Wednesday, March 4, 2015

Update # 177

8 Years

Last night was a quiet rest for Jeff. He stirred a couple of times and the nurse gave him a bit more sedation.

Night nurses and respiratory techs came into Jeff’s room and commented how surprised they were to see he was back on a vent. They knew he had been progressing well. Even the speech therapist who performed the swallow test on Monday, stopped by to say she’s ready to come back soon.

A little after 7:00 AM, the respiratory tech came into Jeff’s room with the machine to set up for the bronchoscopy. The pulmonologist came in right after the scheduled 7:30 time to perform the bronchoscopy. She then came to me in the family lounge after the 20 minute procedure to say that Jeff did well. His lungs look good, the right lung is completely inflated, and she extracted some secretions for testing. She commented the secretions were thin not thick which is apparently a good thing. The doctor also said she feels Jeff can be off the vent soon – as in 2 days. Her words “this is a minor setback” were great to hear. Results came in this PM from the bronchoscopy negative for fungus (so that med has been stopped). Very good. RSV still showed positive but that breathing treatment med is still working in there. Plus Jeff needs to get some strength to cough out the “gunk”.

Jeff was given a bit more sedation to help him rest for several hours. He has rested quite well all day.

This morning’s x-ray showed no pneumothorax and the lungs again looked better from the pneumonia.

Low blood pressure has been an issue today. Not a big problem but a tricky line to get the meds to keep it where they want.

The two infectious doctors stopped by this afternoon and were also pleased with the way Jeff looks. They also agreed a short time on the vent is appropriate. The liver MRI showed nothing that should be causing any problems. Good to have checked it out.

One of the thoracic team members came to see how Jeff was doing with the side tube. She thought all looks good and said when he comes off the vent, the side tube can be removed. But she did not give an amount of time between the two happenings. She commented that Jeff does not need to be on the vent for much longer.

And the BMT team definitely feels Jeff should be off the vent. So early morning they are planning to do a trial time off the vent just to be sure his numbers stay in a safe range. If this goes well, then later tomorrow, he will be extubated. One doc referred to this pneumothorax as a “hiccup” in Jeff’s recovery.

But the BMT team also brought to light a new situation. This has nothing to do with the RSV or the pneumothorax. One of the meds may have caused this or it’s just something transplant patients have happen. Jeff’s hemoglobin has been slowly decreasing the last 24 hours. They did a specific test and it came back positive. This Coombs test shows that antibodies are attaching to Jeff’s red blood cells and not letting those cells live their full 120 day life span. This is hemolytic anemia. They are testing for which antibody is causing the problem. Typical treatment is prednisone which Jeff has been on since 2007 for GVHD. We hope to find out more tomorrow or the next day. Jeff could possibly get some units of blood but he is not yet at that point. Okay, Jeffrey, enough new things this go-round!

One of Ken’s co-workers in the Synod Office and his wife came this afternoon for a visit. Thank you for such an uplifting time together.

Overall, today has been full of positive comments from many medical people. Jeff was slowed down for a few days (sounds like less than a week) and we know he’ll work to get back where he was – ready to eat and begin physical therapy.

We also appreciate the positive cards, letters, texts, phone calls, emails, and e-cards Your words of love and encouragement are felt by all of us. Please continue your prayers that Jeff keeps his recovery road straight with no more little side trips. Thanks one and all.

love,

Marcia