6/30/2008b

Well today Carol stayed pretty stable except for waking up. When she did, it apparently is really freaking her out. They think she may be having nightmares. Her skin on her legs and abdomen was debrided a little and look pink and healthy under the black layers. Her feet have pinked back up the last couple days, which is nice. It may be just me but they seem to do that for a couple days after each time they give her blood. A new ultrasound of her heart is showing that is working normally now. Apparently the last couple weeks ultrasounds have shown it not be functioning fully up to par....but it is now. I think I have met pretty much all the nurses up here, and I think a couple of them read this thing. Thanks for all that you are all doing. Thanks for taking care of Carol and Safiya when we are here and when we are not here. It's very reassuring to know they are in such compitent caring hands. Cheers to the nurses (too many to list at this point).

scott

6/30/2008

Well most of her levels are doing great except for when she wakes up. There has been a noticeable change obviously when talking to her. But when she wakes up, she is in a panic. So the thought today is to get her off the versed (as they can cause nightmares and hallucination...thanks willa) and put her on something else. Heath just told me they are also planning on doing an ultrasound of her heart, not sure why yet, maybe just preventative since her heart has been beating so high for so long (3 weeks tomorrow). Will post more later.

What the heck happened to my yard and Enumclaw last night. I came home to a disaster zone in my back yard?

scott

6/29/2008

Where do I begin today. It's been a great day!! I got here pretty early this morning, and Carol's vitals were all looking good and she was awake sort of. She can shake her head "yes" and "no", so we have been able to communicate with her today. For instance when I got here this morning I asked if she could understand me, and she shook her head yes. I asked if she was ok, she shook her head no. I told her a little bit about the c-section again and the infection and the medications she is on that are making her groggy and imovable, and asked if she understood, and she shook her head yes.

We let her rest for most of the afternoon again, and she kept doing well. Had some lunch with the inlaws. When we got back she was up again, and I started asking her if something was wrong becuase she was grimmacing. I asked if she was in pain she shook her head no. I asked if she was worried about the baby, she shook her head yes. I asked if she wanted to see the baby now, she said yes. The hospital was more than happy to oblige...so we got Safiya in and put them cheek to cheek for a couple minutes, until Carol tired out and went to sleep. It was cool, Carol knew who Safiya was and kind nuzzled in with her. Tear jerker for sure.

As I am typing this in her room, sitting a few feet away. They just gave Carol a shot of Hydrocortisone (a little bit about that in a second) she winced and her heart rate shot up. From a few feet away I can tell her to relax her heart rate is up..close your eyes and try to calm down, and she does it.

The hydrocortisone is just breaking news to me within the last couple minutes. When was I asking about this by they way like a freakn week ago. Anyway, apparently on the 27th they finally brought in someone who ordered a cortisol(one?) level. On the 28th (yesterday) they gave her some (she did great that day) today they just gave her some. She did well when they gave her some last time (although it didn't last that long). So obviously I just asked what did the level say. She seemed a little hesitant to tell me the number but that "it was about normal, but the doctor just want it a little higher." I am not sure if they had checked that out earlier as I had suggested I think a week ago, how that would have changed things.....but I am a little pissed about it. Not enought to ruin my day or anything...but a little pissed.

scott

6/29/2008

Carol had a great day yesterday.....very calm.  She rested alot.  Her heart rate and temperature were down for most of the day...despite the temp outside.  Just about to leave for there, I will try and post some news once I get there.  Thanks

scott

6/28/2008

Carol had another breathing trial off the venitlator that went well this morning. A little less excitement in the room seemed to enhance that a bit. They maybe starting to do that 2 times a day instead of just once. Her feet seem to be taking a turn for the worse, continueing to darken up to the ankle. Her wound from the c-section and other abdominal skin issues seem to be doing well. Watching Finding Nemo with Chloe right now....she is doing good. I haven't seen Safiya yet today, but she is being well looked after by the inlaws. Thanks!!

Scott

Thanks

To all the support people have been showing...THANKS!!!!

It has been more than overwhelming.  Words can't explain how thankful I am.  Carol's reach to people is quite amazing.  

scott

6/27/2008b

Apologies for not keeping everyone informed that well the last couple days.....but there hasn't been much to tell, and life has been busy, and I haven't had a computer where I needed it to update this.

