Dawn is going to get the trach put in later today, sometime after 3pm. Her lungs are a bit better today, the dialysis seems to be working to take the fluid off. They were going for another 6 liters but her blood pressure was falling slightly so they backed off and are going for 5. She has another 15 minutes left and they've removed 4.9 liters so far. Her attitude is much different today, the new anxiety drugs seem to be helping. You can tell she's still frustrated and scared but it's not a constant fight to keep her calm and to keep her from pulling her tubes. The biggest worry today is the liver, it's really taken a turn for the worse. We've asked for a liver specialist to come in and one should be visiting today. Her total bilirubin is 15.7 (normal .2-1.3). Her direct bilirubin, which I haven't posted before, is 10.4 (normal .1-.3). Her kidneys aren't working but that's not uncommon when going through dialysis. Acute kidney failure is usually the result of a trauma or event and when that trauma or event is over, the kidneys usually resolve.
I don't want to scare everybody out there reading but this is a very critical week for Dawn. She has some major body functions that aren't working, some are getting slowly better, some getting quickly worse. Everything that is wrong right now is reversible but she has a long road ahead of her and we really need things to start turning around.
I just got back from taking Dawn down to the OR for the tracheostomy. You can see from the picture below that moving her around the hospital is no simple feat. She should be done in about one hour.
A team of 4 people to move her around the hospital. One is responsible for making her breathe.
She's back from the OR. The procedure went fine. They said it took a bit longer than usual because they were extra careful to not cut any blood vessels needlessly. She's still sedated. Hopefully she'll like this better and won't feel as anxious. Having a tube down the throat is like having your hand down your mouth all day. You can't swallow and you can't close your mouth. This should be much more comfortable, we'll see how she reacts when she wakes up.
Her fever has come down today, it's currently 97.0. The infectious disease team came by and is working with Dr. Costa's team to try and get her off any medications that aren't needed since she has neutrophils and the fever has come down and seems stable. The less drugs she's on, the more it will help the liver. I forgot to mention earlier that she had some arterial fibrilation again last night with the sedative medication she was on. They've changed it again, hopefully they can take her down and then completely off the sedatives now with the trach.
Just back from the OR.
Monday, December 22, 2008