Wednesday 10/31/18 continued

So they found the bleed on the scan, it was near her right kidney. She went to the OR around 11am. They also today had a vascular doctor in surgery. If the bleed was a vein they would try and go through it and fix it from the inside. He came out around 1pm and said it was not a vein bleed. It was ooze bleeding all over her abdomen again. They think the spot they saw on the CT was the contrast dye building up in one area. Doctor came to talk with Rob after surgery. She had the oozing bleeding in her whole abdomen. They found an arterial bleed that they fixed. They packed her again and had to undo the closure on the lower part of her abdomen. The top stayed the way they fixed it yesterday. Next surgery is Friday. The plan is to remove packing, drain out any extra fluids. Use mesh to close her abdomen and do nothing else internally. By not touching anything they are hoping things can heal. They will no longer be flushing her abdomen. If she does begin to bleed again they will go back in if necessary. The biggest issue is how weak her body is. They would like to see if not bothering the abdomen at all, with her own immune system and the medication to see if that will get the infection under control. She was given 13 units of blood, 10 plasma and 3 platelets. Meghan is now resting and hopefully a peaceful night for her!

Wednesday 10/31/18

Hemoglobin is now 4.2. They started giving blood in her room. They are going to do a CT of the abdomen so they can find out where the bleed is coming from. They also have vascular doctors now looking into things with the surgical team. If it is a vein they can do a procedure and go inside the vein and fix it that way. They have already given her 3 units of blood and 3 of plasma. She was sent to CT and will continue to be given blood products until they can read the scan. She is back now from that and now we are waiting to hear more info.

Tuesday 10/30/18

Meghan went down for surgery around 9am and was in surgery until 1145am. They did begin to close her abdomen. They have a mesh over the top and bottom with an area open incase they have to go back in for any bleeding. The doctor said pancreas is looking ok but can’t be 100% sure if it is done causing damage. There was no current bleeding and will monitor that for 6 hours. After the 6 hour mark if no signs of a bleed they will begin the medicated flush of the antibiotic fluid. During surgery they did replace the feeding tube in her nose and will have that ready once they want to start feeds again. That will not happen yet but shortly. Meghan didn’t need any blood during surgery. Meghan was resting and just relaxing as best as she can. Next surgery will be on Friday, to try and let things rest and heal as much as they can before going back in. Around 1030pm Meghan’s blood pressure dropped and they put her on a little bit of medication for it. They drew labs to see if anything was going on. Her hemoglobin was 9.2 around 4pm and now is 6.2. They are giving her two units blood and will re draw in 90 mins to watch counts.

Monday 10/29/18

Today was a day of rest for Meghan. The doctor opted to wait another day for surgery with the antibiotic wash out so Meghan can heal internally as much as possible. Damned if you do damned if you don’t with surgery. If they go in too early it could remove any clotting. If they don’t go in the infections sit and can get worse. Her white blood cell count is still rising and back up to 50. Meghan is set as of now to be the first case tomorrow for surgery. 

Sunday 10/28/18

She had a very busy night after again being rushed back to the OR. She is sleeping and getting rest. She will not be going to the OR today because of last night. Mom, Gram and I got to visit Meghan today. For everything she went through last night she looked good. She was communicating by mouthing with us and we showed her the cards that came for her. She enjoyed reading and seeing them. The rest of the day she has been resting. She will go back to the OR tomorrow later in the day for the antibiotic wash out as well as looking & checking for bleeding. 

Saturday 10/27/18

This morning one of Meghan’s drains fell out. The nurse was changing her dressing and it came out, looked like the stitch had come out. Rob also stated that her sponges looked like there was liquid just sitting on top and very saturated. Doctors were paged to come and take a look at her and stat labs were taken. Her blood pressure had gone down and another number they watch (MAPS) was 56. Doctors think she may be bleeding again. Back to the OR 😢 she went down around 1030am. I will update as soon as I have info. Please say a prayer! 

She is out of surgery. She was bleeding again from her right side and they do not know what caused this to start. They could see exactly where the bleeding was and it has already stopped. They have packed it to keep pressure. The drain that fell was not working correctly and that is why the fluid saturated her sponges, it had no where else to go. Bowels looked the same, no better no worse. Overall look they said abdomen looked better due to medicated flushes. So they want to do those in the OR to help assist in fighting the infection. They may do these every 24 hours for a few days. Pancreas looked the same no changes or bleeding in that area. CT results from over night didn’t show anything they don’t already know. Blood pressure is back up and MAPS is currently 85. 

They had a sonogram done to check for blood clots in her veins. They did find a small one by her neck but it is on the wall and she still has good blood flow. They also believe she is having a small reaction to the new anti fungal medication they started today. Doctors told Rob that this is not uncommon since it’s such a strong medication. Next plan is surgery tomorrow. They will be washing her out again with the medicated fluid. Meghan had her bladder scan done since she hadn’t peed. She did have a full bladder. They told Rob the reason she wasn’t peeing could be from the low blood pressure. They thought it would be a benefit to put a regular catheter in so that was placed. She was put back on a little bit of blood pressure medication for now. Meghan had been pretty out of it today and in and out of sleeping. They noticed her coloring was off and she was very pale. Nurses had ACES (her surgical team) paged to come take a look. When the doctors came in they wanted labs stat and thought two possible things 1. She was becoming septic 2. A new bleed. Her hemoglobin has dropped to 2.6 and she started getting blood right away. Platelets have been moving in the right direction and was over 300 and now currently 65. She got already 8 units of blood, 8 plasma and 2 platelets in her room and headed back to the OR. She had a new bleed. It was an area by the pancreas. She got 2 more units of blood in surgery and 1 of plasma. 

Friday 10/26/18

Surgery is still on for this afternoon. During surgery they will be placing an erector spinae catheter. This is for pain medication. The doctors told Meghan that was an available option and she wanted to try it. OT was with Meghan today making changes to her splints for her hands to not be so curled all the time. Meghan had a little bit of a temperature and was given Tylenol for it. Doctors explained to Rob they believe since she has the current infection she may have had a small temperature the whole time but dialysis can cover that up. She went to surgery around 130pm. Meghan’s surgeon did not come up and talk to Rob but another doctor did. All the info they had was that the bowel is still very irritated, however no breakdown at this time. The infection is still not under control. They are switching out her irrigation fluid to a medicated one. She did get one unit of blood in surgery. Also now will only be pulling labs once a day at 4am. Since Meghan is off dialysis they said it isn’t necessary. With dialysis they need to monitor her electrolytes all the time. With her being off the machine they do not need to do this. Meghan is also scheduled for a CT of her abdomen just as a double check for everything going on.