Carol is pretty much the same.  Pressure and heart rate and temp go up and down at regular times almost daily.  She has looked very uncomfortable the last couple days.  They are trying to raise her sedation, and get her off the ventilator.  Hard to see in that sense...but I guess something she has to go through.

Her feet look a little worse today, but that seems to be a daily change.  Sometimes better...sometimes worse.  Her abdomen looks great.  Her right hand looks great.  Her left hand doesn't.  

I am not quite sure why, but the regular week seems to go really well with daily improvements.  But as the weekend arrives, I tend to see a little regression in her, which is super-frustrating.  

I think I am going to spend the day tomorrow with Chloe, since Carol's family is all here right now, and will be with Carol.  nightnight

scott

6/27/2008

So what happened to the 26th?  Did I write the wrong date on yesterdays post or did I just not write one....can't remember...it was a busy day.

Anyway,  Carol had a repeat of a good day.  Little bit of a temp per usual but not as high as it has been.  I will write some more in a couple hours.  Safiya is becoming alot more alert, and staying awake for a greater part of the day.  Before she would just eat and then fall asleep.  

scott

6/25/2008b

So end of day status for all.

All in all, everyone feels great about today.  Her temp and heart rose slightly at 1 oclock about.  Max temp was 101 and max heart rate was in the 110-120 range.  When I was there tonight, her heart rate really jumped when she woke up and realized it's me.  She would try to sit up, blink, etc.  Looks pretty uncomfortable, yet something she has to go through.  They are really wanting to get her off the ventilator by weekend, and it really seems like she could just pull that thing out now, and breathe fine.  Maybe, it's just me but it seems having people in there talking to her really close to her face, and being very emotional is counterproductive at this point.  She seems to understand, and also get emotional.  If I bring up Chloe or Safiya, she sort of starts crying. It's a tricky thing trying to figure out the right and wrong things to say as she needs to spend her energy on getting better.  I think if you are in the room with her, just reassuring her that she is safe is probably the thing to do, at least until she is extabated.  I notice that if I am in there, but out of sight a bit, her heart rate doesn't jump up quite so high...might just be me.  But if you are in her room, try to take notice of that...thanks!!:)

Enough of that, the vascular surgeon came by at my prodding to take another look at her left hand, and still feels she is not stable enough to do anything.  I need to call him tomorrow to get the full scoop on that.

Safiya had a little milestone of a day, gaining another 1.4 ounces over night.  She drank the full bottle on 3 of the 4 feedings today.  Normally she is out asleep after I feed her at night, but tonight she was wide awake for about an hour after she ate..throwing a semi tantrum.  I forgot already from Chloe what that was all about.  Tonight it ended up being a gas problem....I may have let her suck on an empty bottle for a couple minutes...oops.  Sportscenter was on..what can I say.

Chloe was wonderful as always!!!  Thanks for all the support..cards...and everything else.  Words can't explain my thankfulness I have for all of it.

scott

6/25/2008

So a pretty good night and morning for Carol. Around 10 last night her temp went down to 98-99, and her heart went down to the 80's. Those numbers have remained and are staying at that level. Which is great...I haven't scene her heart rate below 118 in two weeks. The nurse changed her pain medication to Dilaudid ( I think that is the spelling) which she seems to be doing much better with. Much less thrashing around, and looks overall more pleasant. Her oxygen saturation dipped abit with the new drug, but appears to have gotten back on track. Her blood pressure was a little lower than it had been yesterday, this morning. They will be giving a bolus of fluid to get that back up. Have a good day!!



Scott

6/24/2008

So the steroid did not do the trick.  

Her blood pressure and heart rate were better if not "rock solid" today.  Her temp fluctuated up to 103 again today.  The doctors and nursing staff are systematically narrowing down what the source is of this.

No blood cultures have showed anything for several days, her white blood cells are normal, and other blood levels are normal.  The nephrologist signed off on her today, so kidneys good.  They did more breathing trials and she did great.

They want to get her off the fentanyl and put her on something else.  She is very high doses of that, and still seems to be in a little pain, thus the switch to something else she "hasn't gotten used to."  this could be a cause.

