Today was relatively uneventful. I'm grateful for that.
Current status: Babygirl remains off of dialysis, as she is producing adequate urine on her own (she had only one dose of the Lasix). The kidney labs are stable-to-trending slightly worse with no dramatic changes.
Labs that were done on the day of admission, but not resulted until today (either because they really do take that long, or because they are specialized and only get run during the week or get sent out):
Cultures are finalizing. The abscess grew non-MRSA staph. This allowed them to stop the kidney-toxic vancomycin and switch to something less dangerous. Blood cultures have not been reported, but usually if they are positive that shows in the first couple of days. AFB stains are negative for TB.
All of the weird/common respiratory pathogens have been ruled out. Influenza A/B, Covid, pneumococcal pneumonia, Legionnaire's disease. Throat culture is negative.
Heart strain is resolving.
Blood sugars are higher than they should be but not enough to need insulin. Her chart is still missing her Type II diabetes diagnosis. I discussed this with a resident tonight and they will get an A1c with her morning labs. I mean, they already checked her cholesterol.
The current unexplained outlier is a collection of tests for autoimmune diseases. All are negative except for her ANA, which is >2560 (if there is a > symbol in front of your test results, it means that the level is so abnormal that further testing would not make the result any worse LOL). The disease most commonly associated with this test is Lupus, which to date had NEVER appeared on our list of concerns. But since Lupus is known to cause kidney failure, they ordered the test.
And the answer to your next question is, "I don't know." I suspect that a kidney biopsy could be in our future to see if that clarifies things, but, as always with Babygirl and specialty medicine, I am a bit out of my league here.
One ongoing problem for her is nausea. Now this is a kid who never has a belly ache, but she was complaining of constipation for a week or so before the insanity began. She is still having some issues with this, but the nausea only goes away for as long as the anti-emetics stay in her system. She apparently spent much of last night vomiting again. They are converting her from as-needed Zofran to around-the-clock Zofran, and stopping Phenergan for breakthrough and giving her Haldol instead. That combination knocked her senseless, so I left before they threw me out, only 7 1/2 hours into my 4 hour visit. I am apparently invisible LOL.
They feel she is well enough to be managed on a regular floor, but she is one of 2 people in the ICU who could be transferred out if there were somewhere to transfer them TO. I'm not gonna lie - I am not at all sad to see her stay safely in the ICU. If they transfer her out, they have to remove her arterial line, and right now that is where they are drawing all her labs from. It'll be all poking and prodding and "good luck with THAT" if we have to give up that line. She is getting labs done at least 4 times daily.
So I'm "home" in my cozy hotel room with a Chicken Tikka Masala fire pizza (I gotta say, if you can't make up your mind what you want, this is the THING.
DeeDee
PS There's a salad, okay?
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