Angela continues to be on a roller coaster ride of good days and bad with today being a bad day. She did not sleep well last night despite being give a dose of Ativan. Symptoms were not the source of her restlessness but instead just an inability to get comfortable. Six days of lying in a hospital bed can certainly contribute if not cause that effect.
Doctors are still attempting to determine if there is an underlying cause, aside from damage to her bone marrow that is preventing platelets from being produced. An objective today was to transfuse two units of platelets testing her counts one hour after each transfusion was complete. If there was movement in her platelet count or at least evidence of stabilization than there would be no need to deviate from the current plan however if the platelet count were to drop doctors would proceed with HLA testing (platelet compatibility study)
That was the plan however Angela’s body did not want to cooperate. Approximately thirty minutes into the first one hour transfusion she was overcome by severe nausea leading to a serious bout of vomiting. Once reported the transfusion was immediately stopped and Angela was treated with the best of care.
Doctors are still attempting to determine if there is an underlying cause, aside from damage to her bone marrow that is preventing platelets from being produced. An objective today was to transfuse two units of platelets testing her counts one hour after each transfusion was complete. If there was movement in her platelet count or at least evidence of stabilization than there would be no need to deviate from the current plan however if the platelet count were to drop doctors would proceed with HLA testing (platelet compatibility study)
That was the plan however Angela’s body did not want to cooperate. Approximately thirty minutes into the first one hour transfusion she was overcome by severe nausea leading to a serious bout of vomiting. Once reported the transfusion was immediately stopped and Angela was treated with the best of care.
Unfortunately the entire unit of platelets had to be transfused to validate the study so the exercise proved to be unsuccessful. As the doctors regrouped in an attempt to understand why the transfusion resulted in such a violent reaction Angela was able to recall that she typically receives Benedryl prior to a transfusion of this type. When brought to the attention of the doctors they concurred that this could or would have prevented the nausea. A second attempt at introducing platelets into her blood stream is scheduled to occur later this evening/night with a plan to administer Benedryl.
The most bothersome symptoms are still shortness of breath and headache. Shortness of breath is attributed to pleural effusion (water on the lungs) and the headache is most likely a symptom of high blood pressure.
A CAT scan w/contrast revealed a moderate amount of fluid on both lungs confirmed by an ultrasound. The ultrasound also confirmed that there are pockets on both sides of the lungs where a needle can be safely inserted to remove the fluid. This procedure is scheduled to occur tomorrow pending a safe level of platelets can be maintained overnight. There is some concern that there could be an underlying factor causing the fluid buildup so once removed the fluid will be thoroughly tested.
Her blood pressure is a source of concern (at least to me) but the staff appears to be satisfied that it is stable even though high. Her BP remains stable at 155/93 however it peaked at 178/113 during her vomiting episode.
Headaches are being treated with Tylenol however when I brought it to the attention of the staff that it didn’t seem to be working they administered Oxycodone.
The most revealing comment of the day that describes Angela’s current mood is “I want this nightmare to be over”. Unfortunately we were told this morning that her stay in the hospital could extend another five to seven days. She is getting the best treatment in the world but she has had enough and I don’t blame her. She’s tough but even the toughest need a break.
Not whining about my feelings but observing her battle is the most difficult thing I have ever done in my life. I can’t fix this Angela Bursler but I love you very much we will get through this!
