Tuesday, December 2, 2008

Dawn in ICU

Update 8pm: Dawn is still stable. Her vitals have all been excellent and her SpO2 is at 98 right now. It's been decided that she'll continue the Defibrotide treatment. Dr. Stuart thinks it's been helping and the benefits outweight the risks. We agree. They're going to continue to monitor her and if there's any sign that the drug is making things worse, they'll re-evaluate that decision.

Update 3pm: Dawn is still stable. I've seen a few doctors including Dr. Stuart since I posted this morning. The bronchoscopy showed no obvious signs of infection or any other condition. There was some blood in the fluid samples they took. Last night her respiratory condition slowly worsened. She wasn't getting enough oxygen. They use a device on the finger that uses infrared to measure the amount of oxygen in the blood (SpO2). Normally you want 100 SpO2 but 91-100 is acceptable when they do vitals. If it drops below 91 they'll monitor it more closely and provide supplemental oxygen if needed. I'm not sure what number she was at last night, but it was likely slowly dropping and increased supplemental oxygen wasn't helping hence the ventilator. Dr. Stuart says this normally happens when the lung is wet. There are tiny air sacs in the lungs that are surrounded by tiny blood vessels. The air is exchanged from the sac, oxygen enters the blood replaced by carbon dioxide from the blood. When the lungs get wet, this exchange is more difficult or not possible. The ventilator that she's on is providing positive pressure and helping to force that liquid in her lungs, back into the bloodstream, and helping force the air through that liquid barrier. The ventilator has helped restore her SpO2 levels which is good that she's responding. The current plan is to continue to find out what is causing this and supportive care. There's a team of doctors working on her, specialists for the heart, kidneys, lungs, etc. There's a chance that the Defibrotide (drug for the VOD) is causing the blood in the lungs so they've stopped that treatment until they can discuss this with the team doing the study. I'm hoping she can stay on it since that's the only treatment for VOD.

(Original Post)
Dawn had respiratory failure this morning. They put her on a ventilator and moved her to ICU. She has a significant amount of fluid in the chest. It's around and in the lungs and around the heart. They're concerned about the heart because fluid around it can prevent it from filling with blood properly, which it needs to do to pump blood through the body. They're not sure what is causing all the fluid build up. It could be the VOD, but they don't want to make any assumptions so they're starting with a blank slate and testing for everything. They also have to be cautious because she has no immune system and any time they put a needle or tube into her, they risk giving her an infection. She also has a low platelet count so there's also a risk of bleeding. She's stable and sedated so she doesn't know what's going on and she doesn't feel the breathing tube. They're currently doing a bronchoscopy, which is a procedure where they have a camera at the end of a tube so they can look inside her lungs. They can see things with the camera that they can't see on the x-ray and take samples if needed. Unfortunately the rules in ICU are different than in the bone marrow transplant wing. We can't be with Dawn 24/7 but we'll be there as much as they'll allow.


hockeychic said...

Sending good thoughts your way.

Maria G @ Sea said...

sending love, positive energy & lots and lots of good thoughts your way, dawn.

brian fahey said...

know that you have people coast-to-coast who are thinking of you and pulling for you, dawn.

H said...

We love you Dawn! We are keeping you in our thoughts and prayers.

Heather and Becky

Anonymous said...

Dawn, I read of your plight when you posted on the LLS boards and I'm sorry to hear about this latest "bump" in the road.

I will keep sending thoughts and prayers to you.

(fellow CMLer)

Anonymous said...

We are reading every post and praying that some good news is about to happen so we can once again see that big smile on your face Dawn. It is hard to find the right words to say at a time such as this but we must write so you know that we are thinking of you. You, at such a young age, have had enough bumps in this road of life and it is time for the smooth road to now appear and that is what we are hoping will happen.
With love and concern
Grandpa Tony & Nancy

Anonymous said...

Hi Dawn, i am so sorry that the news is worse. i am praying for you all the time.The Lord has plans for us all, and i am sure he has great ones for you.I know about the ventilator and all the rest with lung problems sine i have had them myself and on oxygen 24/7.May God be with you every minute and we love you so much...Grandma Green

Anonymous said...

Sending love to you Dawn from Holland, Ohio. Prayers are being lifted in your name. What a mighty warrior you are.

Matt said...

This is silly, but I keep thinking about the Chumbawamba song when I think about you and Mike:

I get knocked down,
but I get up again.
You're never going to keep me down.
We sing the songs that remind us of the good times.
We sing the songs that remind us of the better times.

We're all pulling for you.

revmiracle said...

Hi Mike,I am a fellow minister with Steve in Toledo. He is a great friend and good guy. He inspires my faith in so many ways.  I am glad he is able to be there with you. Please share the prayers and love from everyone in his cluster. We pray constantly for "y'all" and I do believe in Miracles!Rev. Loran L.Miracle

Annie - Steven's mom said...

Oh boy - you both live in my thoughts! I am glad Dawn is still stable and I will be adding my thoughts to the many that hope that tomorrow is much much better.

love and light

melyferb said...

I'm thinking about you!

Anonymous said...

Dawn/Mike- Just want you to know that I'm sending so much love and light to you. You're in my heart, on my mind and in my prayers daily.