Sunday, December 6, 2015

Days +60/+61

Unless it was some sort of complication of TTP, the doctors believe Raul had septic shock. We do not know exactly what is infected, but he is on antibiotics to cover just about everything! He had one high fever in the evening yesterday, but was as low as the 97s during the day. It is now 8pm and he only had one fever today of 101.7. These numbers are a huge improvement to his recent almost constant 104+ fevers! It sounded this morning like the doctors think the most likely antibiotic to be working is the Vanco, which is the last one we added. It is very toxic to the kidneys, but of course we need to treat whatever is infected first. 

Raul's breathing is so much better! He was requiring the high flow and still having retractions yesterday, but then overnight he was pulling off his nasal cannula himself and his numbers weren't changing so we just took it completely off! In less than 24 hours he went from needing 60% oxygen with a pressure of 12, to 30% with a pressure of 12, to room air without even blow by oxygen! His respiratory rate and heart rate are much better too.

Earlier this evening we weaned him off his Epi (down from .05 this morning) and tonight off his Vasopressin too (down from .0004)! Yesterday morning they weren't sure if we could do dialysis due to his blood pressure and were discussing either skipping it or going to continuous dialysis. Thankfully the nephrologist was willing to give it a try, and he did perfectly! They gave him blood and plasma during it, and even pulled his weight down to his goal weight (and then his weight went .6kg even lower overnight, possibly due to diarrhea). They decided to skip the plasmapheresis yesterday and just gave an infusion, but we did it today with no issue. If anything his blood pressure got better afterwards.

We got him to sit up in bed today for a bit of PT, and will try again later. Him getting mad just helped his blood pressure :) . We are hoping to be back up to the BMT floor tomorrow if all continues to go well. Most likely after dialysis and plasmapheresis just to make sure he doesn't have any problems with his blood pressure during those. We got a few visits from people from the BMT floor yesterday, which was really nice. Raul is definitely having a bit of a hard time with the change in scenery and staff. After being in the same room for so long it has been hard for him to adjust to somewhere new. I am still getting occasional smiles from him though, which is great! 

Raul asked to smile for a picture and this is the face he made haha

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