First, Lisa....I'm so glad that you have David home and that he is getting better. You're on my mind, too.
Secondly, wow how things can change on a dime. Almost immediately afterward I posted my note here, one of the internists (not our regular one) came in and said that we were having to move Stephen BACK to CCU (he had been moved to a PCU room yesterday around lunch, less monitoring, etc.) and that the feeding tube and drain were on hold for now. He completely changed everything, all our plans. As the way things ended up, we were packing up our stuff and moving to another room (our previous room in CCU actually) around 2:00 a.m. The man next to us screamed ALL night long, I swear, I was about to call the ambulance for him. I don't know what they're doing to that poor man - or what they're not doing. He was screaming this way before we left and has been doing it for days. Stephen and I couldn't sleep already, and then on top of that... Bad thing is, I don't think they have any other rooms on this floor for us.
Anyway, the reason the internist and infectious disease guy were concerned is that Stephen's blood pressure dropped alarmingly during the day. Last reading was about 89/50. He has no fever, and his other symptoms are the same. They immediately gave him fluids, even though he's swollen up like a whale. They said that this was really the only thing to do for low blood pressure in his case. The internist said that he's very afraid that Stephen's perforation never healed. He said that he took a look at the CT scan done yesterday at 6 pm, and it looks like there is stiil air in the abdomen. Of course, like he said, reading scans isn't his forte...that was just his initial take on things and we'd have the definitive word by early this morning. Stephen's WBCs rose up to 14 and some of his liver counts were worse.
What concerns me is that the weekend infectious disease doctor totally changed Stephen's antibiotics mid-course, on Saturday. By Sunday, Stephen was so much worse. The numbers that were getting better, got worse, and overall he just wasn't feeling as well. The antibiotics were changed because, according to the ID doc, they had isolated the bacteria and were simplifying his medicine. What started as three antibiotics was changed to two (and different ones at that).
The internist said that it is his opinion that Stephen is “right back where he was when he was admitted, needing surgery.” He said that if the perf is not healed, no amount of antibiotics would help him. The GI surgeons have told me repeatedly over the week that there is no way the perforation hadn’t closed, because they strongly feel like Stephen wouldn’t be alive at this point and he wouldn’t be showing signs of getting better…only progressively worse during the week.
Stephen can’t have surgery. I just don’t think he’d make it. If they make me make that choice, I just don’t know what to do. I was told last night that it just might come to that, and that it would be extremely risky. I don’t know what to do.
The ID doc put Stephen back on the original antibiotics that were helping Stephen in the first place, and all night long he’s had these going into his system along with the fluid. His blood pressure has gotten a little higher, around 95/65 or so, averaging. When I left his room this morning for my mandatory kick-out, it was 100/68. What I want to do is give the antibiotics he’s now on time to work, just to see if that is indeed the problem. I just don’t know if we have the time for these wait-and-see measures.
Wife to Stephen, dx 5/13/09; 45 yo
Stage IV w/numerous mets to liver, 2 to LNs
Colon resection 5/25/09
Folfox/Avastin, Folfiri/Avastin, Folfiri/Erbitux-progressed
Sir Spheres 2/2/2010
Admitted to hospital 4/23/2010
Passed away 5/09/2010