Thursday AM update - about the same

We are now in day 10. The kidney doctor, Dr Welsh, told me this morning that we have general lack of progress. He does not hear bowel sounds. However, the nurses tell me they continue to hear bowel sounds. That falls outside of the domain of the kidney doctor, but he was just offering his opinion on the status of mother. He said that lack of progress in ICU means deterioration of her health to the hospital because she is getting the best of care. Today he is looking at xrays to determine if he should try lasix. He does not want to further dehydrate her unless he needs to. The lungs may need less fluid so he is trying to balance his decision with the appropriate facts. Furthermore, her blood chemical stats are within normalcy now. That includes CO2 acidity and the O2 saturation level.

The lungs doctor, Dr Charbeneau, said that there is less fluid on her lungs today. The hospital reduced her oxygen intake significantly from 100% under the mask to 35%. They tried 30% but her O2 saturation went below 90, so they increased to 35% from that trial level. He wants to put her under ventilation but I asked he try the external ventilation technique first, which is a mask attached to an external machine which pushes and pulls air inside the mask instead from within the lungs. So far that procedure has been working. He says it is inevitable from what he has seen to go to the ventilator. He also stated that she is treatable.

Dr McKennon says he does not hear bowel sounds and believes she has a long hard road ahead of her to recovery if she recovers. He repeated his previous prognosis that she is in a holding pattern and we just do not know where this will take us. If one thing improves, the others are likely to improve as well. The reverse is also the case.

Her skin is improving. The two worse lesions continue to bleed and/or produce excretions but are diminishing in size. The skin nurse notes that they may be able to reduce the number of treatments to one per day in one or two days at this rate. They will treat her again at 1PM today.

Her diet continues to be analyzed. The kidney doctor said she is still malnourished and needs more calories. Dr McKennon said he is awaiting the dietitian who has not completed the analysis of her needs. When they recommend a change (should be today), he will order the TPN modified for her. We expect to see a higher intake of calories and albumin. Her albumin remains at 2.3 and that is low but not in the critical range (it is above 2.0). Her other blood test results show a great improvement in all her numbers. The Bun is at 47. Dialysis has helped her blood chemistry a great deal.

There will be no dialysis today.

Kimberly, Rachael, Shauna (has cold), and Jeff are there visiting from out of town.