In keeping with trying to figure out if there is an infection causing the temperatures, they may replace her main iv (which is in her subclavian).  no biggie, but this could be a cause.

Her OB took out her staples from the c-section to check it out.  There was some pretty old looking blood in the wound, explaining the little bit of oozing there from yesterday.  There also was a little bit of fat tissue necrosis.  Which was removed, the surrouding areas around it looked clean.  Tissue samples sent for cultures.  This could be a cause.

I think tomorrow I am going to press for the vascular surgeon to look and see if she is stable enough to work on her left hand. 

The nurses keep doing a great job of changing her dressings, moving her slightly, and inflating/deflating her bed they got at harboriew.  They are feeding her some crazy goo stuff still via her nose to stomach.  Not sure exactly what vitamins and minerals is in that.  There was some question to that end today.  I can find that out tomorrow.  

scott 

thank you

I don't know who all is reading the comments on this blog but i do have a idea as to how many people are reading the blog it's self. Thank you all from the bottom of my heart. Thank you for your prayers, thank you for your visits, thank you for your contributions, tears and smiles. Carol has always been amazing to me, I know very few people how have her innate nature of selflessness and love. I read your comments and cry, not because I am sad but because I realize she has touched so many lives and has so many people who love her too. I look forward to tears and smiles while helping her send thank you letters. Heath

6/23/2008b

Good evening all.  Well I will tell you how the night went, and answer people question from the last post. 

  Apparently, in severe sepsis, your adrenal glands can get messed up and stop working.  They regulate hormones, that regulate inflammation, a bunch of other stuff, Calcium, Potassium, and other levels.  I was racking my brain today as well as the doctors as to why her temp, heart rate etc would still all be super elevated, if there was no obvious signs of infection, and has been on both broad heavy duty, and specific antiobiotics. They also tapered each antibiotic over the last week to decide if it was one of those causing the temperatures.  

So at around 6 they decided to humor me and give her some steroids (similar to what the adrenal glands produce), and what do you know her temp and everything go down for the first time in 3 days.  Could just be coincidence.  Who knows.  Either way good to see the 105 degree temperature from today go away.  

The "sedation vacation" was a success, and they anticipate getting her off of the ventilator by weekend.  She keeps trying to breathe on her own.  She had her eyes open while I was there, I think tried to talk, grimmaced alot, moved both arms and legs (albeit very small amounts).  Her pupils are dilating normally to light stimulation.

The vascular surgeons came by again, and again don't think she is stable enough to do surgery yet.  They did another doppler of each appendage, and unlike the first ones on her legs, they could not detect a pulse near both ankles.  Which sucks, but they said def not definitive of anything.  All four appendages look pinker to Heath and I, and she has moved them, not the fingers and toes obviously.

She gave the nurse a scare today.  Her C-section incision (which is still stapled, as they hadn't wanted to take them out yet due to bleeding risk), started bleeding today.  Blamed it on the Heparin(coumadin) and stopped administering it.  Which kind of sucks for her left hand, if you have been following along. They are going to remove the staples tomorrow.  

I gotta a good look at her whole body unbandaged tonight.  Her left calf has a decent 4 by 1 area which looks pretty necrosed, and is the first area I have seen that will most likely need to be cleaned up and skin grafted.  She looks to be getting a similiar area near her bellybutton.

Safiya got her first bath tonight.  She is doing well.  I took Chloe out to dinner as well after work, so all in all a busy day.  

Hopefully that answers most of the current questions.  Here's hoping her vitals will stabilize with the hormone they are giving her.  

scott

6/23/2008

Hello, I haven't taken the time to write much the last couple days. Apologies. Thanks to all the family and friends who stopped by to check on Carol Safiya this last week/weekend.

Not much new to report. Carol continues to have a moderate fever, and moderatlely high heart rate, and low blood pressure. It is baffling the doctors, and myself. I've reasked about checking her spleen, adrenal glands, and checking her skin for any necrotizing, but they all say these are fine.

She woke up enough yesterday to move her legs/feet. But seemed in pain so they increased her sedation again. I think they were going to try a "sedation vacation" today. For a short time the decrease the sedation to see how she does, and let her breaths some on her own.

