In the air (Day 7 post 13)

 I did not update yesterday.  It wasn’t a good day or a bad day...it was just blah...and I just didn’t feel like making a post.  So yeah.  Whoops, sorry.

The ICU dr’s have kind of been ignoring the swelling and focusing on the blood.  I think the 2 are related.  I understand that the bleeding is more urgent, but I still had some questions.  I said that last time she had resistant pseudomonas her breathing was bad and there was no bleeding.  If it is only the pseudomonas we are treating, why is breathing OK, but she is bleeding.  They said bugs do not react the same even in the same person, it is based on a lot of environmental things ( different levels and conditions within the body) how your body will react.

Yesterday and today the swelling in her hands looks sooooooo much better.  Maybe it’s the antibiotics, maybe it’s the lasix, maybe it’s the blood products, who knows.

They mentioned that Ritalin could cause low platelets.  It is just a far-fetched theory, but it is much more likely that she is just bleeding so her platelets are low.

She is starting an inhaled med that will help encourage clotting.

She is having major diarrhea ( probably from the antibiotics).  We are starting probiotics and holding all pooping meds.  Her stomach is also majorly bloated, but is still soft.  They are going to send off a c-diff sample.  ( c-diff is when the good bacteria dies and the bad bacteria takes over in your gut.  It happens with antibiotics.)

Copper is still high, tomorrow ( Monday) nutrition will consult and run some additional nutrition labs.  B12 is also high.

Lots and lots of labs are still up in the air.  We are waiting on labs for rheumatology, labs for ID, labs for pulm.  

We still don’t even know if this pseudomonas is susceptible to the avycaz she is on.  Her crp ( level of inflammation) is holding steady...it should be decreasing.

Tomorrow immunology and genetics should be consulting.

They are not giving any ibuprofen, since that can increase bleeding.  She is still intubated.  She is only intubated because they are trying to put pressure in her lungs to stop the bleeding ( like putting pressure on a cut).  Her breathing is actually really stable and really good.  She is needing morphing and Tylenol to tolerate being intubated.  They may also need to add Ativan today to calm her down to tolerate being intubated.  I think fighting the tube is a good thing, it means she is feeling pretty good.

She got no blood products yesterday.  Today she needed platelets.  Her liver ultrasound showed she has fatty liver, they are not concerned about it.

Because she is at high risk to get bed sores, they ordered her a special dolphin mattress ( air filled mattress that has different sacs that inflate and deflate.

Her blood levels are still low, but holding fairly steady, so they believe she is bleeding less, this is great news.

I asked pulm if any remaining blood would be reabsorbed into the body if she couldn’t cough it up and she said yes.  She said there are macrophages in our lungs that will chewthem up.