Day +9 October 1 and +10 October 2

Michelle, me, Chloe, Stefan - can you guess who the statue is?

Day +9 Elle did really well.  Her vital signs were stable, her kidney function, lungs, fluids all no worse than before and she looked relatively good visually.  The family care partner came by to help us and we were even comfortable enough with her condition and her nurse to all go to a Twins game compliments of RMH.  My old friend (as in long-time friend), Michelle is an iinternational makeup artist for Laura Mercier.  She recently text me that she would be working Mall of America and could we get together.  Michelle went to the game with us and even though the Twins lost, we had a blast.

Target Field in its inaugural season (first season, I gather)



Minneapolis road sign, Hmmm....



 Day +10 has been a little different.  We were able to relax a little and S and I both got a decent night of rest which we needed to handle today.  Stefan spent the night at the hospital and Timmy went to Elle's side Early whilst I slept with Chloe at RMH and S slept in the bone marrow transplant unit (her old room which she will return to when out of ICU unless her stay in ICU too extended or the bed is needed).  I guess when the nurse and Tim were getting ready to get Elle's weight, they noticed that she was cool to the touch and could not get a temp or blood pressure.  While working on this, a lead loosened and her EKG rhythm also lost signal.  Anyway, her numbers were all off and they weren't sure if it was mechanical / positional or what and it tuned out that her actual temperature was 93.8 and her blood pressure was 59/29.  A lot of people entered the room with various skill sets, drugs, and talk of bringing "the cart" in (all whilst I slept).  Timmy retrieved Stefan who awoke out of a dead sleep (which he hasn't been getting lately), came to his daughter's room to find a bunch of people working on and around her and sees a pressure of now 30/17 thereabouts.  So  he is understandably disturbed and concerned.  Timmy came home to get me and I arrived to a calmer situation.

Not long after I arrived, O2 Saturations decreased, PIPs increased (indicators on the vent that something is wrong and she isn't getting air the way she should).  Her blood pressures dropped again, her pulse rate dropped, they started to suction blood out of her breathing tube and Stefan and I stepped back so all of the skilled people in the room could intervene. 

According to the brains of the operation (ICU and BMT attendings), she was responding to a systemic or lung infection or a lung bleed.  Chest xray showed a new spot.  The lung doctor thought this also and did a bronchoscopy (washed some fluid in her lungs and sent a specimen to check for infection).  Other specimens taken as well. 

While waiting for results, she was given Factor VII to help her clot and stop her bleed (used in the battlefield - good stuff).  She was also given Vancomycin along with the other antibiotics she is already on to cover a broad spectrum of "bugs".  Epi, Dopamine, and eventually Vasopressin started for BP.  At this time, I asked if the Amlodopine (a drug to keep her blood pressures DOWN) was given as scheduled at 8AM -yes and what was the blood pressure prior.  Turns out that it was 85/28 when Amlodopine was given. Drs  she has some sort of infectious process going on.  Remains to be seen what kind.

They put in a double lumen PICC line (another central IV access, not at permanent as her Hickman, but better than a regular IV.  Her tests so far have come back negative and it isn't uncommon to have an infection where the source can't be found.  #*@!   On top of this, she isn't peeing AT ALL, she is swelling up like a puffer fish, her kidneys not so good (sCr 1.16), her abdomen feels distended a bit, and her extremities are a little purple.  Talk of starting dialysis tomorrow.  At least she's sleeping comfortably through it all.

Currently her Sats are back down and I need to help reposition her to see if we can't make her lungs happy right now.  Hope I can report improvement tomorrow.