Thursday, November 17, 2011

Not boring, dammit (day 23)


Well, today hasn't been so boring. Nancy's daily blood culture results this morning showed that she has a secondary infection in it's early stages, 'gram negative bacilli'. This is something that the doctors are jumping on, of course, but they aren/t particularly alarmed at this point. It could be a common urinary tract infection or something in her intestines or lungs -- this kind of bug is part of the normal "flora", the bacteria on our bodies. Tomorrow morning they will know what kind of bacillus it is, whether it happens to be a resistant strain, etc. In the mean time, she is getting IV Zosyn, an antibiotic combination that is commonly used for this.

One of our friends was here this morning when she got the news about her secondary infection, and she asked our friend to call me. The upshot was, she wanted me to come to the hospital, so I packed up my work computer, and I've been here all afternoon.

She also got more dialysis today, removing another 3 liters of fluid. Again, she is tolerating this well, and her blood pressure has generally been solid. She has lost almost 10 liters of fluid via dialysis in the last three days, a truly amazing amount. The swelling in her body is visibly reduced.

And she had another cardiac event today, the first one since, I don't know, last week perhaps. For about a minute, her heart rate and blood pressure dropped very low, what they call "bradycardia", and she became unresponsive. She bounced back out of it on her own. I was rubbing Nancy's shoulders when it happened, I saw her fade away from full consciousness right as I'm looking at her, and I was the one who called for help even before the machine alarms went off. You can envision this. Patient's husband pops out of her room, sees a nearby ICU doc, and calmly says "doctor, I need your help in here Right Now." I had four people in her room in 20 seconds, as the alarm starts going off. What an up close and personal experience of how fragile our lives are.

We don't know why this happened again; it could be a lasting side-effect of one of the drugs she got last week, it could be related to her surgical recovery, maybe I moved her head the wrong way, it could be something else. But it does mean she's not getting out of the ICU tomorrow. The cardiologists want to watch this, and keep her on the monitor.

Janet has been here with me for the last couple of hours. Nancy has been sleeping a lot this afternoon since the dialysis, which is normal after losing so much fluid. In all other ways, she seems to be doing pretty well, making some urine, but not a anything like full production yet.

I liked dull boring yesterday better. We're not out of the woods yet.


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