Dawn didn't do too well on the diuretics again. They're not getting the fluid output they want so they might consider doing a type of dialyisis. The dialysis is somewhat invasive and has risks, including infection, so it's something they put considerable thought into before doing it. Her liver number is up again today (not good), it's in the 6's. It was in the 3's a few days ago after two weeks of slow decline back towards normal. Her blood count numbers are good again today. She's still climbing. Her neutrophils are up to .8 something - double of yesterday, which was double the previous day. So this officially marks day 1 of Absolute Neutrophil Count (ANC) > .500. Two more days and we can confirm engraftment. With her trend I'm optimistic. I'm not at the hospital this morning but her Mom reported that she was sleeping.
I have some updated numbers:
Bilirubin: 6.3 (up from 5.8 yesterday)
Her swelling looks worse today. They're still considering Dialysis and also doing a tracheostomy. A tracheostomy is where they surgically put a small hole in the neck and put a tube straight into the trachea (windpipe). This will allow her to be less sedated as it's more comfortable than a tube into her mouth. In addition to being less sedated, she'll be able to move around, something she hasn't been able to do in over two weeks.
They've decided to do a type of dialysis called hemodialysis. They're currently putting a central line into her neck. She already has a hickman, an arterial cathetor, and last night for some reason, they put in another IV line. They're going to start trying to take about 100ml of fluid per hour. In the morning they'll probably up it after they see how's she's doing. It's easy to take too much fluid too rapidly so they have to monitor her closely. They've decided to hold off on the tracheostomy for a few days so they can see how well the dialysis works.
They put the central line in her neck and Dawn is now on the dialysis machine. It's currently taking 150ml of fluid out of her blood per hour.
Tuesday, December 16, 2008