I got to hang out with Safiya and Chloe quite a bit this weekend...which was cool. Both are doing well.

scott

6/21/2008c?

Well another day has gone by.  Great to have all of Carol's family and see some of mine today.  Got to go out to eat with some family and Chloe.  Suprisingly Chloe is all about PF Changs?  Who knew?!?  

Carol has done well today, very similiar to that last couple days.  Her routine of blood pressure, heart rate and temp increasing during the day, and normalizing at night continues.  Maybe just trying to work it all out at day, and sleeping at night?  I may have said that already, can't remember.  Anyway,  not much has changed that would allow a surgeon to do surgery on her hand.  I know her finger tips don't look to good on that hand, but I swear the whole hand looks a little pinker today...maybe just me?

So I was mistaken on thinking Safiya would be getting out of there next week.  She is 35 weeks, and they say most likely she would leave a week or two before Carols due date (7/26).  So still 2-3 weels out.  Which is sort of ok with me, but sort of not.  I mean it will be great to get at least 2 of the 3 girls together.  But that will complicate things a bit.  Long term, I will probably need to hire some sort of help....maybe....I don't know.  Someone said to me today, and I think they are right, that what type of help I will need will sort of evolve over the coming months.  So thanks to all the family that have been helping with Chloe, and if anyone has any connections to a good nanny/retired nurse/ Mrs. Doubtfire in the Enumclaw area....keep me in your thoughts:)  

night

scott

6/21/2008b

On a side note I really wish the redsox would play a little better today.:)

scott

6/21/2008

First day of Summer!!! Carol is pretty much the same. On the bright side....kidneys appear to have returned to completely normal function (creatinine and urea levels are normalizing). So hopefully no long term dialysis.

Her temp and heart rate, per normal, are elevated this morning. Her platelets counts are very good. They did an ultrasound of her left arm, yesterday. There is a blood clot from the DIC at about 4 cm above her wrist...virtually stopping blood flow to that hand. It does have some peripheral perfusion/blood flow on the skin. The vascular surgeon decided she is not stable enough for surgery yet unfortunately. I guess the bright side on that is that if that is the only clot in her body, and other major organs have been spaired, it is good, and it could be much worse. They started her on Heparin (Coumadin) last night to see if that may help with that clot situation. Probably not gonna do much at this point, but the probably not going to harm anything either, so why not. Skin is starting to heal abit in the areas it started (her belly and thighs), but it looks "interesting". Her weight has come way down, and at least her face and upper body looks much like the Carol we all know. Heres hoping she stablizes a little more so they can do surgery on her hand!!

scott

Update to Account Information-modified

Carol's Dad and I have received several inquires as to how to contribute to the account that has been set up for Carol Jean and Safiya if you do not have access to a WA MU branch. If you want to contribute and have access to a WA MU branch you can go into the branch and deposit using the " Benevolent account set up at WAMU and it is under Scott C Decker FBO Carol J Decker and Safiya Decker"account. If you do not have access to a WA Mu branch you can go to any bank and have funds transferred from your account to this WA MU account, ask for a receipt for any deposits made. If you would like to send a check, we suggest that you might want to send directly to the WA MU branch where the account has been set up.
Washington Mutual
Harvard Market
1429 Broadway
FCWA0656
Seattle, WA 98122
Please, again if you have any questions, send an email to j2vance@usamedia.tv
Carol and Scott's families appreciate all your support, love, and prayers. Please keep the love and prayers coming.
Jim and Judy Vance

Contribution Account Has Been Set Up-modified

Dear All:
Due to everyone's desire to help Carol, Scott, Chloe' and Safiya an account has been established through Washington Mutual. All contributions are considered as charitable and thus are tax free. Contact any WA MU Branch and reference account for Carol Jean Decker and Safiya. Please email j2vance@usamedia.tv if you have any questions regarding this account.

Benevolent account set up at WAMU and it is under Scott C Decker FBO Carol J Decker and Safiya Decker

Thank you for you love, prayers, and support
Jim and Judy Vance

6/20/2008

So Carol had a slight fever and low bp until about 8 this morning, and has since mellowed down, and is looking good. I think am going to write about some of the not so pretty details here, so if you think it will bother you, just know she is doing well and I am having a vascualr surgeon look at her today, and end your reading here.







