It has been a very slow week for Mr. Bug. A few fun things have happened, though.
First, they have continued to be very aggressive in decreasing both the ventilator settings and the paralyzing drugs, and over the past day or so Mr. Bug has been taking breaths on his own. The reason this is important, as it was explained to me, is that his lungs can be damaged by the ventilator, and the breathing tube is a major entryway for new infections, and so getting the tube out of him as soon as possible is very very important. He had a little crash on Wednesday, but he recovered from that fairly quickly. We have become quite used to these little setbacks, but as long as the steps backward are fewer and shorter than the steps forward, the PICU doctors don’t appear to be too concerned. His lungs are still improving only VERY SLOWLY, and there is a lot of concern that the fungus will find his lungs to be a wonderful place to begin killing and eating tissue, if it has not already, and once that happens, the battle is lost because the blood, and the drugs, can’t make it to dead tissue.
Second, Mr. Bug’s white blood cell count is within what is considered normal now. This is both good and bad, as when he has enough of these cells, his body can help the drugs fight the infection. This is primary at this point, as if he can’t fight the infection before it eats him up, he’ll be, well, eaten up! However, the downside to the increased white blood cells is the increased possibility that he will go into liver rejection. So far, his liver numbers have been fine. He is not as yellow as he was when he first got sick, so the thought is that while his liver initially became unhappy with this state of affairs, it has now settled down, and is doing fine. This is pretty shocking to everyone, I think. I now understand that it was strongly believed that his liver would fail quite quickly in all of this, not able to withstand the drugs and the fungus, and that would be that. As soon as his liver rejects, all is lost. So it’s a fine balance they are maintaining between his body attacking the fungus and his body attacking his liver.
The continuing difficulty has been his kidneys. They failed about 3.5 weeks ago, and we are very quickly approaching the point where they are unlikely to come back. There has been no sign of function at all. They have even removed his catheter because he was not using it, and again, any plastic in him is a portal for infection, so they will leave it out for now. Mr. Bug did develop a clot where the lines for the dialysis machine took blood out of him and brought blood back, and it got so bad that they had to move the lines. This was done last night, so hopefully today the lines behaved themselves.
It has been extremely difficult to be away from Mr. Bug while I am fighting this cold. Not only can I not hold his hand and talk to him at this time when he is more aware and needs his family around him, we also get very second-hand updates from nurses. A 5-minute phone call is so different from being in the room for hours and catching all the chatter, talking to the doctors, and asking questions as the occur to me! They told me that after a week, if I this cold seems to have gone away, I can be with him again. He literally catches EVERYTHING anyone has, it’s crazy! Every day, it seems, some new bacteria or virus has grown out in the cheery infectious disease doctors’ petri dishes. They talk a lot about gram positive rods they have stained and weird bacterias they never see in this part of the country and viruses that have zoo animal names There is always a big party in their dishes, and so far nothing new has been dangerous to him, or at least they have been able to find drugs to eliminate them before they become a problem. The cheery infectious disease team is still my favorite team on Mr. Bug’s case!
One thing we can be very grateful for is that Mr. Bug is now at the bottom of the pile when it comes to who is most critical in the PICU. The doctors used to round quite early in the morning, and a few weeks ago they were rounding twice in a day. Now they make rounds on him late in the afternoon, and instead of the giant crowd of doctors crowded around to put in their 2 cents worth, there is often only one doctor with the nurses and the respiratory therapist.
So really, nothing very exciting has happened We will have another meeting with the doctors on Thursday, and hopefully they will have some kind of plan of action they can let us know about. Right now the plan is “wait and see.” I think it’s going to be that way for months!
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