SICU Day 3

Good morning everyone. I want to take this opportunity to thank everyone who visited, called and commented on the blog yesterday, and to all those who kept Dad in their thoughts and prayers and continue to do so today. I also want to especially thank Jordan and Jane Putnam for their hospitality in allowing my mom and I to stay with them overnight. I would also like to thank all of the doctors, nurses, aids and everyone else who have been taking care of my dad over the last year, and the last couple of days. Almost without exception, they have been extremely kind, caring and willing to answer any of our questions and explain everything they are doing to us. It makes such a big difference to be able to at least understand what is wrong, what they are doing to fix the problems, and what all the machines that are plugged into Dad are doing and measuring. Thank you!

Last night around 8:30 p.m. we were told that Dad had spiked a fever of 104ºF, and his white count was at 19,000 (it should be between 4 and 8K) due to the infection in his body. The theory is that he had a latent infection prior to the surgery on Monday, which the body was fighting until all of the stress of the procedure compromised his ability to do so. They are currently treating him with a powerful broad spectrum anti-biotic as well as an anti-fungal, and then as soon as the blood cultures return (hopefully some time today) and they know what the infection is they will start treating it with a more targeted medicine. When we arrived this morning, the nurse informed us that his fever was gone, his white count was at 12,000, and gave us some other good news which I will address below.

One of the main problems Dad has is what is called Adult Respiratory Distress Syndrome, which means both of his lungs basically completely deflated and couldn't function properly. In order to get them back to normal, the doctors put him on a respirator at a very high pressure in order to re-inflate them. Because the pressure is so high, and because the respirator is set to such a high number of respirations per minute, it feels very unnatural to Dad (or anyone) and the body naturally tries to fight it. So, in order for the respirator to do its job, Dad had to be sedated and paralyzed chemically so he wouldn't fight against it anymore. It is very interesting to see the different perspectives all of the doctors and nurses have about what is going on and what to expect. Some are optimists and others are more realistic in their expectations. Basically, we can expect Dad to be under sedation for at least two to three more days, and on the respirator for anywhere from one to three weeks - depending on which estimate is correct. While yesterday the respirator was set to 100% oxygen most of the day, it was turned down to only 50% O2 today, which means it is progressing in the right direction.

Because of all the problems he's been having with his lungs, his blood pressure and heart rate have not been ideal. Yesterday his blood pressure was around 80/50, and his heart rate was up in the 140's most of the day. The SICU team tried several different medicines to normalize them, but unfortunately, Dad's body didn't really react very well to any of them, so they kept hovering around those numbers most of the day. However, during the early morning hours he was started on a new medicine that helps the right side of his heart function better, which has been working quite well and his blood pressure this morning is around 100/60 and he has a heart rate of about 117, both moving in a positive direction.

Last night Dad's blood sugar, potassium and creatinine levels shot up, so they have been treating those with medications as well. At its peak, his blood sugar was at 200, but this morning it is back down to 121, and Stewart (his nurse today) said that anything between 60 and 120 is considered good. The potassium and creatinine levels are still too high, even though he has started having more urine output from his kidneys. He may have to have dialysis to take care of those two levels if they don't turn around on their own soon.

An ultrasound was also performed on Dad's heart this morning, just to make sure everything is functioning properly, and the ultrasound tech seemed to think it was. Although my mom had a bit of a scare when the tech mentioned to the nurse that it didn't look like he had endocarditis or anything like that. Well, all my mom heard was "endocarditis" and I could see the instant panic on her face, because that is what my dad's mom had that eventually took her life. I quickly reassured her that the tech had said he didn't have it, and the color soon returned to her face.

Below are some pictures for your viewing:



Here is a picture of most of the tumors that were removed by Dr. Bull and his team from Dad's left lung on Monday

This is a picture showing his vitals at about 11:00 a.m.

This picture and the next are for a general idea of the setup of machines that surround him right now

As you can see, the "tree" of IV medicines is quite large - a total of 11 different items at the moment