Thursday, February 12, 2009

More Waiting

It's getting more difficult for me to say how Krista is doing. The way she looks doesn't match what I would expect from the lab results. The liver specialist, however, says that this is the kind of progress they usually see with liver failure. Her liver enzyme count continues to decrease, and this is a good sign that her liver can recover.

Her digestive system is working well; the liquid nutrition they drip into her stomach is not there when they check later. The ammonia levels are declining as well, another indication that the Lactulose they feed her is being digested. The INR value has fluctuated some, but overall it is also down from yesterday. The liver is not functional yet, so they are watching her blood-sugar levels regularly and injecting insulin as needed.

They put her on a constant dialysis machine this morning that is supposed to be "more gentle". I think that means it's not getting out as much fluid per hour as the other machine, but they can run it all the time so it will get more out overall. While that is going on, her kidneys are also showing signs of slowly waking up. She had only excreted 10 cc's of urine all day yesterday, and today it's been 50 cc's already. It's still really small, but it's a start.

Krista continues on the platelet roller-coaster. At one point, I heard them mention they were at 41,000, but later it was 7,000. Her red blood count is up to 7.4 after 2 pints transfused yesterday (starting at 6.7), but they really prefer her to be over 9.0. They gave her another 2 pints of red blood and 1 pint of platelets today. Thank you to everyone who has or has tried to donate blood and/or platelets to the UCLA Blood and Platelet bank. We don't really know how much longer it will take for the stem-cell grafting to take place, and she is dependent on the blood bank until it does. They are very concerned about infections until then.

Even with the improving lab results, Krista's mental abilities have decreased to where she is completely non-responsive now, at least to verbal promptings. She still has reflex reactions to the neurological tests, though; she just can't make voluntary movements anymore. The liver specialist says that we should expect her cognitive abilities to take a week or more longer to recover after her liver gets to full swing.

Her body began shaking involuntarily early this morning. Even with the shaking, she still passed the reflex tests, though. The neurology team also ran an EEG test, looking for signs of seizures, and I just got word that the results were normal for liver toxicity -- i.e. no seizures. They ran a CT scan yesterday and didn't find anything wrong with her brain (they were looking for signs of bleeding or stroke).

Because of her decreased abilities, the doctors became very concerned about her ability to breathe properly. They installed a tube through her mouth into her lungs and connected her to some machines to help assist with that. They have her on a mild sedative to help with the breathing tube, and she has been resting quietly since then (without shaking anymore).

I can't really tell anymore if she is awake or not, but I talk to her from time-to-time anyway since I suspect that she can still hear me. We have received cards and letters which I read to her, along with Psalms that she had highlighted in her Bible. I'll leave off with one of them. (Ear piercing was a Hebrew custom of indicating voluntary servitude, unlike modern accessorizing. Also, when we see references to enemies in the Psalms, we translate them in our heads to: our enemy, the devil, and his minions.)

I waited patiently for the LORD;
He turned to me and heard my cry.
He lifted me out of the slimy pit,
out of the mud and mire;
He set my feet on a rock
and gave me a firm place to stand.
He put a new song in my mouth,
a hymn of praise to our God.
Many will see and fear
and put their trust in the LORD.
Blessed is the man
who makes the LORD his trust,
who does not look to the proud,
to those who turn aside to false gods.
Many, O LORD my God,
are the wonders You have done.
The things You planned for us
no one can recount to You;
were I to speak and tell of them,
they would be too many to declare.
Sacrifice and offering You did not desire,
but my ears You have pierced;
burnt offerings and sin offerings
You did not require.
Then I said, "Here I am, I have come—
it is written about me in the scroll.
I desire to do your will, O my God;
Your law is within my heart."
I proclaim righteousness in the great assembly;
I do not seal my lips,
as you know, O LORD.
I do not hide Your righteousness in my heart;
I speak of Your faithfulness and salvation.
I do not conceal Your love and Your truth
from the great assembly.
Do not withhold Your mercy from me, O LORD;
may Your love and Your truth always protect me.
For troubles without number surround me;
my sins have overtaken me, and I cannot see.
They are more than the hairs of my head,
and my heart fails within me.
Be pleased, O LORD, to save me;
O LORD, come quickly to help me.
May all who seek to take my life
be put to shame and confusion;
may all who desire my ruin
be turned back in disgrace.
May those who say to me, "Aha! Aha!"
be appalled at their own shame.
But may all who seek You
rejoice and be glad in You;
may those who love Your salvation always say,
"The LORD be exalted!"
Yet I am poor and needy;
may the Lord think of me.
You are my help and my deliverer;
O my God, do not delay.
(Psalm 40)

No comments: