Transplant Countdown: Day 3
Today is another wait and see day. I’m going to back up and explain a little since I couldn’t focus on doing so yesterday.
As I reported in earlier posts, Karl came in to emergency a week ago because his temperature rose. He was started on iv antibiotics...Vancomycin and Peptase...and admitted to hospital. His temperature went down, all the blood work looked good, and the extraction was started as planned on Monday. We didn’t get enough stem cells, so on Monday night he was given Plexifor, which boosts stem cell production. Tuesday morning more blood work was taken and results were good so he was put back on the apheresis machine and by the end of the day we had enough stem cells. He was still being treated with the antibiotics for the infection in his line, but on Tuesday afternoon we were told that the line would come out on Wednesday, but the antibiotics would continue, probably for a week. They talked about the antibiotics still being via iv, but maybe as an outpatient here in St. John’s or possibly in Clarenville.
All that changed Wednesday morning. The blood work showed that the level of Vancomycin in his blood was too high and his creatinine levels had risen from 100, which was normal, to 200. The antibiotics were immediately stopped. The line was removed as planned, and then he was put on fluids through iv.
Yesterday the creatinine levels continued to rise to 443, and he started to build up fluid in his lungs and throughout his body. The iv fluids were stopped and he was given lasix to make him pee. A Nephrologist (Dr. Martin) was called and he talked about the possibility of dialysis since his kidneys had been damaged and weren’t filtering as they should on their own. However, a decision about that wouldn’t happen until 3 days. I don’t know if he meant 3 days from Wednesday when the problem started, or 3 days from when he came in. It’s another wait and see for us.
Today the news is no better. The creatinine is 525. We were also given the number for the Vancomycin that is still in his body, which is 33.5. It was 33.6 yesterday, which means the kidneys are really not filtering it. Karl’s blood pressure also went up out of the normal range today, which is totally not normal for Karl, but apparently not unexpected since they gave him lasix to make him pee, which takes fluid out of the veins, and drives up the pressure. One treatment causes another symptom.
The culture on the removed line also came back today. It showed that the infection was staphylococcus. Vancomycin was a good choice to treat that, and it allowed the line to stay in for the extraction which couldn’t have been done without the line, but, as I said yesterday, Vanco really hasn’t been our friend.
So we are waiting. We haven’t seen Dr. Martin today. We saw Dr. Jones who told us he was unhappy with the creatinine levels. He was planning to consult with Dr. Martin again. We’re not sure when or if we will see Dr. Martin. He did say yesterday that a colleague was on call over the weekend and he would be following Karl if necessary.
Karl is feeling a little better today than yesterday since most of the fluid is gone. However when they sound him with the stethoscope they can still hear fluid in his lungs. More blood work was just taken. The technologist told us it was to test for bacteria in his blood. We don’t know if that is a routine test because of the staphylococcus or if they are looking for/suspecting/ruling out something else. To be honest, I don’t want to know. If they find something else they will tell us. If they rule something out and we didn’t know they were looking ...less stress. Worrying about the possibility of dialysis is enough. The first step in that process will be to put another line in Karl’s chest. The same type of line that came out on Wednesday, in the same place.
As I reported in earlier posts, Karl came in to emergency a week ago because his temperature rose. He was started on iv antibiotics...Vancomycin and Peptase...and admitted to hospital. His temperature went down, all the blood work looked good, and the extraction was started as planned on Monday. We didn’t get enough stem cells, so on Monday night he was given Plexifor, which boosts stem cell production. Tuesday morning more blood work was taken and results were good so he was put back on the apheresis machine and by the end of the day we had enough stem cells. He was still being treated with the antibiotics for the infection in his line, but on Tuesday afternoon we were told that the line would come out on Wednesday, but the antibiotics would continue, probably for a week. They talked about the antibiotics still being via iv, but maybe as an outpatient here in St. John’s or possibly in Clarenville.
All that changed Wednesday morning. The blood work showed that the level of Vancomycin in his blood was too high and his creatinine levels had risen from 100, which was normal, to 200. The antibiotics were immediately stopped. The line was removed as planned, and then he was put on fluids through iv.
Yesterday the creatinine levels continued to rise to 443, and he started to build up fluid in his lungs and throughout his body. The iv fluids were stopped and he was given lasix to make him pee. A Nephrologist (Dr. Martin) was called and he talked about the possibility of dialysis since his kidneys had been damaged and weren’t filtering as they should on their own. However, a decision about that wouldn’t happen until 3 days. I don’t know if he meant 3 days from Wednesday when the problem started, or 3 days from when he came in. It’s another wait and see for us.
Today the news is no better. The creatinine is 525. We were also given the number for the Vancomycin that is still in his body, which is 33.5. It was 33.6 yesterday, which means the kidneys are really not filtering it. Karl’s blood pressure also went up out of the normal range today, which is totally not normal for Karl, but apparently not unexpected since they gave him lasix to make him pee, which takes fluid out of the veins, and drives up the pressure. One treatment causes another symptom.
The culture on the removed line also came back today. It showed that the infection was staphylococcus. Vancomycin was a good choice to treat that, and it allowed the line to stay in for the extraction which couldn’t have been done without the line, but, as I said yesterday, Vanco really hasn’t been our friend.
So we are waiting. We haven’t seen Dr. Martin today. We saw Dr. Jones who told us he was unhappy with the creatinine levels. He was planning to consult with Dr. Martin again. We’re not sure when or if we will see Dr. Martin. He did say yesterday that a colleague was on call over the weekend and he would be following Karl if necessary.
Karl is feeling a little better today than yesterday since most of the fluid is gone. However when they sound him with the stethoscope they can still hear fluid in his lungs. More blood work was just taken. The technologist told us it was to test for bacteria in his blood. We don’t know if that is a routine test because of the staphylococcus or if they are looking for/suspecting/ruling out something else. To be honest, I don’t want to know. If they find something else they will tell us. If they rule something out and we didn’t know they were looking ...less stress. Worrying about the possibility of dialysis is enough. The first step in that process will be to put another line in Karl’s chest. The same type of line that came out on Wednesday, in the same place.
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