I'm tired of late night weekend excitement

1:30 AM Sunday morning

Hi,
Well, we started out the day with a desperate need for dialysis. Eric's BUN, potassium, and phosphate had increased very quickly overnight, so they did the fast dialysis on him to return him back to normal. He also had a temperature of 101.3F, so the doctors decided not to try to wake him up until he had stabilized a bit more.

We had a fairly quite day until around 7 pm. He started having trouble oxygenating, so we had to increase his ventilator settings to 50%. Then his temperature started spiking more until it reached 102.4 F. As this was happening, we couldn't slow down his heart rate and his blood pressure started bouncing around and trending down. They ended up stabilizing him with some more meds for both the heart and the blood pressure. Then he started having more trouble with the pressures in his lungs (the volume of air needed to ventilate and get oxygen in was resulting in very high pressures again... approx 40 cm H2O). All the while, we were dealing with a resident who we were not very confident in.

I basically argued with him for 20 min telling him how the ventilator works (he was somehow thinking that pressure and volume worked independently from one another regarding CO2, and would NOT let the subject drop). And then every time he would talk to us about a course of action, he would switch to a complete opposite plan mid sentence. Needless to say, both Sara and I were a bit on edge and feeling like we needed to second guess everything he did. End of story, 5 hours later he has relatively normal stats:

HR: approx 100 bpm (on the heart rate medicine)
Temp: 97.5 F BP: 127/57 (on the BP medicine)
O2 saturation: 97% (ventilator set at 60% O2 and 5 PEEP)

The only concerning thing is that his lungs are still requiring a lot of pressure. Hopefully now that everything else is more under control (and he's back on slow dialysis), they will slowly get better. They are also planning on starting ativan (the 3rd sedative, and longer lasting one) again.

I have a feeling that since his lungs are so susceptible to any change in his body that they may opt to do a tracheotomy. We'll see in the morning. I'm really hoping that things continue to settle down.

(Oh dear, that doctor just walked in again... I think we've determined that he just likes to talk, despite whether or not he knows what he is talking about)

Love, Melissa

P.S. Sara updated the graph below with the past 2 days blood count results. Click to enlarge.