They just finished a broncoscopy. The procedure they did was a Bronchoalveolar lavage (BAL). During a BAL they use the broncoscope to push a tube with a camera into the lungs. Then they inject some saline fluid into the lung and pull some fluid out for testing. They inserted the tube down her trachea and into her left lung. From there you could see how it splits, like branches. They kept going deeper and deeper until they got to a good place to take a sample. They injected and removed three syringes of saline. In the video below you're looking at the image from the camera at the end of the tube. If you look closely you can see the saline being injected into her lungs. Then they pull back on the syringe and pull the fluid out.
Video of fluid going into the lungs, then being pulled out
* Remember you can click on any of the pictures below to see them full size.
Inserting the bronchoscope
Image from camera inside the lung. You can see they're coming up on a "fork" or branch.
Here they're inserting the fluid from a syringe then pulling it back out
This is the bronchoscope (the black device). If you look close you can see the light at the end of the tube. This is also where the camera is. The three syringes contain the fluid they extracted.
She's been real agitated, still pulling on things. The nurse called us at home last night because she wanted one of us there. Her Mom came back to the hospital and stayed the night. They did dialysis this morning and took off another 4 liters of fluid. Her blood pressure was lower today so they couldn't take as much. Her swelling was up again this morning but looks a little better after the dialyisis. Her fever keeps coming and going but none of the tests have show any infection. Right her temp is 99.3. The big concern today is the lungs and liver. Her bilirubin today is up to 11.0 (normal .2-1.3) so it is continuing to trend upwards. She's still doing fine with her blood counts. Her white cell count is down a bit to 4.250 and her neutrophils are 3.315. Even though her white cell count is down a bit, she's still doing good considering they stopped the G-CSF shots that help with her cell production so no concern there.
Saturday, December 20, 2008