Evening Update

I was able to speak with MA about 30 minutes ago (took me a bit to write this), here is her preliminary take on the situation:

• She is very impressed with how proactive and cautious the doctors have been at the same time. That proactiveness probably is saving us from a lot of pain, waiting, and close calls that we had last year. She also said she was impressed with the nursing staff.
  (On a side note, I called the hospital to get ahold of her; every person I spoke with knew two phrases: first, they understood, "Do you speak English?" and second, "Just a moment," as I was transferred to someone who did if they did not)
• The intensivist said that they had a really hard time getting the central line into his left side (basically a big IV-like line that all the IV's go into) which was the same deal last time. They were able to get it in, just not where they were hoping to.
• TJ's white blood cell count has been dropping rapidly; 28k when he was admitted, 18k yesterday and ~8k today. 5-6k is normal. This indicates that the infection is under control.
• In the event that he does not have MRSA (not all the cultures are back) they started TJ on another broad-spectrum antibiotic. With the antibiotics he is on, he should not come home with so much as a flu!
• His kidney functions are back to where they were early December 2008, not great but not bad either. Very good in our current situation.
• The doctors said he came in with bacteria in his bloodstream which they believe spread to his lungs, the cause of the sepsis.
• TJ has endured quite a bit of suctioning today and a lot of bad stuff is coming out. This is, of course, a double-edged sword: it is great that so much is coming out, but it is difficult to imagine something more uncomfortable (other than perhaps being intubated).
• TJ's "peep" (vent pressure setting) is at 16 (max, I believe, is 20) in order to keep forcing stuff out of his lungs. In contrast, last time around the vent was set as high as it would go (including oxygen) when he was doing much worse than he is now. This is part of the proactiveness
• The medical staff is going to try to get TJ into a chair today, while being on a vent.
• Tomorrow, depending on what happens today ICT (ICT meaning Thailand time), they are going to try to ween him off the vent. Given that he was intubated 18 days last time round this is pretty amazing.
• TJ is hypercoagulating, meaning that he is clotting faster than normal and is on a Heparin drip for that. They will cut that down after the central line is pulled and essentially treating him for DVT (deep-vein-thrombosis: clotting in major veins, usually in the legs or arms, hence "deep.")
• The cardiologist who has been watching him thinks everything looks good so far (anyone remember a mitral valve problem last time around? Yeah, apparently not there as far as the cardiologist as seen.)
• Finally, the rest of us (MA, Chip and myself) get to have nasal swabs done! Basically, checking to see if we are carriers of MRSA and if so, what strand. MA most likely is, Chip & I are also a high liklihood.
  
  Some 25-30% of people in the US carry a similar form of Staph, about 1% of the overall population carries MRSA specifically. Both numbers vary depending on the geography and population, health care workers are especially high, which is why MA probably has it. While MRSA isn't airborne spread, Chip & I have had enough close contact with both our parents that between TJ (a known carrier) and MA (a lifetime RN) we get up there in terms of probability.

And that is it! What you can take away from this is that almost everything is going well (great, compared to last year!)

You can:

• Give praise for the continued progress. I don't think anyone expected things to be going so well ~48 hours after being admitted to the ICU.
• Pray for comfort for TJ -- again, the suctioning process is pretty painful (a vaccum being shoved down your throat into your lungs).
• Pray for rest, most specifically for MA & Chip.
• Pray for complete healing. That TJ would be fully restored to his younger self (at least by a 14 months, before this started for the first time!)

Thank you all! Your prayers mean the world to our family.

MA Arrived

MA just arrived at the hospital ten minutes ago. No new news, just an FYI that she made it.

There should be some updates either this afternoon or later this evening (as morning greets Bangkok) after my mom has a chance to talk to doctors and the doctors make their rounds.

Brief Update

Spoke to Chip briefly who is at the airport waiting for my mom, NWA.com says the flight has arrived but there is customs and luggage to deal with. I'll post when I hear from her.

Yesterday (last night for those of us in the US) they were suctioning fluid of TJ's lungs most of the day. This is a good thing, but again, incredibly painful. Last time round it was obvious that TJ was in pain even though he was in a coma. I cannot imagine what it would be like to be awake as they shove whatever it is into your lungs.

More good news, the intensivist (sp?) there thinks that they have the infection under control. So that is a huge spot for praise.

Please pray for the pain, and continue to pray for complete healing of TJ.

It's the Bug that Never Ends

Sorry all, I took some time to sleep in this morning. I'll have two morning updates, this first one is from the same guardian of TJ that I quoted yesterday:

We're here in the room with [TJ].

The Docs here in Bangkok are saying [TJ] should plan for a two week stay before they would certify him as 'fit to fly'. [Name withheld] came to the hospital this morning and went over ALL medical files with the Thai Doc. She was very impressed with the quality of the care.

A couple of things came out this morning. First, [TJ] would never have made it to the states. He would have died enroute and all the Docs agree on that. Second, while he is now stable, the MRSA is back and they are throwing antibiotic cocktails into him hoping that something gets it. The first of the dozen or so blood cultures comes back this afternoon. These are hoping to identify the specific culprit in order to try to design something to kill it. It just goes latent in the body until a trigger sets it in motion like yesterday.

This email mostly speaks for itself. I cannot believe TJ came down with MRSA again. If you recall from last year, many people carry it rarely actually develops into an infection. You would be surprised at all the gross and nasty things your mouth carries in it. The odds of it developing twice in TJ are extremely slim, almost nil, as the antibodies should have been built up.

I'll update again when I know more. MA should be arriving in about 15 minutes according to NWA.com