Our night did not go as planned, and we ended up in the ICU around 2am because Raul's blood pressure was too low. They had been trying to manage it on the BMT floor, but even with fluids and a lower dose of dopamine it was not coming up enough.
He started getting dopamine and epinephrine in the PICU, and now they are going to switch the dopamine to something else. He is not acting any different, and actually slept well once we got down here (he had been refusing to go to bed upstairs and we had just fallen asleep when they decided to move him).
Moving him was a project, with many people along for the walk down. They moved him very quickly after deciding he needed to go to the PICU, but I had just enough time to grab the things we would need overnight/this morning.
We do not know exactly what is causing his low blood pressure, most likely either infection or his TTP. He is now on about half a dozen antibiotics, so if it is an infection we will hopefully see improvement in a few days. If it is related to his TTP, it is the plasma that will help. But in the meantime he is stable as he is getting the medications to keep his blood pressure in the normal range.
The doctor seemed optimistic that we could only have to be down here a few days. He can go up to the unit on a small dose of dopamine, but not the other "big gun" blood pressure medications. Raul was pretty anxious last night about switching rooms after being in one room this whole time, but was happy to get to keep his same bed!
He is getting dialysis now, and we will try to pull some fluid as long as he tolerates it. It sounded like we may wait to do the plasmapheresis tomorrow and just give him regular fresh frozen plasma (FFP) today, but we will see.