Ups and downs

Mike's white blood cell count has been going up and down a bit over the past few days. The docs say this in not unusual. Hopefully, it will continue to go to normal range (4,000 (4.0) - 11,000 (11.0)) and not dip down again.

8/5: .6
8/6: 1.1
8/7: .5
8/8: 1.2

The past couple of days have been frustating ones. Things were going well yesterday. Mike's spirits were good. He's doing everything he's supposed to do: drinking plenty of fluids, doing his mouth care, etc. Then, we discovered that his two catheter lumens have leaks in them (near the clamps). Lumens are the tubes that his IV meds go into and his blood comes out of.

Looking back at it, we realized the lumens have been leaking for over a week now. Mike's shirt would always have these dried wet and blood spots where near the clamp areas. We've mentioned it several times to the nurses, but no one knew what it was because there was no visible evidence of leakage. They probably just assumed he spilled something there, so no one really thought anything of it. A couple of days ago, the night nurse was administering his FK506 and forgot to unclamp the lumen, so pressure built up in that area and caused the liquid to squirt out. After she unclamped it, the nurse didn't see anymore leakage, so she didn't do anything further. Saturday afternoon, we mentioned it to our day nurse. She reproduced the situation by clamping the lumen shut and flushed the line. Sure enough, it leaked. Since our nurse has never repaired a lumen, so she asked the charge nurse to assist. The charge nurse, Terry, got too busy and never came by. I saw the charge nurse as she was about to leave after her shift ended and she said ..."sorry, I was too busy"... We were hoping Terry would be back on Sunday, but were told that she's on vacation for the next week or so. Figures.

So, here we are, on a Saturday night with absolutely no one around who knows how to repair lumens. And the only person that knew how to do it (Terry) did not.

What caused he holes in the lumens? Mike and I deduced that the nursing staff was not careful when clamping the lumens. There's a reinforced area on the lumen where you are supposed to clamp and unclamp. Over a week ago, Mike noticed a nurse was clamping the lumens *not* on the reinforced areas. The lumens are pretty flimsy. If you don't clamp it where you are supposed to, the pinch could easily cause a rupture...like in our case.

So, they had to disconnect all of his fluids, FK506, antibiotics, etc. so that it is no longer going through these compromised lumens. A nurse started another line in his arm for the time being so that he can still get his IV meds in him.

The docs and nurses were saying that they might have to rethread the entire catheter line. You should have seen Mike's face when this was mentioned. He's already had his catheter done twice and the second time was not easy due to tissue scarring (from the first catheter placement). When done, Mike's chest was entirely black and blue. And on top of that, he got a staph infection (which the docs say the catheter was the the likely culprit). He doesn't think his body can handle a third redo of the catheter.

It just really sucks to no end. Here Mike is fighting for his life and doing everything he's supposed to do...then some careless nurse screws things up by compromising his lumens. I hope they can easily repair it, but we've already been told that repairing it is unlikely due to the location of the holes. Alternatively, they can run the catheter up thru his arm. And lastly, they can rethread the exisitng catheter. Of course, we're praying for the simple repair and that no other invasive catheter placements will be needed. We'll get more information on this today.

This is so discouraging when we find out about stuff like this--stuff that could have been totally prevented if the nurses would have been more conscientious. He's trying to keep his spirits up, but stuff like this certainly is tough to get over.