Day 6

Samuel has continued to suffer from fever and nausea over the last few days. Given that he is on 7 different anti-infectious drugs, it is a mystery why the fevers are still happening. "I don't know why" continues to be the response I hear again and again from the team of doctors. They are as frustrated as we are. One doctor described Samuel's case as "intellectually untidy". I thought she was describing my house! :)

Yesterday, the interjugular Quinton catheter was removed from Samuel's neck. The doctors want to eliminate as many possible sources of infection as they can. When/if Samuel needs dialysis in the future, he will have another catheter put in.

Samuel is being fed through a feeding tube that goes from his nose to his jejunum. I had to do a quick anatomy study to learn where that part of the small intestines is....stomach, duodenum, jejunum, ileum, large intestines, etc. Last night the feeding tube stopped working. This morning Samuel and his bed were wheeled down to radiology to have a fluoroscopy done (something like an x-ray in real-time). They could see that the tube was kinked at the far end. They inserted a tiny wire down the feeding tube and were able to unkink it.

Other activities for today included a white blood cell nuclear medicine scan and a CT scan. The WBC scan involved combining some of Samuel's blood with a radionuclide and then injecting this now radioactive blood back into his body. The white blood cells will congregate in any areas of infection. The photon energy that they emit shows up as bright white areas that the gamma camera can record. Two scans were done in a 4-5 hour period. Samuel's lungs were lit up like a 100-watt light bulb. The tentative diagnosis is diffuse alveolar disease. I don't yet understand it well enough to explain it. Samuel will have a bronchoscopy in the morning. He will be sedated for the procedure. Lord willing, the results will provide more information, including whether the diffuse alveolar damage is caused by a bacteria, virus, or fungus. This WBC scan also confirmed that the pockets of fluid that Samuel has in his lungs are pneumonia. Strangely, he is missing the cough and breathing difficulty that one would normally associate with pneumonia. He does have fever and chest pain. We will just have to wait for more answers tomorrow.

Encouragingly, Samuel had about an hour this evening when he sat more upright in bed and watched a movie (thank you, Ryan!). Unfortunately, that was followed by his fever and nausea returning with a vengence. At the moment, he is well-medicated and appears to be sleeping comfortably.

Tomorrow looks to be another long day.