Saturday AM 09-20-08

Today is a very good day, at least so far. The alternating good day / bad day cycle continues. I could hardly believe the prognosis this morning after yesterday's difficulties! Mother's colon appears well and she will be fed by tube today to see if she can tolerate feeding. Her ventilation machine may not be needed now since her lungs are clear this morning. It is expected that she will be weaned from the machine over the next couple of days. She continues to need dialysis but her blood content is well within the norm after yesterday's dialysis. She should be off the dialysis today and tomorrow with the next dialysis on Monday- that is the current plan. Her skin is improved and she has gone to once a day bandaging treatment except for the one place on her left calf. Her heart is doing fine on the medicine to raise her blood pressure. She is having a few small rapid heartbeat events, but the heart doctor is satisfied with that situation for now.

The kidney doctor came in first this morning and listened to her colon, lungs and read her blood test results. All elements in her blood were within normalcy ranges. She has been a little low on hemoglobin. That is the reason for a one unit blood transfusion yesterday. Her white blood cell count dramatically lowered overnight to 14000 from the 20000 yesterday. That coupled with a low grade fever means she still has some kind of infection but the internist should comment on that. She had 1.5 liters of fluids removed yesterday and 2.4 liters input. That is an expected increase in fluids, so she is a little swollen this morning but he believes she is within acceptable levels of hydration. He will look at her again tomorrow to make sure she is OK with the hydration level. Asked if she will require dialysis i f she recovers from everything else, he responded that he cannot predict the future. He has patients regularly go either way, so it will be a wait and see situation. He commented on the photo of the 4 wheeler with mother driving it. We put that in her room to give her something familiar from her apartment to see. We also put her Xmas gift from her children (the blanket) in the room. He was impressed that she would be doing something like getting on a 4-wheeler at her age. I am too! He has been aboard my description of her from the beginning - a strong woman for her age and capable of recovery.

Dr McKennon was more positive than I have ever seen him. A total reverse from yesterday. He said she is having clear and normal bowel sounds today. This was the primary obstacle to her recovery and negative prognosis. He now gives her a good chance of recovery except for the kidneys. He said he believes almost certainly she will require dialysis WHEN she leaves the hospital. He ordered the feeding by tube today and said if she tolerates it, he will take her totally off of IV feeding(TPN) as early as tomorrow. The fecal culture came back with preliminary results of being only yeast. He normally does not treat yeast unless it shows up elsewhere in the body. He will not be treating the yeast in this case either. It is a normal situation when on antibiotics. Chepa reminded me today that she told me the very same thing yesterday. Yep, she did! He was questioning her thyroid medicine and regiment of treatment before this even occurred, so he can make sure she is getting all the medicines she needs normally. I told him I thought she was off of thyroid medicines but he found where it was being administered to her via IV and that her TSH was normal, so he would leave it at that for now. He will watch the TSH to make sure she is not over dosing it nor under dosing it. Not a problem, he said.

The nurse said she rested well overnight. We went in about 10PM and returned home to sleep, allowing us, her and the rest of the ICU patients to rest.

Amazing the difference one day makes!

Kimberly, Cassie, her daughter Peighton, Shauna and Rachael all visited her yesterday. Linda, Chepa, Maria and Miguel came also. Wayne will be here today. Russ left on a 2 day business trip.