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Precarious Plateau

Journal, Blood, Head CT - 10/06/2009

6:30 AM
Jaymun still is on a very wide and delicate balance of life-support.
The pressure in his head (ICP) pins us down, preventing us from
   ...reducing his osmolar treatment
(high sodium levels to reduce water in brain)
   ...lowering sedation
(we have to keep his brain very quiet or pressure rises)
   ...letting lungs heal faster
(we need to blow off CO2 preventing vessel swelling)
Because of delicate lung capacity we can't increase fluids and    ...maximize colloids
(FFP, Platelets, Cryo to normalize his coagulation)

Consequently we are managing his heart output (contraction) and blood pressure (vaso dilation / constriction) with two drugs (.06 epinipherine and .07 milrinone), and pushing his kidneys with lasix to keep fluids off. Overnight they sped up his ventilator rate to 26 breaths per minute to keep CO2 levels down because the ICP (intra-cranial pressure was rising into the 30s). I stopped the Vitamin E due to coagulation concerns. His vent settings stalled again: 45% oxygen (35/7 pip/peep). His subcutaneous air is slightly worse again this morning. He is on a battery of sedatives ...they are slowly adding methadone into the mix (eventual easier withdrawal?)

Meanwhile his cancer grows in the background, and every day we continue the steroids his immune system takes an exponential hit ...too much longer and it will be depressed for months.

The high sodium levels will take a toll on his kidneys (higher BUN) and we are going to need his kidneys to keep running extra hard to get rid of extra fluids. His stomach/intestines are still not working ...the only other easy way into his blood (other than sublingual) is rectal, so I've been thinking of doing a 1 ounce green-tea enema (green tea protects kidneys). (I have a concentrated green tea supplement - 4 cups worth of green tea in an ounce of liquid)
However, his coagulation numbers are worse, so enemas are dangerous (bleeding)

12:00 Noon
We're taking a "road trip" to get a Head CT. His ICP keeps going up and we are running out of medical options.
Grandma picked up a few things for us this morning ...we have Lavender Essential oil to rub on his tummy. For some odd reason even though he is unconscious he must like it, because his ICP drops by five points whenever we rub his tummy. One of the pharmacists here spent some time last night studying Vitamin E, and advised me this morning that she thinks the studies about coagulation only apply if you are deficient in Vitamin K. And that for a short time it would be ok to overdose him. So I gave him another 300iu dose (sublingualy). Also made a paste of Green Tea powder, Indole-3-Carbinol, and Rose Hips to put under his tongue.

I know this might sound kind of hokey if you are first reading this journal (and I'm sheepishly admitting that I'm sounding just a wee bit like my mother who is probably sitting four hours away up in Michigan smiling inbetween her prayers). But the doctors again had a meeting with us this morning to emphasise that even though pulmonary (lung) edema is no longer the emergency, we are up against a wall with his cerebral edema, unless something changes he won't make it. So at this point we're pulling out all the stops even if Jaymun looks a bit weird with green gunky stuff on his lips.

After all, Jesus used mud and spit to heal a blind guy's eyes
   ...I'm sure He can use green-tea and vitamin E to take care of Jaymun's liver, kidneys, brains, and lungs.

5:15 PM
Jaymun's Head CT showed very little change (which was a relief I guess). No new bleeding - if anything a slight improvement.
(last week's scan compared to today's scan)

His ICP came down this afternoon, and we relaxed for an hour. But now he just spiked a fever, blood pressure started falling, heart rate rising, and he is trending septic again.

We sent cultures. Not sure what is going on.