Dad's Night Report - 05/17/2006 4:00pm and 9:00pm

Dad's Vitals at 4pm
HR: 89-94 bpm
BP: 164/71
SAT: 92-96%
Ventilator @ 70% Oxygen, peep (the pressure) @ 15 cm of H2O and the rate is 26 breaths/min

We spoke with the Intensivist, Dr. Arcot at 4pm and he mentioned the Nephrologist (kidney specialist) Dr. Patel said that based on his blood chemistries dad did not need any dialysis at this time. Dr. Arcot said dad's BUN was 93 (10-20 is normal) and the high creatine of 3.76 is an indication of renal problems and his inability to remove the toxins from his body. Dad has been receiving albumin to help him urinate and he has been putting out ~1400ml per 8 hour shift. The albumin also helps to elevate his blood pressure. His blood gases were also described as "real good". His nurse Rebecca said, "we are taking baby steps for improvment."

Dad was also given two units of blood today and more platelets yesterday. Dad's temperature was 101 at 4:30pm and the nurse attributed that to being strapped into the bed which covers his body almost completely.

We left Dad at 5:30pm to go to dinner with friends Bob and Joy from their old condo in New Smyrna. They treated us to a very nice dinner at an Italian restuarant in New Smyrna. We toasted to Dad and had lots of garlic, just like he would have done.


Dad's Vitals at 9:30pm (call in to nurse in the ICU)
HR - 119
BP - 123/72
Oxygenation level 93
Ventilator working @ 70% peep @ 15

He is maintaining a very good blood pressure and HR. He is developing small blisters on the prone postition just below the shoulders. One more on the right knee. They have all been covered with a special band-aid to help keep the blister low. His eyes are good as well.

Have a good night dad. Love you, Patrick and Vivian XXOO

May 17th 2006 - Visited Hospital

Vitals
HR - 97
BP - 137/71
SAT - 95%
Ventilator is running at 70%, peep is at 16

Chest X-Ray shows improvment in oxygenation. Dr. Arcot believes this is primarily due to the bed but could also be due to the infection receeding, but not conclusive. We will know better in future x-rays if the infection is receeding.

Kidney - Creatinine level increased to 3.76. Although the Urine production is adequate, it still is not eliminating all toxins.

We are awaiting direction from the kidney specialist, Dr Patel, on whether dialysis may be necessary. He will call us here today to give his opinion.

His platlets are better today (he recieved platelets yesterday). He will receive 2 additional pints of blood today.

He is receiving 4 antibiototics - 2 are for the pseudomonous. They still don't know dad's sensitivity to the antibiotics (except pseudomonous), the other 2 are to cover the other bacteria, not yet determined.

Dr. Crossman - (infectious disease doctor), is still trying to determine the exact bacteria type he is infected with. The cultures can cake some time to grow and thus the delay in determination (up to 2 weeks, about 1 week to go).

Dr. Arcot - ICU Doctor (intensivist) - believes that the bacteria that we have identified, pseudomonous, is the primary cause of the infection. Which could mean that determining the other infections may not be as important.

Tentatively:
Chello is leaving today. Virginia is coming in on Thursday the 18th and returning the 27th. Paul and Ana are arriving on Friday. Vivian is thinking to go back on Sunday 21st and Patrick returning also on Tuesday the 23rd, to Denver.

We need to try and schedule the travel so that Mom has family here throughout Dad's intensive care.

Another Call to the Hospital 5:41 pm - 5-16-2006

We spoke with Rebecca, dad's nurse, and she said earlier today they tried to move him to different positions to see if his oxygen readings would change. They did change enough to where they thought he could benefit form the Roto-Prone bed. Since he has been in the prone position they have been able to reduce the ventilator to 80 percent and dad is now maintaining his oxigenation level at 95%. All vitals are good and stable. He is prescibed to be in the prone position for 18/24 hours. They will routinly check his skin and eyes to make sure everything is ok. The next step is to talk with the Doctor in the Am to see what he believes dad's neurocologcal function is.

He could have been at a low oxygen level or had a bad reading. We noticed earlier today when they tried to do the reading from his ear, but with the same machine and a different measurement point on his body, the reading was dropping quickly. We pointed this out to his nurse and she changed the reading back to the finger and the reading again stabilized to a higher level of 65 (still not the best) . We are not doctors, just observers.

Update this afternoon

Well the roller coaster ride continues. Viv just called the hospital to check on dad. His vitals have improved dramatically. Below you read pat's Blog but they were able to get dad in the roto bed finally and everything has improved. His vitals are all back to normal his oxygen level is up to 95. The nurse I spoke to said dad was very close to death this morning but God seemed to intervene and he is still here with us. Love <3 V

Evening Update

Dad's Vitals this evening are looking a lot better.

Sat 97
Heart rate 86
BP 157/67

Dad will be getting a roto prone bed which suspends him in a prone position and may have a positive effect. It is pictured to the right.

this is the latest. V

Monday May 15 - 6:30am

I called into the nurses station this monring to speak with Dad's nurse. She said that the oxygen levels were stables and good, but the creatinine and albumin were not improving. The critical Care specialist will be in shortly and we should see her when we get in this morning.

Update from Vivian and Chello - 05-14-2006

We spent the day in the hospital today with Dad after we learned that his kidneys were not working well. They are unable to determine if it was the antibiotics or the ARDS (Acute respiratory distress syndrome) or the Lymphoma is causing the kidney issue.

The creatinine levels doubled overnight indicating a poor kidney function. (1.4 to 2.3).

We have determined that the bacterial infection is caused from psuedamonous, which is not an acid fast bacteria.

They gave him 2 new antibiotics today - azactam and tobramycim (1 dose) which target this particular bacteria. He stopped the following 2 antibiotics bactrim, and primacin.

They continue to give him Levaquin and Zithromax. (antibiotics). No additional news on the viral infection.

They continiue to give him Bicart and today they gave him Albumin to help stimulate his kidneys. It did not work as well as they had hoped. His breathing seems to be maintaining a high oxygen level around 90. But his blood preassure and heart rate were pretty high from the Albumin. They are having troubles removing the medications that were stopped due to the poor kidney function.

They still hear fluid in his lungs.

We are hoping the extreme sedation will help him recover. It is hard to really say.

update

Today we recived the news that Dad's kidneys are failing. We are praying for him to go peacfully and we are not optmistic.

An interesting link

This is a link to an article about sedation. It was helpful to me in understanding what dad is going through. It is written by a nurse and is designed to be a manual for other nurses. Love <3 V