Sandi remains at Medical City Dallas and is not a happy patient. She has completed a CT scan of her lungs (not the full body one I thought she was getting) and has had a blood transfusion. They did a nasal swab yesterday and that has comeback as negative for MSRA and Staph. They are awaiting more test results that they hope to have tomorrow as they try to determine if it is truly pneumonia. In the meantime they are using two very powerful antibiotics on her in the hopes they will either stop whatever is happening or slow it down long enough they can get a handle on things.
They intend either tonight or tomorrow to get a sample one way or another of the actual lung fluid. Not only do they want to culture it, they want to examine it in some way. When I directly asked if the nightmare scenario that I thought of at 3am this morning was possible that the lung fluid was a sign that her original cancer was back, the only answer I got was "we are exploring all options and possibilities." To me that indicates that, just like it turned out to be in November 2011, the lung fluid could be a sign of cancer.
I also did not know before today that one had to have a white blood count above a certain threshold before one would show symptoms with pneumonia. The coughing, fever, etc that one thinks of with pneumonia all require a white blood cell count above a certain point before there are obvious symptoms. Sandi has a white blood cell count that while slightly higher than last week, is down significantly from two weeks ago and is below that threshold line that triggers an immune system response. Despite that fact, Sandi is coughing now a bit and coughing quite hard at times which seems to indicate additional fluid in the lungs.
She is on a high level of oxygen all the time and it is now being run through some sort of cylinder full of water to moisten the air before it goes into her. The only time she goes off of it is when she goes to the bathroom. On several occasions she has come out of the bathroom to find a nurse waiting for her with the oxygen sensor to check her once she gets back in the bed. Each time she was 69 or less. The worst I saw while there was a 62. Whether this means she is getting worse I do not know and those I asked were very noncommittal.
The bottom line is nothing positive is going on except MSRA and Staph have been ruled out. We await more test results. The original timetable had her getting out tomorrow which every nurse said flatly today would not be happening until her numbers off of oxygen would be above 90 and hold. I had figured that much out without being told. Clearly, when she drops to 69 or worse during the few minutes it takes her to get to the bathroom with her IV stand and back, there is no way she is coming home anytime soon.
So, she is down there and very unhappy. When I left her late today she had started coughing more and more from time to time. Since she has a deviated septum they would prefer she wear a mask for the oxygen. Since the mask is of a size that she would have to take her glasses off and lay there blind to the world, she is adamant that she won't wear the mask. So, she has the tubes up her nose, her crochet needles in her hands and is working away on her chemo hats.
More as I know it....
10 PM UPDATE----
Late this evening they tried to make her cough up some stuff so it could be analyzed. That did not work and instead caused issues for her including a rise in her blood pressure and a severe headache. They gave up that attempt and will re-asses in the morning. At this point, the only other option that I know of is they could try to stick a needle through her ribcage into the base of a lung to get a sample. That is not a good option considering the permanent scar tissue damage she already has in her lungs from everything back in November 2011. Even when on full oxygen and reclining in the bed, the best number they are getting tonight is 92. That is way too low for that situation from what we understand..
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