Karen managed to get a good 5 hours of unbroken sleep last night, which is fairly good for a hospital stay, but as her condition becomes more "interesting" we have more and more people that want to talk to her. So she was barely able to sleep after that and is very tired. Her pain level is still slowly climbing, she's a 5 or 6 out of 10, even with the PCA pump. She's also more nauseous than before, which she thinks might be due to her pain level. No one's offered any other suggestions as to why that might be. Her blood counts are still dropping and her hematoma is still enlarging. This indicates she still has some internal bleeding.
The surgeon says even if the bleeding were to stop now, there's so much blood trapped in the tissue that it would become very hard and take a long time to recover. Having such a large hematoma also presents a chance of infection. He wants to reopen the surgical site, flush all the blood out, and see if they can pinpoint the leak and fix it. If nothing else they would have washed out everything that's built up so far, greatly reducing recovery time. She's being given 2 units of red blood cells to replace what she's lost. After that they will give 2 units of platelets, not only to try and stop the bleeding, but in preparation for surgery. She's still NPO - no food or water. It takes some time to receive all those transfusions and then we're expected to go into surgery sometime early afternoon. Although I wouldn't be surprised if it didn't happen until later in the day.
The palliative team was also here and they are going to up her PCA pump dosage more. There are a couple antiemetics we like that help with the naesua and don't have many side effects, but Karen's been needing something more and they have been giving her Compazine. It knocks her out for hours at a time and she has trouble answering questions or holding a conversation after it's been given, an effect neither Karen nor the doctors like. The palliative team wants to try something called Haldol. The hope is that it won't be as sedating as the compazine.
