplant), cath days have been difficult days with complications. We hope tomorrow is different now that he has a new heart with better function! The concern driving the need for this procedure is twofold: I mentioned a while back that our team was concerned with blood flow through his superior vena cava (SVC). The SVC involves one of the suture points for the new heart. It's not uncommon for this area in the SVC to become stenotic. The cath team will investigate , and if necessary balloon this area to improve blood flow. In Gus' case, there are signs that this may in fact be the case (e.g.poor drainage from the upper body and increased swelling in the head when pushing fluids). Another reason for the cath procedure is the need for more accurate data. Since his new heart was placed, it has been slowly recovering. His new heart is stiff and thick. This condition can cause issues with pressure in the heart, which in turn may cause other systemic issues. The cath procedure will involve gathering more accurate data that will help our team treat Gus more effectively. Both the internal pressure of the heart and the potential SVC stenosis may be contributing to the increased chest tube output that is throwing off his fluid balance. The increased pressures can cause systemic fluid backup that is shed by the vascular system. Cloudy chest fluid drainage may also signify Chylothorax, which would involve significant diet change (a test for that is running now -- please pray it comes back negative!). We hope the cath procedure will shed light on these issues with increased chest output. On top of all that, there is also concern for his kidneys as they too can suffer from systemic pressure issues and fluid imbalance. His urine output has greatly decreased over the last week. Our team is trying to walk a fine line in caring for the heart and the kidneys at the same time. The cath procedure may also involve a biopsy of the heart -- a common procedure that tells us how his body is responding to the graft. We're not certain at this point whether they will do this test or not. Please pray that tomorrow's cath procedure goes well, that it is free of complications, and that it will give our team answers that help guide their treatment. Gus is doing really well in some areas, but the increased output of fluid through his chest tubes is concerning, and we need to determine the condition of his SVC. We hope this cath procedure provides some helpful direction for these and other issues. We are enjoying more time with Gus since he's been less sedated. God is so kind. He has granted so many of our requests. We continue to storm the throne of grace for his help. He is our refuge and strength. His will be done. As always, thank you for praying along with us.