The Good and the Bad

Yesterday brought both good and bad developments. As expected, Esther's echocardiogram was fine. And best of all, she didn't have a fever all day!

The difficulties yesterday included the progression of the typhlitis. Esther developed some of the clinical signs that come with typhlitis - abdominal pain and bloody diarrhea. It was a confirmation of the diagnosis, but something I had hoped to avoid since Esther has been on antibiotics since Monday. She was able to sit up in a recliner for a few hours in the evening. We watched some television together and chatted. During the night, the pain made it difficult for her to sleep.

Today was harder. Esther just didn't feel well and didn't get out of bed except to use the bathroom. Her canker sores make it so hard for her to take some of the required medications. She was understandably irritable and teary. She wasn't up for even trying to eat until dinnertime.

The typical course of treatment for typhlitis includes giving the gut a rest by not eating for several days. The medical team is hesitant to require that of Esther because she is already behind nutritionally after being sick for the last three weeks. They recognize the importance that nutrition plays in her body being able to heal. She may end up fasting on her own because eating makes the pain worse. They are monitoring the situation and will make adjustments as needed.

Esther's labs were off today and she was given some IV magnesium and phosphorus. Her potassium was too high, so they have changed the composition of her IV fluid. Hopefully, we'll see the results of these changes in tomorrow's labs.

In addition to checking her vitals, a nurse or resident comes every four hours to feel her belly. As long as it remains soft and squishy, she is not in danger. If her belly were to become hard and stiff, it would be a sign that there has been a perforation of her bowel. That would be very bad. Soft and squishy is good.