Wednesday, November 9, 2011

Transplant Day +30... a solid month!

After a slightly adventurous night, in which Logan had chest pain and required a portable chest x-ray, things settled quite well.  Turned out that he has a significant amount of fluid in his right lung, and a small amount in his left.
The run down today..
Weight: 75.3kg
Girth: 94.5cm - taken twice daily again now (cant remember yesterday's measurement)
Hb: 91 (YAY)
White cells: 8.4 (YAY)
Platelets: <10 (bloody hell!) - two more units required - must be a bleed somewhere that they are running to...
Neutraphils: 6.8 (YAY)
Bilirubin: 116 (damn, damn, damn, damn)

This morning's blood test also revealed that his potassium was way high, as was his kidney function. Apparently, you get rid of potassium through peeing, something which he hasn't been doing much of lately, as he is dehydrated (apparently), even though his belly is distended with fluid!

The fluid has collected in the peritenium space which surrounds the gut/bowel; the cavity holding the gut/bowel, but is not in the surrounding tissue.  This fluid was possibly drawn from the tissue in this feet and other areas by the albumin, but not distributed to the blood stream as it needed to be.  This is causing Logan pain on movement and extreme pain on pressure, which the doc's have to do to assess him.

His albumin levels are low again today, so they will give him another dose.  I am not sure of the strength.  Probably 4% as it will most likely run all day.

Getting back to the potassium, this can be quite a problem, so this morning they gave him his usual insulin, plus a little extra, and five minutes worth of ventolin via a nebuliser (which he will have every two hours) to help combat the effects. They also did a tracing to ensure that the potassium hasn't damaged his heart - which it hasn't luckily!

They also confirmed what I could see with my own eyes... he is much more yellow that yesterday.  His eyes glow a sickly yellow and are sunken.  The latter is due to dehydration, but the rest is clearly jaundice. His VOD has become worse again, so they are increasing his steroids to the top dose possible.

His TPN has been stopped as it contains potassium and they are replacing it with other fluids....

NEWSFLASH!!! this just in...

Docs need to put a cannula in... initially Logan said no. They really want to take out his hickman and put a three way line in, but he is too sick to have surgery. It took us a long time to convince Logan that he really needs it.  He is not being told just how sick he really is, and I told the nurse that it doesn't help Logan to help himself if he doesn't understand the seriousness of the situation.  He is going to need to have insulin through IV at a steady rate to help bring down the potassium.  Apparently it is worse than we were led to believe and in danger of doing harm to his heart... not the impression they gave us during this morning's talk.  Logan ended up yelling four letter words at the doc (and yes I mean THE four letter word), who decided to leave the room and let me calm him down... he is sick of being left in the dark and being fed bullshit... (mushroom syndrome).

At present they have put up a bolus of fluid (running at the rate of gravity) containing sucrose and bicarbinate to decrease the ph balance and help improve the potassium.  Then they will be putting up the albumin.  

Anyhoo... it seems that things are much more complicated than before, and Logan is a wee bit sicker than we thought, and that things are now moving much faster than they were!  Evan is on his way back up and we will cross one bridge at a time...

If I have repeated myself anywhere, my apologies... too many things to remember for my small brain.

Our background noises today are;
The kid in room 16 heaving like an old man (he is only 10)
The kid in room 18 screaming at odd intervals... he has asperges and is not coping with the vomiting and pain feelings, let alone the inconsistent routines... 
The docs and nurses are constantly discussing the kids and we can easily hear them talking about Logan and his issues...
The helicopters come and go with their precious cargo...
The machines click, buzz and whirr

please pray for our son... in whatever form this may take... love, wishes, positive thought, healing thoughts, humorous thoughts (this suits him), or just glancing thoughts... 

they are all appreciated

Puns for today:

If you jumped off the bridge in Paris, you'd be in Seine.

A vulture boards an airplane carrying two dead raccoons.  The stewardess looks at him and says "I'm sorry, sir, only one carrion allowed per passenger!"

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