Back from OR (Day 5 post 9)

Before the OR

J

After OR.  She is on her normal bipap settings, which is fantastic.

The liver ultrasound shows she has fatty liver.  I am not sure if we need to do anything about this.

They have not done the Heart Echo yet.

Platelets were low this morning, so she got a unit of platelets before going into the OR.

Her CRP (level of inflammation) was down a bit yesterday (down is good), but it was up a bit today.  When it is going down they assume that they are on the right antibiotics.  They are not stressed yet that it was up today and they expect that it will be up tomorrow due to the bronchoscopy irritating her lungs.  They said we just need to give a little more time to see where it trends.

They are continuing to run and draw lots and lots and lots of tests each day to try and figure out what is going on and see if there are any solutions.

She is back from the OR where they did a bronchoscopy and endoscopy.

The bronchoscopy ( looking inside the lungs) they can only go into the big airways, not the small airways. But both lungs have blood in the bottom parts of the lungs.  She could not see any active bleeding because there was too much blood and the bleeding is probably coming from the smallest airways.  She did 3 large suction amounts which they will send for cultures to see if there are any unusual bugs or things growing. She thinks she may not have enough for the large amounts of tests that infectious disease wanted to run, but ID prioritized what they thought was most important. This will take several days to get back the results.  Sometimes high dose steroids can help stop bleeding in the alveoli, but they don’t want to blindly do steroids, because steroids can make infection worse.  They will wait until the cultures come back if possible.

The GI saw some gastritis in her stomach.  This just means irritated stomach.  This is probably just from being chronically ill.  They are switching her acid reflux med from famotadine to Prilosec.  They took biopsy just to be sure.

She came back to ICU still intubated  ( breathing tube in mouth).  This will allow her to rest a bit and the ICU can extubate ( remove breathing tube) on their timetable instead of feeling rushed.  Pulmonologist had mentioned that if she needed more samples she can do that bedside through the intubation tube, so the team will check with her ( pulmonologist) before extubating.