Sorry for the late update. Just cause one is in the hospital doesn’t mean the other three are any easier to deal with.

A very busy day for Faith with some acting up.

• Infectious Disease (ID) is satisfied with her progress thus far. She still had a positive blood culture but it took much longer than the previous one to grow. This is an indication of a drop in the number of bacteria and how virulent they are. The theory is that there are some islands of colonization in her various blood clots. As the clots dissolve they release bacteria/toxins and since they are clots it’s also harder for the antibiotics to effectively work on them. The short story is she is going to be on IV antibiotics for at least 6 weeks with all the fun of the associated PICC line.
• Fever of 103.1 (Axillary) today. Treated with icy rags (yup just what it sounds like). They also ordered a cooling blanket. It’s a water filled mattress pad that has an external device that can circulate chilled/warmed water to help regulate her body temperature. More kind than icy rags but sometimes old tried and true works best. Two possible causes for the spike were 1) Her paralytic agent (Vecuronium) was just stopped which is known to sometimes cause fever 2) Because the infection is still active she might have these spikey events for some time until it’s fully controlled.
• Much more awake now. She was able to talk a very little bit even with the ET tube in. Her words “Leave”, “Stop” & “Home”. They are afraid her sedation levels are too high to extubate as she might not have the drive to breathe on her own consistently. Our concern is she isn’t sedated enough to remain intubated. She may make the ultimate decision if that tube stays or goes.
• ICU vs. ENT – Our old nemesis “the tracheotomy” entered into conversation again last night sorta out of the blue. ENT is much more confident in a patent airway than ICU. As a “bonus” our least favorite attending (Mr. sit around as she decompensates) is back next week. We are working hard to move to the other unit for that and other reasons. The ENT surgeon spoke with Sue yesterday and will strongly advocate for a non-surgical approach to getting and keeping her airway intact and functional.
• I’m spending at least Friday night and maybe Saturday night with Faith again so who knows what hijinks she will pull this weekend. Historically the kids have always had their most memorable events (code for trips to the ER) on Dad’s watch. Guess they must feel more confident in my ability to deal with their childhood folly :-).