It is 11:00 I just finished talking to the doctors. Andrea is the same maybe slightly worse. I could tell when I walked in that she was weaker then I expected. I had hoped she would be sitting up and awake like she was on Monday. She will respond to you but she falls asleep when you stop talking. We have some decisions to make today.
First they want to do a CT scan on Andrea. The issue is getting her on a portable vent to be able to move her. The portable vent does not provide the kind of support Andrea is on right now. So they are going to try to change her vent settings to reflex how the portable vent works. If she is able to handle the settings they will put her on the portable vent and do the CT scan.
Why the need for the CT? Foremost is her stomach. They are trying to find out why she is not absorbing her food. Also she awoke with a bruise on her back, and they want to see what may be causing it. It could be the drugs she is on or it could be related to her stomach problem. If they find there is internal bleeding then we are in trouble. This brings up more questions then answers so we will just have to wait and see. Secondly they will look at her lungs with the CT. I doubt the CT will show much more then the X ray but we will see.
The next decision will be do we try steroids now. After 11 days on antibiotics and minimal gain there is little hope that this infection is caused by bacteria. We may have to wait up to a week to see if she responds to the steroids and that means more time on the vent. The doctor is not fixed in the decision to move the vent to her trach after 14 days, which is this Sunday. So she may be on the vent for over 2 weeks. That decision will be made later. There are many things that could happen between now and Sunday.
Third, the doctors may want to do a test to draw some fluids out of her lungs. In her condition this can be hard on Andrea. Also there is only a about a 40-50% chance this will give them helpful information.
Why this procedure? This may give them better information of what the cause of her lung problems, either cancer, bacteria or something else. They lung doctors are going to meet with the oncologists to ask if they would find cancer could Andrea be put on any form of chemo. If not then they won't do the test. Because if the test showed cancer and there is no treatment option then why take the risk. If it does not show any cancer then we would just stay with what we are doing and the test would not be worth it.
Overall the doctors are more concerned today. Just too many questions left unanswered and to little progress.
Overall I'm concerned, of course. I asked the nurses to leave the room to talk to Andrea. I told her what was going on and what the doctors wanted to do. She was okay. Then I told her, "Andrea if you are too tired it is okay." She said, "I'm okay." I asked, "Do you still have fight left in you?" She said, Yes, I will be fine."
Is she not amazing? I prayed with her and she smiled at me.
Right now it is 12:00, she is on the temp vent settings and seems to be doing fine. I pretty confident she will be able to get the CT scan.
So as of right now here is the plan,
Get the CT scan - see what caused the bruise. We have get past this hurdle before we make any other decisions.
Talk to the oncologist and see if there is an option for chemo if needed.
If they don't think chemo is an option then we try steroids and wait each day for improvement. If there is no improvement then the most likely cause is cancer.
If she can take chemo we will do the scope of her lungs to see if it is cancer. And then treat it best we can.
We have a lot to find out today, and some answers may be hard to hear.
Please pray for Andrea's strength and wisdom for us all. Pray for each other as this is difficult news for us all, especially her family, Nic and Anthony.
I have not given up hope. I just ache for my wife and the battle she has to fight. I just want it to be over, and for Andrea to be able to rest, but I don't want to be without her. I'm tired of seeing her suffer yet I'm weak when I think of being without her.
First they want to do a CT scan on Andrea. The issue is getting her on a portable vent to be able to move her. The portable vent does not provide the kind of support Andrea is on right now. So they are going to try to change her vent settings to reflex how the portable vent works. If she is able to handle the settings they will put her on the portable vent and do the CT scan.
Why the need for the CT? Foremost is her stomach. They are trying to find out why she is not absorbing her food. Also she awoke with a bruise on her back, and they want to see what may be causing it. It could be the drugs she is on or it could be related to her stomach problem. If they find there is internal bleeding then we are in trouble. This brings up more questions then answers so we will just have to wait and see. Secondly they will look at her lungs with the CT. I doubt the CT will show much more then the X ray but we will see.
The next decision will be do we try steroids now. After 11 days on antibiotics and minimal gain there is little hope that this infection is caused by bacteria. We may have to wait up to a week to see if she responds to the steroids and that means more time on the vent. The doctor is not fixed in the decision to move the vent to her trach after 14 days, which is this Sunday. So she may be on the vent for over 2 weeks. That decision will be made later. There are many things that could happen between now and Sunday.
Third, the doctors may want to do a test to draw some fluids out of her lungs. In her condition this can be hard on Andrea. Also there is only a about a 40-50% chance this will give them helpful information.
Why this procedure? This may give them better information of what the cause of her lung problems, either cancer, bacteria or something else. They lung doctors are going to meet with the oncologists to ask if they would find cancer could Andrea be put on any form of chemo. If not then they won't do the test. Because if the test showed cancer and there is no treatment option then why take the risk. If it does not show any cancer then we would just stay with what we are doing and the test would not be worth it.
Overall the doctors are more concerned today. Just too many questions left unanswered and to little progress.
Overall I'm concerned, of course. I asked the nurses to leave the room to talk to Andrea. I told her what was going on and what the doctors wanted to do. She was okay. Then I told her, "Andrea if you are too tired it is okay." She said, "I'm okay." I asked, "Do you still have fight left in you?" She said, Yes, I will be fine."
Is she not amazing? I prayed with her and she smiled at me.
Right now it is 12:00, she is on the temp vent settings and seems to be doing fine. I pretty confident she will be able to get the CT scan.
So as of right now here is the plan,
Get the CT scan - see what caused the bruise. We have get past this hurdle before we make any other decisions.
Talk to the oncologist and see if there is an option for chemo if needed.
If they don't think chemo is an option then we try steroids and wait each day for improvement. If there is no improvement then the most likely cause is cancer.
If she can take chemo we will do the scope of her lungs to see if it is cancer. And then treat it best we can.
We have a lot to find out today, and some answers may be hard to hear.
Please pray for Andrea's strength and wisdom for us all. Pray for each other as this is difficult news for us all, especially her family, Nic and Anthony.
I have not given up hope. I just ache for my wife and the battle she has to fight. I just want it to be over, and for Andrea to be able to rest, but I don't want to be without her. I'm tired of seeing her suffer yet I'm weak when I think of being without her.
It is 1:30 still waiting to go for the CT. Looks like it may not be for another 2-3 hrs. I will post an update as soon as I hear something.
Andrea says this vent setting is easier on her and her numbers actually look better then when Nic and I arrived.
Okay update. They are drawing the blood to check the C02 levels in Andrea's blood. If that are okay then she can stay on this vent setting and they will order the CT scan. I'm off to run some errands and I have to go to the office. That way I will be here when they do the CT scan.
Jim, you're amazing how you are able to concisely understand and plan in the complex world of medicine.
ReplyDeleteAndrea, you're strength has always amazed me, as an ol' ICU nurse, "let the vent breath for you", so you can get some rest, and give your lungs some more time to heal.
Some people's lungs just take longer to heal...the docs need patience!!
As I type, I hear the F15E's fly over (night flying), which reminds me....the times I saw you both walking in the neighborhood on a hot summer's night. We miss not seeing you all.
You're all in our prayers. Andrea, wish you a quiet nights rest...so you body can get stronger.
Love Donna and Bob and Ryan