Day 22....Back to the ICU

I’m finding it difficult to write a post this evening. Sometimes I am tired of sharing bad news and sometimes I am just tired. Tonight I am both.

When I last wrote on Friday, Samuel was really struggling. Saturday was even worse. His red blood cell count was extremely low and his white blood cell count was rising again. He was very “out of it” and sometimes incoherent. He had spiked a fever, so they drew more of his precious few red blood cells to try to grow more cultures. They did an adrenal stimulation test to check his adrenal function. They sent him down to radiology for another thorough ultrasound. They wanted to check out his spleen, lymph nodes in his neck, the graft, and his renal fossa (and YOU know what that is!!). It was a long and painful exam for Samuel as the radiologist had to apply pressure on his tender abdomen and neck in order to get good pictures. Thankfully, they didn’t find any surprises during the ultrasound.

There were multiple brains engaged in trying to make sense of Samuel’s degraded condition. In the process, it was discovered that for the last week, Samuel has not been receiving the prednisone dose that they had intended him to get. It is possible that some of his issues have been caused by suddenly (and unintentionally) stopping the prednisone. To correct this, Samuel is back on some big doses of prednisone for 3 days and then will go back to his small daily dose. They also discontinued one antiemetic drug that might have been making him too drowsy. And lastly, they gave him 2 units of packed red blood cells.

Saturday evening, even before receiving the blood transfusion, Samuel’s blood pressure began to be too high. The nurse was in his room very often during the night monitoring both the transfusion and his pressure. There was just a little too much going on for me to sleep, so I took the opportunity to work on a project that Dr. Guillot had asked me to do. She wanted to see all of Samuel’s temperatures from the last 20 days plotted out on a graph. It is just the type of challenge that I enjoy, so it was a great distraction for me during the tense night. I finally went to sleep at 5 a.m. for a couple hours. Hence, my weariness today.

This morning, Samuel was more alert, appeared to be in less pain, talked a little more, and generally seemed much better....except for his blood pressure. It was dangerously high and the decision was made to send him back to the ICU.

So….that is where we are. We seem to be trying out all the ICU rooms. This is room number five for us. It is at the end of the hall where it is quieter, but the view isn't so hot. Oh, well! We hope not to be here too long. Samuel is on a Nicardipine IV drip which will be ever so gradually increased until his blood pressure is where they want it. Meanwhile, they have increased his other BP medications. Once those start taking effect, they will begin the process of slowly backing down on the IV dose. It is a tedious process of tiny steps up and down until everything is stable and where they want it. The process requires close monitoring and can only be done in the ICU.

To remind you of some good news.........

Despite all that Samuel's body has been through since the transplant, the function of his new kidney continues to improve! This is truly amazing! Glory to God!