I called a vascular surgeon today becuase I want them to check on her left hand/wrist. It hasn't really warmed up and is still sort of blue, but normal color in other areas. All five finger tips are black and shrinking in size...she will lose the tips according to the surgeon. I conviced him to do another ultrasound of her entire left arm to check for blood flow, and see if surgery is a possibility if needed, since she is semi-stable and may be able to tolerate now if needed. That would be some sort of arterial surgery to reconnect blood flow if that's the issue. She will be losing a good portion of her right ring finger. He doesn't know about the other digits...he said the rest may come back even though they are a little dark...only time will tell.

Enjoy the sunshine!!

scott

6/19/2008b

Well

1.ct scan....check no problems

2. feeding tube ....check no problems

3. bandages...check overall skin looking better.

4.still a little temp..maybe from medicine(antibiotics?)

Carol woke up for the first time tonight......she knew who I was and understood what was going on I think, maybe too well.  She woke enough for us (her dad, step -mom, heath, nurse, and I) to tell her the baby is doing well and Chloe is also.   They sedated her again after I got done talking to her.  

scott

6/19/2008

Same issues today as yesterday. High temp (103) and hight heart rate. On today's agenda
1:00 FULL BODY CT SCAN (LOOKING FOR OBVIOUS INFECTION, ABCESS, ETC)
2:00 FEEDING TUBE FOR SOME SORT OF SHAKE LIKE FOOD (UPGRADED FROM YELLOW LIQUID DIET.......UGH)
3:00 FULL BODY BANDAGE CHANGE

Busy day for me, I woke up at 1 in the morning remember I work at 7 on thursday, not 8. Safiya is good, but her nurse on the second floor now cares for 4 babies at a time, so not the same 1 on 1 as before.

I think someone asked if the girls could be visited. Carol can be seen anytime pretty much. She is on the 6th floor ICU at Swedish.

Safiya can be visited anytime except between 7 and 7:45. But I, or Carol's mom have to be with you. Hope everyone is having a good day!!

scott

6/18/2008b

Well it's late and just getting in.  Carol continues to do a little better each day.  The doctors said today was a bit of a struggle controlling her temperature, and heart rate.  It was 103 degrees most of the day and 140's for heart rate. They are really starting to get concerned that they can't find the locale/focal point of the infection.  

As I said ( I think I said) they were going to pull some fluid from the membrane around her lungs.  She had a lot........about 600 ml on one and about 800 ml on another.  After pulling that her temp, and heart rate almost immediately went down to normal levels.  But the fluid didn't look very (sorry for the icky word) pussy, just looked like edematous fluid.  Bacteria cultures on it I am guessing will take another day or two.  

They are thinking another CT of her colon, to see if something has started up there.  As most of you know, Carol has ulcerative colitis, well, I would write more about that, but I think Carol might say that is getting too personal:) anywho......

To answer Stephanie's question about the spleen. I think they think I am just being intrusive a little about suggesting it.  Rightly so, I would think the same. The ultrasound showed nothing, they say.  But I don't think a hypofunctioning spleen would show anything on a ultrasound or any other imaging scan.  A hyperfunctioning would I think...I could be wrong, feel free to correct me nurse practitioners and md's that may be reading.  I think a very specific blood test has to be done, and even then it's kind of iffy.  But, I really, really, really think I am right.  Not much to do about it if it is, except that it explains things, which may be why they are trying to rule out everything else first.

Safiya was moved out of the nicu to a different floor for kids who are on their way.  They say she will probably be ready to go in about a week and a half.

thanks again for reading this tirade....I am amazed at all the people that I and others have run into saying..."oh I read the blog....our thought are with your family"  THANKS!!

scott

6/18/2008

Hello all!! Carol continues to do well. Big issues this morning....
Her blood pressure was extremely high (140/8osomething)? they gave her something to bring it down. Her temperature is high (103). Ultrasound show considerable fluid in Pleural Cavity , and they think the blood pressure and temp are related to that somehow? That's being relayed to me, so I am not sure how that all would equate to eachother as of yet. In anycase, they are going to remove that fluid somehow. Guessing that means more needles.

