Monday, November 11, 2013

Day 21: Balancing Act

Each day I get more and more amazed at Krista's progress. Today her white blood count rocketed up from 1.7 to 4.1! That is just incredible... she's already in the normal range for white blood. (Most healthy people have between 4000 and 10000 white blood cells per microliter of blood, and they call this range 4.0 to 10.0). There's not much keeping her back from being discharged now, though it still is likely to be this weekend.

One of those "not much" is that she needs to be able to get enough nutrition on her own. Right now she's being fed through her bloodstream by a constant IV infusion of nutrition. They recently added some insulin to help her process the nutrition better, since her blood-sugar level was a little high. Today they also added lipids to the nutrition mix (apparently that's something they do 3 times a week normally). Instead of all that, she needs to be eating regularly (and keeping it down). We discovered that she's not ready for heavier foods like biscuits and gravy or grilled roast beef and provolone hoagie. But she does seem to do well with cereal, yogurt, soup, and puffed rice cakes (not all at the same time). The rice cakes seem to be particularly helpful to counter the "I need to eat now or I'll throw up" attacks that are continuing. 

We've also noticed that she's reacting to too much pain medicine given at once. She can give herself a small dose of the pain medicine once every 10 minutes and she seems to be ok with that (though it sometimes requires a nibble at rice cake). When the pain gets severe, she can request a boost from the nurse once per hour. Every time she gets that dose now, she instantly vomits without warning. We talked with the pain specialist about this and he agreed to try a lower dose. The bad effect is happening even with today's reduction. Tomorrow we'll try an even lower dose.

The cause of the pain is the very thing that is making her progress so wonderful. That new blood factory is just working so hard it hurts. Often times, it hurts a lot. I did a little research on it and couldn't find anything that they weren't already doing to help her through this pain. The muscle relaxer only takes the edge off, but it really takes pain killer to get through. Hopefully we can find a happy balance between addressing the bone pain and causing stomach upsetness. This inbalance is working against her being able to be discharged.

Another one of the "not much" keeping her her is her physical abilities. She will need to be able to get around on her own a bit better. Today she did really well. She left the room for the first time since the transplant. The physical therapist came and helped her walk two laps around the floor. They want her to do that twice a day, but she was knocked out this evening fighting the nausea/pain battle so we only got the one time in today. We'll try again tomorrow. In the meantime, we bring her to Jesus in prayer for healing.
News about him [Jesus] spread all over Syria, and people brought to him all who were ill with various diseases, those suffering severe pain, the demon-possessed, those having seizures, and the paralyzed; and he healed them.
(Matthew 4:24)

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