Making it Through the Night....

 All medical people will tell you that the majority of disasters seem to occur at night. If people are going to crash, it will be in the wee hours, as happened to Babygirl yesterday. So the overnight hours are generally more critical than the daylight ones, somehow.  There are biological reasons why this is so: Hormonally and immunologically we are at are weakest in the hours before the dawn.

That being said, last night was not disastrous. However, a few things need updating, so here we go.

Yesterday while we were here in the ER, the nurses were repositioning Babygirl.  I had stepped out of the room and was just coming back around the corner when I spotted blood in her armpit.  It was a right time/right place discovery. Given Babygirl's condition, no one might have noticed it for quite a while.

Nursing paused to clean it up (I suggested twice that they culture it, but....no.), and I continued to mention it to each successive provider.  One of them ordered an ultrasound of the area to see if it was a concern. That was not done until late last night, and I was fortunate enough to see it done.  In medical terms, there is a 2-3 cm loculated pocket of pus in her armpit (1 inch or more, with numerous separate pus pockets). A surgical resident was here this morning and he kept talking about the "incision" and that is "draining through the incision. It took a couple of tries to firmly explain that there was NO incision, and that he should LOOK at the ultrasound pictures.

They are doing a procedure later today to fully remove this, or at least get it to fully drain. 

I slept 3 times, about 3 hours each, so I am doing okay. But at the hour when I was completely OUT, the nurses woke me up to give consent for blood transfusions. So, good thing you let me stay, eh?

She is not actively bleeding that we can see. Her blood counts were low (hemoglobin 8.2) at Lourdes yesterday.  Last year she was at 11, much closer to normal.  But yesterday she was absolutely dehydrated, so adding a gallon or two of fluid further diluted the blood she has, so her hemoglobin dropped below 6. Since her blood pressure is also low (yes, it was HIGH yesterday!), transfusions were in order.  Hopefully it will make her feel warmer.

She began running a fever last night, and is still febrile. No one knows why.  The abscess, perhaps?

She is alert and feisty and her hand restraints have been removed. When I asked her yesterday if she had any skin lesions, she was too obtunded to answer. Today, she says that she knew there was a problem in her armpit, but she can't remember if it was there before the vomiting started.

Which moves us to the most encouraging part of it all.  She is sedated, but lightly.  I can talk to her and get answers, she can accurately complain of discomfort via a 20-questions sort of routine, and she wants to go home, preferably NOW.  But the fact that she is on continuous dialysis and a ventilator makes that, well, currently impossible.

DeeDee