I will write more as I hear it!!

scott

6/17/2008b

Our favorite nurse (Jaqui fron Boston) is on for the evening...so Carol is in great hands.  Carol is doing great....peeing alot on her own without dialysis. The nephrologists are pleasantly suprised.  Her lungs are doing better as well.  Her skin looks ok.......the vascular surgeon is very hopeful on all of it except one finger so far.  Her pupils seem to be constricting when exposed to light now.

Safiya is taking like 32cc of bottle fed milk per sitting.....alot.  She screams about 10 minutes before her feeding time...until someone holds her, and then gets quiet.  I think she knows if she screams she gets food...at least that is what the nurses tell me.

Go Celtics!!!

scott

6/17/2008

ok, so busy day for me. First day back at work. I am living in Seattle for the forseable future, so saw the girls in the morning, then drove down to work.

Carol is doing good again today. Her dialysis machine began leaking again this morning at 4 am. This is the 2nd time this has happened, and all the nurses are a little baffled by it. The decision was made to stop the dialysis. This has seemed to be beneficial becuase she is peeing very well now, which was the worry that she wouldn't.

Temp good, circulation good. the vascular surgeon came in this morning and moved the dialysis line just in case they needed it, and got some special topical burn cream for skin for her, and come special vascularizing gel for her fingers and toes, that may help with some of the gangrenous fingers and toes.

Doing a little research of my own, since I could finally get to a computer, this morning. I really think this all has started with a spleen problem. A hypofunctioning spleen (not working). This is not too uncommon in a patient with ulcerative colitis for 10+ years. Hyposplenic patients have a high incidence of septic strep pneumonia infections. It would would be very rare for an otherwise healthy individual to aquire an infection of this type. So I suggested that they check that out this morning, so they are going to take a ct scan (which might not really show anything), and check her blood for some chemical that would indicate a spleen problem:). I really think this is what has happened, all the symptoms seem to match up, plus her going to the ER the week before with severe left posterior flank pain........who knows...we'll see

scott

6/16/2008b

So to answer a couple questions first. She kept waking up....grimmacing may be a better word, when moving her. They wanted to keep moving and changing out her dressings on her skin to prevent bed sores, and other issues. They have since given her more sedation so that she won't do that anymore. But they were going to originally lighten her sedation for a little bit, just to make sure she was still having brain function...which she does since she is moving a bit.

No big changes to report....we/she just needs to keep on keep'n on. Minor temperature again, but managed with ice around the head. A vascular suregon may be moving her dialysis line. He initially put it down by her groin in the right femoral, but probably will be moved to her neck. The skin where it is, has kind of sloughed and they are afraid of getting a secondary infection down there, and possible that is where her mild fever is coming from.

The nurses got some connection to some burn supplies from harborview. Her skin has sloughed pretty much and it appears it is just the top layers of skin effected. So they got a special burn wrap/dressing from harborview that only is changed weekly. As opposed to every 5 hours or so, as that is how it's been for a few days. The hopes is that will all heal with no grafting needed. A plastic surgeon still has not consulted yet. Hopefully tomorrow.

She officially lost 1.3 lb's today, which is great becuase she gained about 10 lbs of liquid weight since being here. I got to wash and brush her hair tonight....don't want dreads when this is all over. Although that would be kind of cool.....

I remebered to finally call our pediatrician...Carol used to handle those details...sorry. She is in great hands where she is he said. Funny guy, brilliant, but wears different colored socks kind of doctor...if you know what I mean.

again thanks everyone!
scott

6/16/2008

Well another night has passed. The intensivist seems to want to get a vascular and plastic surgeon involved today, and have them heavily way in on Carol's skin, fingers, and toes. So I'll let you all know on that.

She slept well, and is still stable as far as all her numbers go. They are talking about doing an MRI of the brain, to check for clotting up there, even though everyone is convinced she is functioning well up there becuase she keeps waking up.

