Friday, September 16, 2005

Heart function worse than previously thought

Here's the update as of about lunch time today. The official word on Denise's heart is that it's worse than what they thought (ejection fraction is 20-25%, not 30-35%). What she has is commonly referred to as congestive heart failure, most likely brought on by tachycardia (high heart rate for a long time). We're waiting to see how the two drugs they're giving her work. The drugs will slow the heart down, allowing more time for the chambers to fill with blood for the next beat. One drug is usually specifically for hypertension. As applied to the heart problem here, it dialates the blood vessels, making it easier for Denise's heart to pump out against an overall lower pressure. We're waiting to see what the latest thyroid check has to say (might have some bearing on the heart rate). The last thyroid panel came back essentially normal (thank you to family members that contacted me to contribute your thyroid histories). According to an outside-the-hospital opinion, this heart condition should get better once the infections, fevers, and breathing begin to come under better control, since Denise is young and was in great shape prior to going into the hospital.

By the way, have I ever mentioned that this is Denise's first hospital stay in her life? She's packing a lifetime of hospitalization into one long stay.

Fevers crept up to 103 since the last post, so I assume that there's an infection that's either new or getting worse, or one of the antibiotics or antifungals isn't as effective anymore (possibly related to yesterday's decision to switch the antifungal meds). Still waiting to find if the PICC line was a player in any infection. Pseudomonas still present in sputum. To fight the infection, the IV nutrition is either way down or discontinued. The thinking is that the very high sugar in the TPN that's going through the IV tube increases the risk of infection in diabetics (which Denise is dealing with at the moment... most likely temporary). So by cutting the sugar down, the risk of infection goes down, too. At least that's my overly-simplistic understanding. She still probably has a c. dif infection, but that's to be expected until the antibiotics are discontinued. Sounds weird, as I *think* c. dif is a bacteria, and should be whacked by the antibiotics. But then again I've been amazed by lots of things during this whole ordeal. The more I learn, the more I find out how much more there is to learn. Let me restate that... the more I learn, the more I realize how stupid I am.

Her bone marrow seems to be working, as she's still on procrit, and that can only work if the bone marrow's working. This is based on the reticulocyte count (a word I need to research, but my preliminary understanding is that it's basically an adolescent red blood cell, and used as an indicator of marrow function). Now whether her marrow's able to crank out enough cells to deal with her needs as related to infection-fighting and hemoglobin is something that is foggy in my mind.

And my mind is quite foggy right now, as Jacob was awake many times last night. The pediatrician says that he's got gingivostomatitis (sore throat w/white patches), caused by a virus, pretty common. Fortunately, he said virtually all adults have already had this and there's slim chance that I'll get sick, so I can probably still visit Denise. Also, the fever & contagious phase is short, and I got him into the doctor early on, so the meds they gave him should work great. The bad news is that Gracie is probably going to get it, too.
Oh, how I long for the days when if I took a sick day from work, it was because *I* was the one that was sick. Life's real different with kids!


Blogger Call Me Grandma said...

Storming the heavens with prayers for you and yours. God Bless

September 16, 2005 4:46 PM  

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