Hosp Day 18: "outta here"

Well the doctors surprised me today when they called to give me an update that Tai is being discharged today!  Great news! 

He got his permacath today, is breathing without supplemental oxygen, and can gimp around like an old man with a walker, but at least he'll get to gimp around AT HOME.

Now I'm assuming he wants to go home in something other than a hospital gown, so I'd better head over to the hospital to bring him some clothes .....

Next post - Mr. Tai Bui himself ????
my job here is done?

bena

Hospital Day 15: 1-1-11: "stay on target ...."

A brief update today, in hopes that we stay on target towards discharge home:

• Labs look stable:  blood count holding steady, white blood cell count trending downwards (good).
• Medication regimen is being simplified:  only antibiotic left is levaquin!
• Tai walked around today - progress!
• He had some time off the oxygen today too - also an improvement!

We'll see what the chest x-ray shows us tomorrow,
"go away lung consolidation"
happy new year,

bena

Hospital Day 14: a new year awaits!

So it's Bena reporting on / clarifying my earlier blog post: 

• The wednesday embolization procedure was fairly extensive, but did not need to explicitly include the renal artery (good).  It did involve embolizing numerous areas, deploying 16 (!) coils to stop the bleeding.  The perinephric (next to kidney) hematoma (blood clot) was as big as 10 x 9 x 14 cm (bad).  Regardless, it seems to have worked because the blood counts have been stable for the 2 days since then.

Today we are back on track for re-establishing some goals:

• continue / complete antibiotics for presumed (although never identified)(grrr) infections that led to the horrible pneumonia
• wean off oxygen requirements
• manage blood pressure and kidney disease with medicines, and convert these to pills instead of IV's
• get a more permanent catheter (aptly named PermaCath) when there is no/minimal risk of infection
• regain strength with physical therapy

onward ho Tai,
happy new year friends and family,
bena

Dec 30th...

ok so today was a very good day..

I came in around 0930 and Tai was going thru his regular day of dialysis ... his dialysis nurse was Melodie and she was very nice ... Tai seems to know the whole routine of it.. which is kinda funny .. one would think you would never want to know or experience it ever... well that took a lovely 3 hours.  I want to say they did 4 liters..

Dr. Barme (urologist) came in and said his blood counts is rising again.. so that means they plugged the kidneys and stopped the bleeding.. but if you haven't yet .. please think about donating blood.. it helps Tai or others in need.  Dr. Robinson (infectious disease) said his test came back negative... some disease they wanted to rule out but i have forgotten what it was.. and the last thing Dr. Barme said was that Tai gets to move upstairs since he is progressing well .. of course that made Tai all anxious to move and get out of the ICU...  that was the only thing on his mind actually.. and he didn't get moved until 1900 ... he is now in room 6W-031...  so yeah for that hope he stops having setbacks and progresses forward to some sort of recovery like Bena said.

Overall an uneventful day =)

signing off and resting: Tai Bui

his brother Tanh.. more to come soon ..

Hospital Day 12, Wednesday Dec 29: Back to the ICU

Apparently Tai failed to get the memo that I sent out requesting no further complications.  Tuesday night was a difficult night and this morning a repeat CT scan showed that the blood clot next to the kidney was larger in spite of the embolization on Monday. 

So he went back to interventional radiology and had more areas embolized.  He also had a new dialysis catheter placed.  I have yet to see the final report, but the nurse tells me that they had to embolize the renal artery (more on that tomorrow when I read the final report and talk to the urologist).

After the procedure, the doctors felt like he needed to be monitored a little more closely, so he went back to the ICU again (this time 1st floor south, bed 5).  They are also being fairly aggressive in trying everything to avoid further bleeding, including giving him meds and blood products (FFP, DDAVP, vitamin K, and more blood).

IT'S NOT TOO LATE TO DONATE BLOOD FOR HIM (SEE PRIOR BLOG POST)!

Tai is now back on his pain meds (dilaudid and ativan) so he was pretty groggy tonight. 

Here's for hoping for no new surprises - I've never been an adrenaline junkie anyway and would LOVE some boredom right about now ....

be well Tai,
bena

Update from Monday December 27: buy a lottery ticket

So just because I believe in science doesn't mean I don't believe in luck .... Dr. Dang the nephrologist says that Tai should buy a lottery ticket and I'd agree ... it was unlucky that there was bleeding from the kidney.  The good news is that he went for the embolization yesterday and the doctors found 4 (!) areas bleeding and blocked (placed coils) in each one.  Now we're waiting to make sure it holds steady and doesn't bleed again.

Now that this is hopefully stabilized, we can get back to where we were on Christmas day, which is:

• graduating to dialysis every other day, instead of each day
• having a port in the chest placed (permacath) for dialysis so that the leg (femoral) catheter can be removed (maybe surgery on wednesday if things going well?)

The pneumonia seems to be progressing but very slowly and a lung specialist (pulmonologist) may be brought in to consult to see if there are any further interventions that might help expedite the recovery.

Lastly, the blood pressure and heart issues are undergoing medication adjustments with the goal of graduating to oral medications instead of IV meds.

good luck with the lotto,
fingers crossed for no bleeding,

bena

Sunday Dec 26, Hospital Day 9 continued

ok it's Bena again with a oh-so-boring medical update.   

First - while I was hoping this would not happen, we need to deal with a hematoma (bleeding) around the kidney that occurred as a consequence of the renal biopsy that was necessary to establish Tai's diagnosis.  Tai needed to be moved to a more monitored (telemetry) floor (6 West bed 30) and must remain on strict bed rest to avoid a lot of movement.  He was transfused 2 more units of blood so if you were thinking of donating blood for him - it's not too late!  We are hoping that his blood loss will stabilize.  If it doesn't, options might include a small procedure to block the bleeding areas (embolization with interventional radiology).

Kidneys took a little step backwards with a creatinine of 6.8 but this is not surprising and regardless, he continues to receive dialysis.

Heart improving - not normal yet, and they are adjusting his heart meds to manage the blood pressure and optimize the strength of the heart.  (ejection fraction 40-45%)

Pneumonia slowly improving.  One of the 4 antibiotics will end tomorrow, and the game plan is to end each of the other 3 antibiotics after completing 7-10 days (depending on each drug).  The chest x-ray still looks pretty serious, but clinically he is improving.  And as a side note, the radiology findings typically lag behind the clinical improvement anyway.

ok, that's all i've got for now,
i'll update again after tomorrow's urology evaluation,
bena