CT Results (Last Evening Post?)

Looks like this will be right on time.

The CT showed no fluid in TJ's pleural cavity.* This is especially interesting as the second to last showed approximately two litres worth of fluid. At most, TJ has drained one liter through invasive methods (like chest tubes).

The scan also didn't return any signs of an abscess. This is both good and bad. It's good that there isn't another infection in the lungs, bad in that the doctors are sure that there is a second infection and still can't find it.

Both lungs showed "significant" inflammation which may be either pneumonia or
ARDS (acute respiratory distress syndrome) of which there this is a difference, but I am too tired to go into detail.

Prayer requests would be:

• Rest for the family
• Finding the secondary infection
• And the complete healing of the mitral heart valve

As of now TJ is stable thanks to a numerous drugs, which means he is only kind of stable.

This is probably the last post for the night.

*There actually might be a small pocket of fluid, but this is a might and of little importance at this point.

P.S. Someone asked if TJ was still in an induced coma, yes, he is, and has been since December 8th.

Q & A

Soembody Asks:

I was just wondering if we should also disable our Blogger connections if they connect to certain entities and just use nicknames or if you are not concerned about that?

I had a discussion with someone who used to work with TJ, especially on the issue of internet security. To be honest, the cat is already out of the bag, and I don't think we can get it back in as TJ has been quoted -- with a title -- in a newspaper, and there are websites that have cached pages of him with his current title.

I am not going to tell you what websites these are, but if you know his full name you can Google them and find them.

So no, you can use you blogger entity or whatever nickname you want. At any rate, comments on prayers, etc. are expected for anybody in this condition so I don't see this as being a red flag.

Results on the CT will be up by 6:30 CST, 00:30 UTC (London)

P.S. If you have questions see the link on the upper right column of the page.

CT Finished

TJ has just come back from the CT scan*. He's back in his room, but we haven't heard any conclusive results just yet. We'll keep you posted as we find out more**.

*The purpose of the CT was to check the lungs for the source of the secondary infection that was not found in the heart this morning.

**Getting results may take a little while - the doctors need to assess the scan, and then come talk to us. The fact that the doctors are not rushing to give us information is a good sign for now. So, no worries if this takes a bit. Just pray in the meantime!

Overheard...

One of the cardiologists to another nurse -- not to us -- after the tee, "[last week the mitral valve] was wide open..." It's not anymore! (It's not completely healed yet either)

Kevin writes:

With the clear connection of "issues" coming up at around 3:30am I am committing to pray each day from 3:00-4:00am CST for TJ. Do you think we should put out a call for others to join in concerted prayer at that time? It seems that there is a significant spiritual battle that is happening at that time. (My personal experience has been that this time of day is when the Enemy seems to often be active in attacking God's people.)

We are working on setting up another prayer deal here. Specifically, one of our bestest family friends is working on it.

However, please continue to pray as you are prompted. The Holy Spirit has and will wake you up as needed.

TEE Done

First, Tom writes:

My comment is only a slight correction. The trans-esophageal echocardiogram (TEE) is a long tube that goes part way down the esophagus, but does not enter the stomach. Its purpose is to visualize the heart from right behind the heart, as opposed to the regular echocardiogram which tries to see it from the front of the chest wall where things like ribs get in the way. Check out: http://www.heartsite.com/html/tee.html for some diagrams.

The cardiologist just came back and said that the valves look fine, no abscess. He described the mitral valve leak as "moderate," not severe. (c.f., this post)

One of the doctors confirmed that there is a secondary infection, somewhere. It is the white blood cell count and temperature that point things this direction.

So you can pray that we find it, and preferably, find it quickly. We -- the family, and our closest friends -- are praying that we find it today.

TEE About to Start

They are finishing setting up the TEE and going to start soon. They'll be looking at the mitral valve to see if there is an abscess (infection) there.

TJ will also be going down for a CT scan sometime later today.

His white blood count is up again enough to indicate a secondary infection, but not enough to worry at this point.

P.S. If you don't know what a TEE is, see the newly added glossary to your right.

Morning Update 1

I realized that there should probably be two morning updates, at least to the extent possible. A wrap-up of the overnight and then the doctor's rounds, at least if anything comes up.

Forgive me if any of these thoughts seem disconnected, I got about two hours of sleep and am starting to slow down in the head...

Summary
Jon (me) spent the night, everything went pretty well. From midnight to 1:00am (until I fell asleep) the vitals were just about perfect. TJ's sats fell to a low of 84 (bad) around 3:30am and his fever started rising. To counter this, the percentage of oxygen going through the ventilator was turned back up to 75 (it had gotten down to 60 again yesterday evening) and the cooling jacket* (called a cold jacket in the last post). TJ also got another chest x-ray around 5:15, but it will be partly obscured by the jacket.

Finally, they turned off the food going down the ng tube slightly before midnight. The reason they put off the TEE from yesterday to today was because he needed to be off of the food for at least six hours beforehand.

Vitals Summary
I've actually been writing this post for about the last hour when I stepped out to let them do the x-ray and things have changed in a good way. TJ's heart rate is sitting around 83 bpm (it had gotten up to the upper 90's around, you guessed it, 3:30ish), his temp is 99.7' F, his sats are an amazing 100 (it literally doesn't get any better), so hopefully the O2 will be turned back down to 60 or so. His blood pressure is a little low, but in the "watch" range as opposed to the "worry" range. So compared to some of yesterday's issues, things are much better.

Meds & The Heart
TJ is on a beta blocker to keep his heart rate down, which is not entirely uncommon, I was on one at 21 for a month. He is also on another drug, amiodarone, that is meant to work with fast heart rates to help with the arrhythmia.

Perspective
An extended family member recently noted that on the blog we haven't used the term "stable" it is usually used in the media. When you read "stable" in the newspaper it means someone is doing well over a long period of time, when you read it here, we usually mean that we got the vitals back into a normal range.

Even for us -- the family -- it is easy to start losing the sense of urgency. TJ has been in the ICU for 13 days now, and seems to have fallen into a pattern: relatively good night, crisis at some point during the day, resolution of crisis, rinse, wash, repeat. So I wanted to put up some stuff to put his condition in perspective.

TJ is on 6 drips, that is, 6 different IV's, 6 different drugs. This doesn't include the "food tube" (the ng tube delivering what looks like chocolate milk). He is on a ventilator, of which there are approximately a total 3,000 1,175** in the state of Minnesota (out of 4.9 million people in the state; e.g., not many vents), and in a cooling jacket to control his temperature.

In other words, TJ is a pretty sick dude.


*This is what looks to be a white plastic bubble-wrap type thing that goes around the chest and upper abdomen. Water flows through it at set a temperature (currently 96' F) to keep the body at a desired temperature.

**Correction thanks to Dr. P from Bethel University