Jameson's effusion did not grow so he will not being having a chest tube placed today. The intensivist checked it out on ultrasound and the fluid he did find appears to be loculated, meaning there are little pockets of fluid, not just one big one. That makes it much harder to drain. Since Jameson is ventilating well, it isn't worth the risk to go after the fluid today.
The docs are going down on one of his IV
diuretics today. He is peeing great, but his body isn't doing it the
right way. His kidney function is decreased and he is intravascularly
depleted. Basically, the diuretic is pulling the fluid from his veins
and he is peeing it out and his body is supposed to be then pulling
fluid into his veins from all of the extra places he has it to replenish
the veins but it isn't doing that. The edema is still there and he
needs blood to replenish his veins. He has gotten platelets, chryo, and
packed red cells this morning. His body isn't cooperating and it is
hurting his kidneys to dry them out this much. Hopefully his kidney
function will improve now they we've backed off on the diuretic a bit.
coags were all off this morning and the intensivist said it can be
caused by a few different things. Infections can cause coags to go
crazy and so can liver disfunction. I'm really hoping it is just
infection. That liver scares me and so far it has been big but still
functioning fine; that has made the docs scratch their heads, but no one
has been really scared about it it yet. However, if his liver function
is truly diminished, that is another story. The liver isn't something
we can mimic with technology and it would be very scary and devastating
if his disease is causing his liver to fail. We are all hoping and
praying that is not the cause. Again we wait and pray and hope.