4 months, 1 week, 6 days since diagnosis
day #26 of current hospital stay
I woke up again this morning to see that Riker's breathing had again deteriorated overnight. I had stayed up until nearly 3 o'clock in the morning and she still seemed great when I went to sleep. The nurse woke me early in the morning to let me know they had ordered another chest x-ray to check for pneumonia again.
To me, she didn't look worse than she had the last few mornings. She was, however, visibly struggling to breathe again. Apparently, her CO2 levels had come back high again. She was definitely not doing as well as she had been when I went to sleep. Why do I ever sleep, again?
When the ICU attending that was on today came in to look at her, he was somber and indicated he didn't like the way she looked. He was very concerned and talked about intubating again. He indicated that it was likely they would today but wanted to first evaluate all the other contributing factors to the decision. He had not seen her yesterday and I assured him that she had looked much worse yesterday morning when she was transferred up here. Also, Riker always looks worse in the mornings and gets progressively better throughout the day. The doctors on the BMT floor had indicated that was typical for their patients.
Thankfully, the NP that was on yesterday was still on today. When she saw Riker, she indicated with obvious surprise that Riker looked much better than she had yesterday. As Riker woke for the day, she threw up and began to cough up the mucus that was sitting in the back of her throat all night. She actually got out some of the bloody flesh that had been falling off and obstructing her airway.
When the doctors rounded and discussed Riker's care, they decided they would wait to intubate her. Riker did not clinically look to be in distress and the airflow was keeping her stats where they should be. They would continue to draw her CO2 levels and keep a close eye on them in case she was getting worse because she was too tired to expel the gas from her lungs properly.
As the day went on, she got better again. She slept most of the day but she seemed comfortable and her stats remained stable. She even sat up and played a couple of times. I swear, a smile is coming soon. Her mouth is bleeding and has less skin hanging than it did before. You can see the fresh baby pink of her mouth showing through. I swear she's getting better.
An ANC was not drawn today but her last WBC was 400 up from 330 and she had an ANC of 40 last night down from 60 in the morning. That's a good sign - the ANC is still present. Labs will be drawn and a CBC will be run again at 4am today and when I get up in the morning I should have updated numbers. I have a good feeling that those numbers will be up. She's so close to day 20 - she's has got to be engrafting right now. Those white blood cells are healing her right now.
....waiting for those numbers in the morning!