Well off to meet the pediatrician with Safiya. She is actually gaining weight, and taking a bottle now, and looking alot like Chloe did when she was born. Carol and I were desperatly hoping for a mellow kid, but I have been informed by the nurses and doctors than she is very opinionated and much like Chloe, if she is not hungry for what she is presented with, she will throw it......

scott

6/15/2008 #2

All in all a good day. Carol eventually stabilized everything again today. Her temp is down, her blood pressure is up without meds. Her breathing is good, and she keeps trying to wake up, but they don't want her to yet, becuase of the amount of pain she will be in due to her skin sloughing.

For the first time, several of her doctors said tonight that she might make it, versus they don't know if she will make it. YAY Night.....

Scott

June 15th, 2008

Today is kind of a yin-yang day. Late last night Carol was able to stop having her blood pressure supported by blood pressure med's, and keep it high enough on her own. She is "grimmacing" when we move her, and moving her head when I hold her hand...all good signs.

Today her temperature is slightly elevated (102 degrees), and her heart rate is a little tachycardic (fast). They are not quite sure why yet, maybe just the internal inflammation causing it. They are looking into it. Her blood levels dropped again, so she is getting transfusions, and platelets for clotting...all not great signs.

Her right arm, and both legs are getting nice and warm again, good sign that blood is getting out there again. Her left arm is staying pretty cold for some reason. Maybe a clot somewhere, they are checking that out as well.

So a couple steps forward and couple back today it seems. Will keep you posted. If have questions on anything...feel free to ask.

Scott

June 10th, 2008

So here is the play by play so far. I will try to sum it up as briefly as possible.

On Tuesday the 10th, I took Carol up to Swedish becuase she had been having a mild fever for a couple days, and she was going into early labor. Contractions every 3-5 minutes. It was apparent when I came home from lunch on Tuesday at 1, that I needed to take her to the hospital again.

Carol was in the hospital 2 weeks earlier for a suspected kindey stone, but never confirmed. She had been having extensive debilitating back pain, and maybe a uti ( hard for her to tell while she is pregnant for some reason). In anycase, we eventually got her home, and she seemed to be ok for a week. She still wasn't great, but we figured she was just 7 months pregnant and very uncomfortable from that.

The weekend before taking her to the hospital, she had been getting sniffly, and having a temp of 101-103. Doctors were called and we thought she just had a mild fever...take tylenol and bed rest. On Monday the 9th, Carol began complaining of severe body pain all over, not localized at all. This went along with a mild fever.

So Tuesday the 10th she has 103.7 temp, sever body pain, and contractions, we decide to take her to swedish.

Call the OB on the way, they just want her to come to their office next to swedish. Checked her, having contractions every 5 minutes but the dialtion. They immediatly scoot her to the delivery triage at swedish, who immediatly get her a room and put her on a monitor. The hospital was trying to get ready, so waited there for abit together. She was in horrendous pain, and going to the bathroom every couple minutes, and began complaining of big abdominal pain. She asked for pain medication, which she never does, they cam in with some Diluaded? I seem to remember.

After a couple minutes she began to get quiet, I figured the medicine was working so I called Carols mom to fill her in. All of sudden there are many nurses and doctors in the room, putting oxygen on Carol. Carol is awake but not responsive to me. They check her cervix and is now 3 cm dilated. They recommend a c-section.

Safiya was born about 10 minutes later at 4:51 pm....4.15lbs....17 3/8 inches. She is doing great, breathing on her own, and suckling a pacifier, and trying to eat from a bottle, but not very successfully yet.

Carol is in surgery for another 2 hours...apparently her blood pressure dropped severly. Enough that several drugs had to be used to keep it up. She was then trasnferred to the ICU, at about 7:08 pm. Where she has been since.

The details of the next few days are lengthy, but I will sum it up. The rest of that night was a battle to keep her blood pressure up, which they did by about 3 in the morning, but with several vasopressor medications. A very critical situation still. (her bp is fairly stable now, and they are trying to ween her off the med's to see if she can sustain it).

The 11th was also a very critical day. She spent the whole day fighting a fever that was generally at least 103 degrees, and for a couple hours was around 106.9 degrees. She had ice baths, blankets, etc. That is now stable at 98 degrees. Late this day, she was placed on dialysis continuously. She was not clearing any of the toxins in her body, and getting very chubby from all the fluids they are pumping into her.

