Condition is better Friday AM

This morning, mother has shown her resilience. She is alert, interactive and emotional. She has cried and laughed, she has talked but she is difficult to understand with her dry mouth and no teeth. Her eyes are more open today than they have been since she arrived at the hospital. She asked for ice cream to eat this morning. In fact, she asked several times for it. Visitors may come today but only two people can be in her room at one time. Meretta and Chris came by for the first time today. There were quite a few of us there this morning, close to noon. Visitors should wait and talk in the ICU Waiting room, not in the ICU. MOther had a centrail ine IV installed this morning by the kidney doctor. I do not know if it being used yet but the nurse will take off the others and channel all IV's through the central line later today after verification that the line if functional and nothing was injured when it was installed. An Xray was taken to verify the procedure was successful.

Her heart condition has stablilized and the doctor has lowered the amount of heart medicine. It remains arithymic but at a normal pace. Her blood pressure is normal, slightly low on the low side because of the heart medicine.

Her chemistry markers for the kidneys are slightly better. She took 10 pounds of IV salt water yesterday. That has improved her hydration quite a bit. She remains on a relative high volume of hyrdration IV. Her color has also improved, probably from the hydration. The Kidney doctor is more positive now and has consented to an IV feeding trial. He said is is more positive now about her ability to get through this without a dyalisis and is resisting any suggestions to the contrary. She has not taken any nourishment other than vitamins for 5 days.

Speaking of nutrition, the surgeon (Dr Sankar) came by today and explained that her albumin is very low and she needs it raised. This is accomplished by food! The level is so low (1.3) that she is in a risk profile of 30% mortality rate, just because of nutrition. Anyone with an albumin reading less than 2 is at a 30% mortality risk. You add the other issues to this and mother is at high risk. The Kidney doctor said that he is willing now to see how her kidneys react to an IV feeding. He and Dr McKennon has agreed to take this step. Mother needs nutrition. I believe now that a nutritionist is being consulted for an IV formula.

Another specialist has been added to the consulting staff of Dr McKennon to follow the condition of her intestines. About half of the intestinal tract is inflamed as determined by the cat scan yesterday. This is potentially a threat to her health. It is one of the primary reasons the doctors are not going to feed her by tube anytime soon. Thre is no bowel sounds in her system so the doctors want to remove any risks of mother getting sores or infection in her intestines. Right now, they are swollen but there are no perforations. What they do not want is for her to have something like a perforated appendix.

Her skin is in pretty bad shape but improving. Laying on the floor for that length of time has caused various skin problems. I walked through them all with the attending in-hospital skin therapist. She came in and treated all mother's wounds with a salve and bandages, explaining her strategy and also demonstrating the procedutres to two UT students. On her back she has a severe wound where the subcutaneous skin has died. It is about 4x2 inches in size. There are several large places where the outside of the skin has died but healthy tissue lies underneath. The therapist explained that she probably laid mostly on her left side and for some time she also laid on her right side. Where the skin of her legs touched, there her legs also had circulation problems and has damage. The therapist said mother was lucky. It could have been much worse. She thinks mother will heal fine with this treatment. On Monday a decision will be made on whether to continue this treatment or do something else.

OK, now you see everything I see. Mother has several issues - heart, kiidney, skin, intestines. Fortunately, she is alert and her mind is healthy. I am cautiously optimistic. Seeing her smile this morning was simply emotionally uplifting. Seeing her crying was the same. I know she is going through a rough time. Getting that out emotionally is a good sign of strength. She is fighting to live and I am really happy to see that as I am sure you are also!