Sunday, November 15, 2015

Day +39/Day +40

Saturday was a very long day. Raul's nose appeared to have starting bleeding overnight Friday, and continued heavily throughout the day. Some of it came out of his nose, but even more ran down his throat and then he was throwing up large amounts of blood and huge blood clots on and off. He got platelets twice and blood once, as well as a medication called Amicar to help him clot. We later also had ENT come by and they put some foam stuff into his nose, but it seemed to be bleeding further back than the foam reached. It continued through the evening, but then stopped for the night by 10:30. Today his nose has trickled on and off, and he has thrown up blood twice, but not nearly as much as yesterday. We have also been venting his g-tube to try to get it to come out that way. His Defibrotide has been put on hold until there is no more blood coming from his g-tube.

Raul had dialysis yesterday, and had the day off today. His BUN was actually lower this morning than it has been in a long time, which was good. However, we do expect his kidneys to take a hit from the new antifungal meds. As far as the yeast goes, he has not had another positive line culture. The yeast showed that it should be susceptible to the Micafungin he was already on, but since it doesn't seem to be, he is being switched to another medication. He has been having more of the rashes that were attributed to a medication reaction before, but we do not know to what. The timing seems to fit with the anti-fungal, but the doctors are hoping it was the azithromycin that finished yesterday.

His CMV level was a little higher this week than last week, so he is continuing the antiviral med. for that. The BK virus he has could potentially be contributing to his problems with kidney function, but we don't know for sure, and even if we did there is not much that can be done for it so we are just hoping it will clear from his blood on its own (it is more common for it to be in the urine, but he has it in both). It could also cause problems with the bladder, but we aren't seeing those symptoms right now. It is also possible that it is doing nothing, so it is really up in the air!

He is still having fevers, but not as high, which is good! We have had to keep him from eating for a few days to see if that would help his GI symptoms improve, but so far we have not seen a change. Most likely, he will end up having a GI scope this week. He has been doing surprisingly well with not being able to have his yogurt! Raul still has his PICC line now, and we will most likely leave it in for about a week before replacing his Hickman as long as it keeps functioning well. After his busy day yesterday, Raul has rested most of the day today and taken two naps, though he did do a little OT this morning. Hopefully this will help get his energy back! 

8.5 (11/14)
6.7 (11/15)
5 (11/14)
5.1 (11/15)

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