Tuesday, December 09, 2008
Hour By Hour
10 am this morning
These pictures are a good illustration of what recovery from a transplant is all about. They say take it day by day but hour by hour can be a more useful plan.
This morning, William woke up asking for his advent calendar. His stoma had been working, if not overworking, all night and I was all set for a good day. By 10 am, William was in extreme pain, his gastrostomy was pouring out all his medicines plus a good hundred mls of bile and, of course, his stoma wasn't working. He was breathing very fast and bubbly and was in a real state. His nurse came in to do the 10.00 obs to find his oxygen saturations were worryingly low. The physio had come to do some work on his sitting and standing but ended up doing chest physio before leaving him on oxygen and very drowsy. This was all more than a tad worrying. The doctor came in to review him with news that his earlier blood test (gas) had shown him to be very acidodic again ('base -12' for the nurses and medical types I now know are reading this). This explained his breathing and drowsyness.
Sodium Bicarb infusions are magic. Look at how much better he was in the second picture when we were having a good old laugh at 'The Shiny Show'!
Needless to say, William is still pretty unstable and his bowel is working on and off. No feed was started today. The doctors do think he will get there eventually but just needs more time. He has been through a lot over these last three weeks and so has his new bowel. He was back in x-ray and his bowel is full of fluid. There are no obvious obstructions at the moment. It is all just a bit sluggish and needs to wake up and get going. The consultant left our room during the ward round saying 'We'll just have to see what tomorrow brings'. That is the best plan you can get in this post bowel transplant game of snakes and ladders. I am learning that it is even trickier than that. What is happening right now doesn't even necessarily reflect what will happen in an hour or two. I am so looking forward for things to stabilise. We will then, perhaps, be able to begin to move forward.