Midday Update

Last night was not the best, with Kim feverish, a drop in blood pressure, and a bout of diarrhea. The diarrhea has cleared up, but the fever is lingering, and they suspect she’s fighting a bacterial infection and possibly pneumonia. As a result they’ve tightened down on the visiting and ask that anyone with even a hint of a cough of sniffle stay away, and those that do come in need to gown up. Unfortunately I have a slight cough related to my asthma, so I’m sitting at home today getting my updates from phones calls with the nurse and texts/pictures from Cheryl. It’s almost certain I’m not contagious but to be on the 100% safe side I started taking a Z-Pak yesterday so I should be good for a return tomorrow morning. Needless to say I’m going absolutely nuts not being able to keep an eye on her vitals and talk to her entire medical team myself, but it’s obviously best this way.

The good news is her fluid levels are looking much better, and they’ve taken her off the Lasix (diuretic), EPO (enhances oxygen in the blood) , as well as the propofol (sedative). She’s still got her epidural as well as a fentanyl drip to manage any pain and discomfort, but without the sedation she’ll start to wake up a bit more and become annoyed with the tube in down her throat. If that happens, she may require a bit more sedation, but the team feels she’ll get a deeper sleep without the heavy drugs than she’s been getting thus far. They’re also keeping her ventilator settings stable today, and her oxygen saturation levels are looking just fine. She’s had the ventilator for 6 days now and hasn’t eaten a thing, so it’s time to starting pushing nutrition through a feeding tube so that she maintains her energy and strength to combat the fever.

The number one concern is the fever, infection and possible pneumonia. A blood culture has been sent for analysis to determine exactly what’s ailing her, but this can take a couple of days to turn around. Later today she’ll have another bronchoscopy to keep a close eye on what’s happening inside her lungs, and also a chest x-ray to get a sense of what the fluid distribution is looking like.

Taking a step back, I want to reassure everyone that nothing has happened that’s completely abnormal or unexpected. I’m reminded of when Ki m was pregnant with Jack, and for months we heard all about birth plans, what to expect, etc. Those of you who have kids know that it never actually works out exactly like that, and there’s always a quirk or special case or something that moves the experience in a unique direction. Fortunately these fine folks at UW are trained to expect and handle all those contingencies, and I have immense faith in their abilities to bring Kim to full health in short order.

The other thing to keep in mind is the tricky part of organ transplants is finding the balance between immunosuppression and antibiotics. You want to keep the body from fighting with the new lungs so you lower the immune response, but that makes the body more vulnerable to infections which need to be quickly identified and treated. Again, this is normal and expected, but watching close up is definitely more unnerving than having read about it beforehand. Maybe I should write a book “What to Expect When You’re Expecting a New Set of Lungs”. :)