Wednesday, November 9, 2011

Rollercoaster (day 15)

Hi, everyone, today has been more of a roller coaster.

Overall, I think she's making progress. The scary part is that Nancy's blood pressure nose-dived last night for a few minutes, with her pulse below 40 and barely detectable for a minute or two. This is one of those alarms that brings everyone running ("code blue!"). She was on dialysis at the time, which can be a trigger for low blood pressure. She's now on norepinephrine, a drug to boost her blood pressure, and her vitals have been stable ever since. I asked if this is one of the things that happens when someone is losing a battle with an infection, and her very experienced nurse said, "no, not in my experience". As alarming as this is, no one seems to think it's a particularly bad sign.

Her hands and feet are warm for the first time in days, so more blood is flowing through her periphery. This explains the low blood pressure, and is also a normal body response to infection. Is her body picking up the fight? Is the infection getting worse? No one can say for sure. So much of the complex story is like this, tons of data, little real information. Such an inexact science. But her body temperature is normal.

Because of the alarm, she now has an EEG monitor, electrodes on her head. And she's getting another MRI right now; they are taking a look at her skull to make sure there isn't another abscess somewhere that is impacting her heart function. The cardiologists are investigating, but seem to take it all in stride.

The good news is that her kidneys are picking up the action. I'll just be technical, there is no other way to communicate this. Her urine output was 300 ml on Monday, 300 ml on Tuesday, and 200 ml in the last 12 hours. We are shooting for more like 1200 to 2000 ml per day when they are back to normal. So she's heading in the right direction. Another piece of good news is that the doctors have gotten her immunosuppressive drug level back where it should be. This was causing hallucinations two weeks ago, and was one reason she was originally admitted to the hospital. I think her prednisone dose is getting lowered tomorrow too, which should help.

One of our dear friends has a young daughter who has learned about prayer, and he sent a note today: "the prayer is, please Jesus, let Nancy go pee pee. How can God not answer that prayer?" Perhaps the prayer is working.

She was on a lot of pain meds when I saw her this evening, her neck has been hurting a lot, so she was pretty groggy. I'm waiting until she comes back from the MRI around 9pm.

I can't believe it's been more than two weeks. Please, Jesus, let Nancy go pee pee!

Love,
-tdc

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