They got Karen back on the PCA pump around 5 or 6pm, and with a higher dosage than before. She's been able to bring her pain back to around a 4 or 5, and seems at least somewhat comfortable. Her heart rate has been somewhat elevated since the surgery, but it's in the mid 120s now. Her temperature was 99.8°F when they tested it last. And lastly, she's has an NPO order for after midnight - which means no food or water.
I guess when they said a doctor would be coming around later they just meant sometime later in the day. A pair of them came in about 10pm. They say what Karen has is a hematoma - a collection of blood within the tissue. They says it's actually pretty common and not something we should worry too much about. They also said her blood counts have gone up slightly since she received the platelets, so that could mean whatever internal bleeding she had has stopped. It could also mean she isn't getting enough liquids and her blood is simply thicker. So they want to make sure she's getting enough fluids. They will reevaluate in the morning, and one thing they may decide at that time is to give her more blood product to help things clot. They also said the NPO after midnight is in case they decide they have to go in surgically to resolve the situation. We asked if they could just drain it with a needle and they said that's one thing they will be discussing with our surgeon, but they want to watch the situation till morning, and want her ready in case surgery turns out to be the best option. They may also do an ultrasound to look at the hematoma before making a decision, but that would also be in the morning. Often times the body will simply reabsorb the blood without intervention. We asked about the increased temperature and were told it's common with hematoma and not a concern yet. The heart rate is probably also related to the hematoma, but other things such as pain or dehydration can cause an increased heart rate.
They're giving her 500ml of Albumin, which is the primary protein found in the blood. If she is dehydrated this should also help pull some fluid back into her blood. Now we wait until morning.
