Monday, September 19, 2005

Wait and see... still bad but stable

Things are still pretty bad, but stable. We have to wait & see what's going to happen.
Main points:

Heart: Denise's heart is a big concern. Her ejection fraction (heart output) is still low today (20-25%). She's got some catheter threaded through the chambers of her heart that give us all kinds of measurements. Her PAP (pulmonary artery pressure) is higher than they want but her cardiac index has stayed essentially what it should be for her size & age. A nice thing is that her blood pressure is acceptable while blood pressure meds are decreasing. She's still getting a lot, but not nearly as much as Saturday night. Her heart rate is slowing (got down to 100 while my aunt was rubbing Denises's feet) and oxygen saturation was still at 100%, so that's good.

Bowel not working: Today they put contrast in her gastrostomy tube to check placement and flow - it supposedly looked OK. They are putting meds down it now and are hopefully starting feeding soon (they're trying to avoid the IV feeding). She also has a tube down her nose to take the acid off of her stomach. Her tummy looks pretty big again.

Liver: Her liver also was affected by the shut down this weekend - it's not filtering as it should and her liver enzymes were way up yesterday & today - but today's is 1/2 of yesterday's. So we'd like to see that trend continue.

Kidneys: Yesterday she had 2 liters taken off with dialysis. Dialysis will be decided each day based on her electrolytes and fluid status. Denise is only putting out 42-44 ounces per 8 hours, but we are hopeful if the sepsis is controlled that the renal tissue that was damaged by this weekend's scrape will regenerate.

Thyroid test came back OK.
Lungs holding their own, Denise is able to get 100% oxygen saturation.
Fever only went to 100.8.
She's on Xigris (sepsis), Primaxin, Vfend, Vanco, Ampho B.
Labs show hemo count at 10.6, white cells 17.2, platelets 95, hematocrit 31.5.

We were sort of in the boat a bunch of weeks ago... organs shutting down, things looking scary, Denise on Xigris. The things going for us this time are Denise's ability to tolerate dialysis (that does some of her body's work for her), her ability to breathe more efficiently, even more of you pulling for us, and the knowledge that things were pretty darn bad then, and she was carried through it. Things against us this time are getting weaker after this long fight, different infections in different places, bowel not working... I think I'll stop there.

Today's non-crisis events: At times today Denise would reach out for hugs, especially from the respiratory therapist. She wrote "wheelchair" on a note pad in fairly normal-looking writing (she really wants to get around & maybe go outside). I was more anxious at work today than normal, probably because of Denise's condition. You might be wondering how I could show up at work in times like these. I wondered what I was doing there, too, sometimes. With all the family & friends around, I my heart felt at ease that Denise was getting emotional & spiritual support, on top of medical care that the CCU staff provide. I could worry by Denise's bedside, or worry at work. I thought as long as I'd be worrying, and Denise wasn't alone, I might as well be productive. Work is a short drive from the hospital, so that helped, too. We got a nice bit of lightning & thunder, then a whole bunch of rain tonight (the first of the rainy season). Know why? After not washing my car for 10 weeks, my buddy that came from Tennessee to be my right-hand man gassed up my car & ran it through the car wash yesterday. I think he brought some of the weather with him.

My cousin is working on a world map that we can all put pinpoints into. It's based on Google maps... you can zoom right down to street maps or satellite photos or a hybrid of both. Depending on what area you live in, you might be able to find your rooftop. There'll be a link to it as soon as it's all ready to go live.

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