No Blood Given

The doctor who performed the larger part of the surgery on the 9th came back in from a conference. He was the one everyone else was waiting on. He says since the fluid they removed is sterile, there's nothing urgent happening there. The bigger concern is the air. He said the pain seems to be in the same areas as the air. To have that much air a week after surgery, there is most likely a small leak in the intestines, but too small they can't see it on the CT scan. He says the only way to know for sure is to open her up to see, which is overkill at this point; the body will close small holes just fine on it's own.

He also canceled the blood transfusions. He said the risks and negative effects on the immune system outweigh the benefits, especially for cancer patients.

Lab Results

It doesn't appear the fluid is from a leak in the colon or intestine because it was steril. This means a surgery is unlikely after all, although more doctors are reviewing the results. We should know by tonight what they will do. Until then she's still NPO, so, no liquids.

They've decided to upgrade the blood transfusion to two units.

Back From Ultrasound

They took Karen to a steryl ultrasound room where they extracted roughly 60 cc's from one of two pockets of fluid they found. Lab results will take roughly 1 to 2 hours. It's looking more like a surgery will be necessary. During the ultrasound they also found she's retaining urine, so she's getting a catheter yet again. Third time's a charm?

Blood work they ordered this morning just came back. Her hemoglobin is low and they've decided to give her one unit of blood (450 ml).

Peritonitis

The CT results are in and it looks like she has fluid in her abdominem. They called it peritonitis, and is most likely the cause of the fevers. They will remove some of the fluid with a needle, guided by ultrasound. It will be analyzed to find the content and source. No ETA on when they will do this or when they'll get the results, but it should be fast. Best case scenario is it's just leftover water from the surgery, but that's pretty much unheard of after 7 days. It could also be an abscess or a leak in the colon or intestines. If it's the later, she will need surgery again.

Trouble

What started out as a good night for Karen took a turn for the worse. It seemed like she was finally able to sleep well, but it didn't last. First there was some stiffness and (more) soreness. That was followed by chills and sweats, and then a fever of 103 °F. She seems to have some kind of infection. They're worried it's related to the operation, but they took out the catheter just in case it's a bladder or urinary tract infection. She's able to void without it, so that's good. They took her off fluids again, but she does get to drink a bottle of disgusting contrast for a CT scan.

Scary Night

Karen had an asthma attack last night. She didn't have a rescue inhaler so she had to wait for the nurse to call the doctor and get someone over to do a breathing treatment, which was torturous for her. She was having trouble breathing, but just had to wait. They put oxygen on her immediately and her oxygen levels were ok, but not being able to take anything but a shallow breath really left her rattled. To compound the fear of not being able to breath, they aren't going to give her a rescue inhaler, just regular breathing treatments. They're suppose to negate the need for the inhaler, but the idea of it happening again without her having a rescue inhaler really made her anxious. They gave her something (lorazepam) to help her calm down.

They're not sure what triggered the attack, but it could be pain induced. Overall, the pain meds still aren't cutting it. The only good thing about this is the lorazepam knocked her out, so she managed to get some sleep when all was said and done. She has some visitors coming today but is thinking of telling everyone to wait a couple more days.

Pain Again

It's been a couple days since they halved Karen's morphine dosage, so yesterday evening they took it away entirely. They're trying to get her off the IVs and on oral pain killers. They put her on Norco - which is pretty much the same thing as Vicodin - but it just wasn't cutting it. Her pain level slowly climbed all night long and they eventually had to give her morphine again, but only every couple hours, not as a constant drip. So, once again, it was another rough night.

On the positive side, she was doing well enough that they didn't think she needed the morphine. She's completely off the oxygen. She's eating broths and Italian ice now. Oh, and she's even walking without a walker now. The PT guy "signed off" on her, which means she's free to get up and move or walk around without supervision.