Tuesday, August 09, 2005

New Vent, High Fever, SPT?

The new ventilator seems to be helping Denise! It has a special mode on it that is enabling Denise to use a 50% oxygen concentration and get 95-97% saturation. For those that would ask, it's a Maquet Servo-i and the respiratory specialists hang around it and admire it like it's a nice new car. They've lowered the Atavan drip so that Denise will be less sedated (still snockered, though) and try something called bilevel ventilation. The machine will give her some air at a normal 10-12 breaths per minute. On top of that, she'll be able add her own breathing (hence the need to lessen the sedation). At least that's the limited understanding I have. If you want to learn more, my aunt found a link for you to look up. Knock yourself out: Bilevel explanation

Fevers have still been brutally high (above 104). Could be due to infection-fighting, could be due to meds... whatever it is, it's scary-high. Though my old Boy Scout manual said that above 103.5 runs the risk of brain damage, current thinking seems to be 105-106. Obviously, we'd like to see the fevers come down and stay down.

There's a puzzle about why the white count is about normal, but the fevers are so high. One of the stones that the doctors have turned over is the possibility of Septic Pelvic Thrombophlebitis (SPT). For our education, here is a bit that I copied from the femalepatient.com about SPT:
Septic pelvic thrombophlebitis (SPT) is a rare condition associated with the postpartum period. Postpartum endometritis may spread throughout the pelvic venous system, including the inferior vena cava. The embolic disease process is more common in the right ovarian vein, whereas left ovarian vein disease with renal vein involvement is less common. Patients often present with pain and fever in the postpartum period. There may be initial clinical improvement with antibiotic therapy, but patients with SPT will continue to "spike" fevers daily, usually in the evening, despite the resolution of pain. Computed tomographic (CT) scanning or magnetic resonance imaging (MRI) studies are best for diagnosis. Care must be taken to rule out ureteral obstruction or urinoma. Patients respond quickly to heparin anticoagulant therapy, and long-term anticoagulation is seldom needed. Most clinicians continue antibiotic therapy along with anticoagulation, although research has failed to show a quicker resolution of the febrile course.
There. Now you know as much or more about it as I do.

Since hearing that Denise will be in the hospital for months, I've been worried about what to do with the kids once school starts. Today I started the ball rolling in figuring out what to do. I'm starting my 12th year at Pasadena Christian School in a few weeks. The school is bending over backward to accommodate my situation, and for that I'm very grateful. We came up with some very workable solutions for the next few months. Not only is PCS a great place to send your kids (shameless plug), but it's also been a great place to work (sucking up). Really, though, I'm blessed to be there. The amount of support I'm receiving from everyone- administration, co-workers, families- is comforting, humbling, and incredible.

2 Comments:

Anonymous Anonymous said...

Once you thought you knew all the medical terms there were they throw in some more. Phil - you'll be able to pass your boards for internal medicine and pulmonology after this. Each thing is another hurtle but is seems each has a treatment that can pull her through this so someday our Denise we love and cherish will be back with us. I give thanks for all the advances made in the last 6 years that were not available for a friend who lost his fight with ARDS brfore that. Thank you Lord for the constant miracles the science you gave us can accomplish. Aunt Jackie

August 10, 2005 4:04 AM  
Blogger Alison Ravasdy said...

Phil,
Let me know how I can help with the kids. I will be going to PCS everyday to take Jack and Megan on Tues.-Thurs. Please let me help.

Alison Ravasdy

August 10, 2005 6:46 AM  

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