ICU Day 5

Andre is still heavily sedated. He seems to be calmer today as well.

He did better on his spontaneous breathing trial (SBT) today than yesterday, but it is still not good enough to be off the ventilator. The respiratory technician added a humidifier to the ventilator setup. I’m taking this as a sign that Andre will probably have the breathing tubes for several more days. I hope I’m wrong.

They did a chest X-ray today to see if the chest tubes that drain the fluids and check for air leaks in the lungs can be taken off. Everyone of Andre’s doctors agree that getting these tubes off will decrease Andre’s discomfort. I hope the surgeon’s will take them off soon.

A sonographer was also called to do “Doppler ultrasound” to check for clots in his legs (DVT). Her unofficial verdict–because it’s the radiologist who does the read–is that there are no clots in his legs. Thank God that’s one less possible cause for a pulmonary embolism. As I mentioned in yesterday’s blog, the docs can not confirm if the dead space in Andre’s lungs is due to an existing pulmonary embolism because they can’t do a CT with radio-contrast due to his poor kidney function. I know they are closely monitoring his fluid intake to get his kidneys up to speed. I forgot to ask what their plan is to address the dead space in his lungs (NOTE TO SELF: ask this question to the pulmonary critical care doc when he comes in for his 2nd visit of the day). I hope there is a plan.

Andre’s attending oncologist also spoke to me today. She’s not one to cite statistics, but I think she was trying to impress on me the precariousness of Andre’s condition–some people recover and some don’t. She mentioned all the things that they’re addressing. According to her, the medical team’s main concern is still the infection that he has in his lungs. They’re worried that the pathologist not only confirmed the fungal and viral (CMV) infection in his lungs, but also found Gram-negative bacteria (definitely Pseudomonas aeruginosa; I don’t know if there are others). Andre continues to be on antibacterial (Levofloxacin, Imipenem and cilastatin), antifungal (Amphotericin B and Posaconazole), and antiviral (Foscarnet) medication. The better way to fight the infection is for Andre’s bone marrow to start producing white blood cells again in sufficient numbers. He’s been able to do this before but not currently probably because of the myelosuppressive side effects of some of the drugs that he was/is on. The docs have pared down Andre’s medication to the essentials. I hope this, plus the G-CSF shots that they’ve been giving him since before the surgery, will work soon.

I continue to hope.