Burning Down The House

Cathy struggled hard to breathe throughout the night. For me, last night was one of the longest I have ever experienced. I am sure it was even longer for Cathy. Cathy began to have difficulties around 9:30 or 10 pm and could not get any relief until just before 10 this morning when she was given an additional dosage of a sedative. The nurses, respiratory therapists and care partners were assisting Cathy all night. (If I hear another person tell Cathy that ALL she needs to do is relax, I think I am going to scream. Telling Cathy to relax has the opposite effect). This morning both teams of doctors were in to assess Cathy's condition.

This morning they upped the anti on the amount of lasix Cathy received. Although she released a lot of fluids over the past 24 hours, there is no noticeable difference in her swelling, and more importantly for Cathy, no improvement in her breathing. The medicine team said that the x-rays did not show any fluids in Cathy's chest cavity. The pulmonary team believes that, with the amount of fluids Cathy is carrying in her lower extremities, she could also have extra fluids in her lungs. This would explain her difficulties. It also means that after the fluids are removed, Cathy should see improvement in her ability to breath. It has taken several days to build up the fluids. It is going to take a few days to bring the levels back down.

Lasix has been a part of Cathy's daily routine since her transplant. Sometime during the past few weeks, her daily dosage of lasix was DC'd. I missed this change. I asked the pulmonary team about the reasons for this change. They speculated that Cathy's blood creatinine levels may have been a little high. This would have been an indication that her kidneys were not functioning properly. If high creatinine levels were observed, the medicine team may have DC'd her daily lasix dosage.

In the midst of Cathy's struggles, the world around us is on fire. Although no fires are anywhere close to the hospital (yet), the air outside is filled with smoke and soot. The doctors have ordered a room air filter for Cathy's room. The small amount of contaminants that are entering the room may be contributing to Cathy's difficulties. Therefore, after the filter is put in place, we have been asked to keep her door closed as much as possible.