Timna Update Wednesday 11/04/2009 5:30ish pm Eastern
Things were a little rough for Timna this morning after a feeding tube was inserted. Her gag reflex kicked in with the additional volume of tubes in her throat. Hourly injectable sedation had to give way to a morphine drip which complicated things by lowering her finally stable blood pressure. Medications brought that back up but, from what I gather, put additional demands on the healing kidneys.
Her blood acidity has moderated.
Her lymphedema has been exacerbated by more fluids going in than are coming out which causes blistering and rupturing of same on her feet and legs as well as sites traumatized by blood drawing, etc.
The sepsis ( http://en.wikipedia.org/wiki/Sepsis ) turns out to be MRSA ( http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus ) which caused, or along with, the DKA ( http://en.wikipedia.org/wiki/DKA ) took her down.
Did all this start out with a virus? I wonder. Since Timna and I were both sick at the same time we just naturally assumed some form of influenza. Maybe it was and her being weakened by the flu created an opportunity for the MRSA. Or, Maybe me being sick with the flue was merely coincidental to her suffering from the sepsis.
From the first referenced Wikipedia entry:
- Sepsis is usually treated in the intensive care unit with intravenous fluids and antibiotics. If fluid replacement is insufficient to maintain blood pressure, specific vasopressor drugs can be used. Artificial ventilation and dialysis may be needed to support the function of the lungs and kidneys, respectively. To guide therapy, a central venous catheter and an arterial catheter may be placed. Sepsis patients require preventive measures for deep vein thrombosis, stress ulcers and pressure ulcers, unless other conditions prevent this. Some patients might benefit from tight control of blood sugar levels with insulin (targetingstress hyperglycemia), low-dose corticosteroids or activated drotrecogin alfa (recombinant protein C).
That one paragraph pretty much defines Timna's current state.
They started feeding her some yummy looking grayish tan... not sure what to call it in a G rated communication. Brand name Oxepa. (I don't want to know from what part, if any, of the ox it came from.) As expected it raised her blood sugar levels so they are going to increase her insulin to compensate.
Her blood pressure is currently 103/38 so the medication is working to bring that back up.
The morphine (which she still refuses to share) is allowing her to rest comfortably without gagging and fighting the respirator. They are taking steps to prevent yeast, etc., infections on other parts of her body such as behind her knees and between her toes where moisture could collect and provide an environ for yeast, etc.
With her creatinine levels dropping slowly any decision concerning dialysis is able to be postponed. But that option is not being ruled out, just with her blood pressure on the low side and her general weakened state it is best to avoid dialysis.
Please keep Timna in your prayers.
Thank you.
It's hard when every brainstorm results in a power failure.
- Lee Peterman
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