Picture, No pseudomonas, Vision damage?

Here's a picture of Denise that one of the nurses took last night. It's a scan of a Polaroid, so it's not very high quality. She's tired, but sitting up and smiling. Denise gave her permission to post this. The staff at USC has been talking about what amazing progress she's made in the last week & a half, and how different she is now than when they first got her. I thought that the Arcadia Methodist crew might be especially happy to see Denise smiling, not tethered to a ventilator, and getting ready to enjoy some refreshments.

Today she brushed her own hair, brushed her own teeth (using a regular toothbrush), and continued to enjoy lower temperature spikes (she was in the 99 range every time they took her temp today). A sample of her stats: HR 116, BP 116/69, 91% sats w/no oxygen. I found out that she does use the nasal oxygen when laying down, but doesn't need it when upright. The PT showed us some more exercises to do with Denise, and they let me stick around for the wound care. Her bed sore is continuing to heal up. Still pretty deep, but getting better. I brought her Converse sneakers that they got her at Arcadia Methodist to prevent ankle drop. Densie said they were too tight. I don't know how she'd remember that, since she hasn't worn them since being at the other hospital, which she said she doesn't remember. She was wanting to nap more than talk today, but she did tell me that she doesn't like having to look up at everyone from bed all the time. So if you visit, pull up a chair & try to get on the same eye level with her. She also doesn't like people getting in her face to talk (except me... hubba hubba). I once heard that we have a tendency when dealing will sick people to lean in too close and speak either too loud or too soft, often with a syrupy, "Mr. Rogers" voice. She said I do well at acting normal around her, which is good since she says she's already warm enough without people getting close to her face, and she's not a deaf preschooler.

I spoke with someone from the infectious disease department today. He did think that discontinuing the antibiotics (she's been off for about a week) helped lower the fever curve. I guess that we may have been chasing our tails with the antibiotics. The most recent sputum samples are not showing the presence of pseudomonas (yay!). A couple more negative test results like that, and she'll get a ticket out of the ICU and into a regular room! The ascites continue to build up, but not as fast. He thought that as the nutrition gets better, the ascites will go away. I asked about the mold in the meningeal fluid. Once again, I heard that yes, it's present, but the treatment is and has been appropriate. He also pointed out that they're treating the patient, not the lab results, and the patient is getting better fast. If she weren't, then they'd be more alarmed by the lab results.

I got a very helpful comment on what the criteria is for removing a trach:
1) Put in a fenestrated trach, no cuff. Check
2) Use the Passy Muir valve (speech valve). Used it, ditched it a couple days ago (Check).
3) Plug the trach, suction as needed. Check.
4) When no more suctioning is needed, yank the trach. That's what I'm waiting for.

Remember that you can now send email to Denise at pullingfordenise@yahoo.com. Though her vision is blurry right now, you don't need to use a larger font. I'll read everything to her. Oh, when I called tonight, she said that the opthomologist came to dilate her eyes again, and said that she had some damage caused by the valley fever. I know that this was a concern, but thought that the concern had diminished. She was tired and may have been confused. Still, it's a prayer point and I'll check into what the optho people said when I visit tomorrow.

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