3 weeks later
So, Saturday marked the 3 week anniversary of hospitalization for Zippy's Severe Acute Necrotizing (70%+ of his pancreas is thought to be dead currently) Pancreatitis. Today marks 2 weeks since he's been put on the breathing machine and been sedated fully so it doesn't trigger his gag reflex. His pancreatitis has affected other organs, specifically he is in renal failure (kidneys shutdown) and respiratory distress - aka ARDS (thus the need for the breather). For the kidneys they have him receiving dialysis, at first they were doing dialysis daily, now he's getting it every other day (I personally feel that's actually a good thing - because he is producing some urine, and his Potassium and Calcium levels are not spiking too much so really he's in renal dysfunction, not renal failure). They attempted last week to wean him off the ventilator (breather) but his blood oxygen levels went out of wack and his heart rate went up so they stopped the attempt and went back to full support. For him full support is 40% FiO2 (40% pure oxygen) and 25 reps (25 breaths per minute) and the machine is currently doing all of his breathing for him. The risk there is that the muscles of the chest that run his lungs can atrophy making it that much harder later to wean him off the machine. But, not much can be done about that right now.
The drugs they have him on are:
Meropenem - Broad Spectrum antibiotic
Insulin - because the pancreas produces this and his pancreas is inflamed, they have to supply this artificially for him until his pancreas can resume this function on its own.
Fentanyl - Powerful narcotic and painkiller, some sedative effect.
Versed - Sedative, not a lot of painkilling effect.
Vasopressor (actual name unknown) - used occasionally during dialysis to maintain bloodpressure in case it drops due to the displacement of blood.
edit: I stuck a peak at the drug they occasionally use to assist his bp - the IV bag said phenylephrine.
During the time they were attempting to wean him of the ventilator his WBC (White Blood Count) was around 28,000 (28k). Back on Nov. 22 when I first brought him to the hospital his WBC was 27k, and they put that in perspective for us by saying normal WBC is around 4k, Influenza usually results in a WBC of 12k, so 27k is really high. 3 Days ago his WBC spiked up to 40k! so they rushed a contrast CT (Computed tomography) scan to see what the heck was going on and found that more of his pancreas was now involved in the inflammation and that there was fluid surrounding the pancreas. When we talked to the doctors about that scan they said that in his imaging he's getting worse, but that he is clinically stable so they are unwilling to go in surgically at this time due to the risk of introducing further infection. So, the plan of action (which has been the plan really since day one) is to continue to support him and wait for that inflammation of the pancreas to go down. The irritating and frustrating thing about this disorder is they really don't know much about inflammations, and especially why the pancreas can have this type of reaction. In addition, they have no medically proven methodology to counter this type of reaction. 20 years ago they used to go in surgically and remove the dead spots on the pancreas, but they found the mortality rate of such actions was too high (as much as 80% mortality) and stopped that practice, so now all they can do is support the patient, support the failing secondary organs during the inflammation and wait for the pancreas to resume to a "normal" state.
That's what we are doing now, just waiting for his pancreas to stop burning, and when it does then we can go in and clean up the dead tissue, remove the excess fluid buildup, and ultimately remove his gallbladder - which is the cause of all of this, a gallstone had passed into the bile duct connected to the pancreas and blocked the passage resulting in a build up of pancreatic enzymes irritating the pancreas.
I'm at the hospital daily. Arriving there anywhere from 10am to 12pm and staying until either 6:30pm or 8:30pm depending on the conditions that day, i.e. if we have something bad happen we stay to find out the results.
Any cards can be directed to the house, the ICU does not allow any personal items for the patient so anything we take in we must take out with us, so I only carry my laptop and purse around with me.
Even thought the doctors say this severe of a case has a higher chance of not surviving due to the conplications, I refuse to believe that he will not make it through this. He's 32 years old, and has no major medical history, and although he's "gravely ill" (that's what the doctor said verbatim) I trully believe he will pull through this. It's going to be hard, but we WILL make it through and be stronger for the experience.
The drugs they have him on are:
Meropenem - Broad Spectrum antibiotic
Insulin - because the pancreas produces this and his pancreas is inflamed, they have to supply this artificially for him until his pancreas can resume this function on its own.
Fentanyl - Powerful narcotic and painkiller, some sedative effect.
Versed - Sedative, not a lot of painkilling effect.
Vasopressor (actual name unknown) - used occasionally during dialysis to maintain bloodpressure in case it drops due to the displacement of blood.
edit: I stuck a peak at the drug they occasionally use to assist his bp - the IV bag said phenylephrine.
During the time they were attempting to wean him of the ventilator his WBC (White Blood Count) was around 28,000 (28k). Back on Nov. 22 when I first brought him to the hospital his WBC was 27k, and they put that in perspective for us by saying normal WBC is around 4k, Influenza usually results in a WBC of 12k, so 27k is really high. 3 Days ago his WBC spiked up to 40k! so they rushed a contrast CT (Computed tomography) scan to see what the heck was going on and found that more of his pancreas was now involved in the inflammation and that there was fluid surrounding the pancreas. When we talked to the doctors about that scan they said that in his imaging he's getting worse, but that he is clinically stable so they are unwilling to go in surgically at this time due to the risk of introducing further infection. So, the plan of action (which has been the plan really since day one) is to continue to support him and wait for that inflammation of the pancreas to go down. The irritating and frustrating thing about this disorder is they really don't know much about inflammations, and especially why the pancreas can have this type of reaction. In addition, they have no medically proven methodology to counter this type of reaction. 20 years ago they used to go in surgically and remove the dead spots on the pancreas, but they found the mortality rate of such actions was too high (as much as 80% mortality) and stopped that practice, so now all they can do is support the patient, support the failing secondary organs during the inflammation and wait for the pancreas to resume to a "normal" state.
That's what we are doing now, just waiting for his pancreas to stop burning, and when it does then we can go in and clean up the dead tissue, remove the excess fluid buildup, and ultimately remove his gallbladder - which is the cause of all of this, a gallstone had passed into the bile duct connected to the pancreas and blocked the passage resulting in a build up of pancreatic enzymes irritating the pancreas.
I'm at the hospital daily. Arriving there anywhere from 10am to 12pm and staying until either 6:30pm or 8:30pm depending on the conditions that day, i.e. if we have something bad happen we stay to find out the results.
Any cards can be directed to the house, the ICU does not allow any personal items for the patient so anything we take in we must take out with us, so I only carry my laptop and purse around with me.
Even thought the doctors say this severe of a case has a higher chance of not surviving due to the conplications, I refuse to believe that he will not make it through this. He's 32 years old, and has no major medical history, and although he's "gravely ill" (that's what the doctor said verbatim) I trully believe he will pull through this. It's going to be hard, but we WILL make it through and be stronger for the experience.