They also identified what is wrong with her.
She has a Streptococcal Pnuemoniae infection. A septic infection...the worst.....with all possible complications. All major organs have been effected including her skin. The scariest part of this, is a syndrome called DIC. This has effected they way she clots, and bleeds. It's fairly complicated, but she clots where she shouldn't, so when she bleeds somewhere, all her clotting factors have been used up, so she bleeds.

This has made putting in every needle, tube, etc. very dangerous. All the clotting over her skin is starting to "boil". The hope is that these spots are just on the top layer of her skin. If they are deep, it would be like she had been on fire, and will need to be transferred to Harborviews burn unit to deminish chanced of a secondary skin infection.

On the 12 and 13th, Carol has had some improvement. We like the upward trend, no matter how small it is. The goal for this weekend is to continue (I finally figured how to unbold it :) ) losing fluids, and maintain her blood pressure. If that is successful, they want to reduce some of her sedation (oh yeah she is not in a coma or anything, just general anesthesia...versed and fentanyl for the savvy) and see if we can get a finger to move or anything.

I will post more later....thank you all for all the support. It means the world to me, and I think it means so much to Carol.

Synopsis

Erin is typing this so here's a synopsis of Carol's state as of 6/14/08 to the best of my knowledge. Scott will add to or correct anything he needs to shortly.

Carol is at Swedish Hospital in Seattle in their Pediatri Intensive Care unit. She is unconscious due to a combination of pain med and another drug. This way, she isn't feeling pain nor wanting to tear out her ventilator or feed tube. She was admitted there on Tuesday the 9th in the afternoon. The doctor's did an emergency C-section around 4:45 pm or so because Carol and the baby's blood pressure dropped very rapidly. Carol stayed in surgery until after 7 pm because the doctors could not get her blood pressure stable. That night she had a CAT scan to see what is would show. It ruled out a perforated colon.

The following day, Carol's temperature spiked at 106.9 F so the doctors wrapped her in ice blankets to help bring her temperature down. Later that evening, it had come down to around 100 F. She started showing signs of DIC. That is when the body trys to fight the infection by sending clots to places that don't need clots. Eventually there is no blod flow to those places so the skin necroses (or dies) and begins to slough off. This also means that when she does bleed (i.e. scratch from inserting a feed tube) she doesn't have the clotting factors to stop the bleeding, so she bleeds a lot.

Carol started dialysis yesterday (6/13/08) because her kidneys are now starting to fail. They started to fail due to low blood pressure or flow. It is also why she is so edematous or swollen. The dialysis is helping with Carol's excretment and diminishing water retention. There is a 20-30% chance Carol will need ongoing dialysis after this is over from permanent damage to her kidneys.

The doctors have not given an estimated time to expect Carol in the hospital. It could be from weeks to months. So prayers and positive thoughts for Scott and the many doctors and nurses that work with her are always welcome.

Since all this Carol has had both her leg's below the knees amputated, her left arm below the elbow amputated, her right ring finger amputated; and is now blind. All of that is due to ischemia from vasopressive drugs used to keep her blood pressure high enought to survive.

On a different note, Safiya (say it phonetically) Christian was born on June 10th around 4:45 pm! She weighed in at 4/15 lbs. I don't know how long she is but she is BEAUTIFUL! She has Chloe's lonf feet, toes and fingers. She doesn't have nearly the head of hair that big sister had when she was born, but Chloe had a little while longer for growing it! Safiya is doing well in the NICU at Swedish Hospital. She was on the ventilator but I think they have her off of it. She has a bit of rapid breathing but I think that is ok. Scott will need to update us all a little more on Safiya's progress soon.

Introductions

This blog has been set up for Scott and Carol to help all of us learn about and try to understand what Carol is going through on a daily basis. It was set up so Scott could put all pertinent (and nonpertinent is he wishes) information so he doesn't need to repeat it 40 times each hour. We love all the support everyone has given the family during this trying time for Scott and Carol. I hope this helps Scott find more time for Carol, and I hope it gives all of us much anticipated updates. More is coming as soon as Scott can get it on here.