ICU update - day 12 - 100 Days in the Hospital

This is an anniversary I hoped never to celebrate.  Since being called up to UW Medical Center on February 13, Shirley has now spent 100 of the past 114 nights in the hospital:
--19 for the initial transplant (actually 18 post transplant, plus the night before as we waited for the operation)
--61 days due to the infection in her incision
--And now we are at the 20th day for this latest round which has included the removal of her gall bladder; unknown infection - probably in her abdomen; likely pneumonia; acute respiratory failure; ICU delusion and now injury to her kidneys.

This is not the recovery we signed up for!

The frustrating (and yet fascinating) thing about the last few weeks is being witness to the incredible balance that is the human body.  I'd listened to doctors debate the trade-offs:

• Too much fluid causing pressure and potential lung damage vs. negative impact to the kidneys cause by aggressive diuretics.
• Pain control for Shirley's obvious discomfort over limiting the factors that may be impacting her current mental state.
• Whether to administer contrasting fluid to aid in radiological diagnoses vs. the potential damage the contrast can do to already weakened kidneys.

Here's today's update:

Breathing and lung function continue to be doing well.  Hooray for small victories!

They did another CT last night (without contrast) do see if there were any identifiable issues.  Radiology found a pocket of fluid that caused them some concern.  After much deliberation, they decided to draw off some of the fluid by inserting a needle into her abdomen and then collecting the pressurized fluid in a bottle.  This procedure relieved her of 750 cc (that's a wine bottle) worth of fluid.  They termed the fluid "bileous," meaning that there is some sort of leak in her digestive track.  The general surgery team is now consulting with the GI team to determine next steps.

Pain control is becoming an issue as they attempt to steer Shirley away from narcotics because it can add t the delusions. Unfortunately, she is not yet speaking, nor will she point to specific areas that are painful.  She just has this very sad/distressed look all the time.  They switched her over to Lortab for pain control and are giving scheduled doses to try and give her some relief.

Renal challenges continue.  Blood tests show continually rising levels of certain toxins that would normally be filtered by the kidneys.  They are now very focused on minimizing impact to to her kidneys as they outline her treatment plan.  There was a consult with Nephrology today to get their input and advice.  Tomorrow or Sunday they will let us know if it makes sense to put her on dialysis while her kidneys heal..