Everything has been going good today. She's still on the ventilator but the settings are so low it's barely helping her at all. They're going to pull the tube tomorrow and get her breathing on her own barring a setback tonight.
It seems like every time we get good news (below) , there's a bit of bad news. Dawn has tested positive for Clostridium difficile (C. Diff). C. Diff is a hearty bacteria that lives in the intestines. You can be healthy and not know you have C. Diff because you have millions of other helpful bacteria that keep it at bay. The antibiotics Dawn takes for infection control can also kill some of these "good" bacteria. Without enough of this good bacteria, C. Diff can grow out of control. The C. Diff releases toxins that are harmful to the intestines. It causes diarrhea and in severe cases can cause small holes in the intestines. Ironically, the first order of treatment for C. Diff is antibiotics! There are three that are known to target this bacteria. C. Diff can live in the air, soil and pretty much anywhere it wants. It's common in hospitals so the longer someone stays in the hospital, the greater the chances of catching this. Her symptoms right now are mild and the CT scan yesterday showed no related problems so hopefully they caught this early and treatment will be effective and swift.
BIG NEWS! You can see below her WBC is .400K. I thought that was a good sign but didn't want to get too excited until I talked to the oncology team. The WBC is her white blood cell count. It's still very low but it's climbing! That means some of the cord blood cells have engrafted and are starting to make new cells! Dr. Afrin was doing rounds today and said that the count is in-line with a "normal" timeline. He said we should hope to see some neutrophils in the next 3-4 days. Getting some white blood cells and neutrophils will really help her body get better, not only fight infections but get all the functions working properly too.
They're also doing some respiratory tests to see how well she'll do off the ventilator. So far she's doing pretty good. I think they're going to change some more settings and lower the support the ventilator is giving her. If she does well, they'll get the tube out later today or tomorrow. I think they'll wait until tomorrow, give her body more time to remove fluid and let her get a good nights sleep before having to work harder to breathe.
Breathing Test off Ventilator- Passed
Ok, the nurses (cough, Val) up on 5 West (the transplant floor) have been asking for numbers.
So here you go:
Bilirubin: 5.1 (up slightly from yesterday, 4 something)
I think that's everything you wanted, if I left something out, write a comment.
Dawn's heart rhythm became normal around 7:30pm last night. She still has good fluid output. She's back on the feeding tube and the pain on her right abdomen is still there but better today.
So her heart became normal as suddenly as it became irregular. She's on an Amiodarone drip that could be helping but it's likely it just resolved itself. They're not sure exactly what caused it to become irregular but with all the treatments and drugs she's been on lately, plus the fluid around it, they could point to many causes. The CT scan yesterday came back negative for any obvious signs of infection or bleeding in the abdomen. Other lab tests for bacteria have come back negative so hopefully the pain will resolve soon.
Monday, December 8, 2008