Monday, February 1, 2016

Day +118

We had a bit of a scary weekend, but Raul is back to his baseline now! On Saturday when he came off dialysis his blood pressure started getting quite high. We gave a medication to lower it, but it still stayed high. Then he got a bad nosebleed, which hasn't happened in a while, but isn't totally abnormal for him. It bled quite heavily for an hour, despite our attempts to stop it, and he had started to throw up clots of blood that had gone into his stomach. He was acting a bit unusual, freaking out more than usual about the nosebleed and breathing differently. Suddenly he tried to throw up/cough up a clot that he could not get out, and it blocked his airway, causing him to turn blue. He could not get it up, so a code was called since he was not able to breathe. They came amazingly quickly, and he did manage to either get it out or swallow it back down. But then he was still not responding to the doctors, and his eyes were rolling around. They checked some labs and his bicarb and blood PH were very off. They also checked an EKG and chest x-ray, which luckily were okay (we thought he might have aspirated the clot into his lungs).

It took two boluses of sodium bicarb, but he actually started acting more normal pretty quickly. He was sent down to the PICU for one night so that he could be monitored more closely. Down there he also got two bags of platelets and one of blood. After a nap, he was back to acting like himself. That night he had a couple issues with high blood pressure and low heart rate, but they resolved. We do not know exactly what caused his issues with his blood chemistry/blood gas, but think it may have been a combination of pulling a lot of fluid with dialysis and his chemo from the day before, then complicated by the bad nosebleed. It was a perfect storm of issues, that caused a more serious episode, but he thankfully recovered quickly. We are back up on the BMT floor, and he is doing well! 

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