Another day where nothing got worse, most things fairly stable, some things better, some much better! Very cool! She's not is as good a condition as she was before the shut down on Saturday night. But she's improving, and for that we're thankful! Here are the nuts & bolts:
The Xigris seems to be helping Denise fight the sepsis. That' stuff's been a life-saver twice now. We're hoping there will be no complications related to it so that she can benefit from the full regimen of it. It ends about 2pm tomorrow. Kidney function unchanged - still low. But her creatinine is down to 1.7 from 1.9 (we want it to get to 1.0). There's a possiblity that her kidney damage is here to stay and she'll need dialysis for life... or not. To early to tell. But as a buddy put it, dialysis for her life is a fair exchange. Her blood pressure is holding at 103-113 and the blood pressure meds were decreased again (down to 4 mcg/minute). Temperature stayed around 99.8-100 most of the morning, then increased to 101.2 after Ampho B was started... it has a side effect of fever. White cell count is down to 10.4. Again, those two bits of info hopefully indicate that the infections are subsiding. The infectious disease doctor says blood cultures & recent ascites fluid are not growing anything. Chest x-ray is unchanged, oxygen saturation is around 100% on a 40% concentration.
Great news is that her liver enzymes are *dramitically* improved (ALT 79, AST 155... both numbers were many times this earlier). We hope that the liver kicks in and starts working full bore, and real soon.
As far as blood goes, her hemoglobin is 10.2, DIC (that weird bleeding/clotting problem) seems to be improving (as based on a fibrinogen level being essentially normal in the DIC workup). She's got a Swan pulmonary artery catheter (this thing sounds incredible... it's threaded through the chambers of her heart... she had one in the beginning weeks). It shows the pulmonary artery pressure is getting closer to normal, pulse got as low as 106, high as 121... much nicer than those 150s-160s that we were seeing earlier. And her respiration continues to hover around 20 (much better than the 30s-40s that have marked the past two months.
The gastro tube feeding is doing OK so far, after some starts & stops. That would be great if she can continue to tolerate that. We heard that Denise had some vomiting episodes, but the nurse said that there was very little, and she thought it was mostly mucous causing a gag reflex more than anything.
Denise again wrote that she wanted to get into a wheelchair. When told that she has a big ol' Quinton catheter in her femoral artery for dialysis, and that it can't be bent by sitting, she wrote, "What about a walker?" That's my girl. My mother-in-law and my aunt also cut Denise's hair today... with bandage scissors. They don't cut hair as well as what you might find in a salon, nor do my mother-in-law and my aunt.
Correction: In the Monday September 19th entry, I stated that Denise's kidney output was 42-44 ounces per 8 hours. I meant milliliters, not ounces. Big difference. Those of you that are hip to nephrology probably caught my error & knew what I meant. Those of you that aren't probably thought Denise & I were having beer & pretzels or something.
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