7.12.2006

July 12 at noon

Mike is a freaking warrior. They've got his heartrate in the 140-150s, and his mean arterial pressure back up to 90 ish. They are starting to reduce his vasopressors.

What is amazing is that he is responding. He squeezes our hands from time to time, and can give a thumbs up. This is f*cking unbelievable. It means if his brain didn't get oxygen while he was code blue, it was only for a second and the damage may be minimal.

The problem - among others is that his brain is still unable to properly regulate his heart rate and pressure. If they just bring him off of pressors and let him do his thing, he's likely to skyrocket in his heart rate again and drop his pressure. Andrews calls it a sympathetic storm. It is likely that this scene will result in a code blue yet again - and possibly result in damage to the brain. You can't just code over and over and be brought back to life again and again.

So, the plan? Without a "road map" as Dr. Lee, the neuro intensivist (NICU head doc), said, they can't identify a plan (ps: Andrews has nothing but great things to say about Lee). The question is what is going on in his head (The age old mystery of one Mr. Young - even BEFORE the SFT). They need a ct scan. THere are large risks associated with this because he's on a f*cking lot of machines and moving him is sort of a clusterf*ck, but they need to see what's going on in there. Dr. Lee is currently working on personally bringing Mike to CT to get this scan. He made it clear that he doesn't usually do this. It is a special case for him to be accompanying him.

Mike's currently in DIC again (See Monday's post). This means there is a lot of risk for bleeding. He's getting plasma (fpp - 8 units) to help his blood's coagulation factors.

Possible plans: If there are no acute factors (massive bleeding etc) revealed in the scans, then they have an option that could protect Mike's heart and other vitals in the short term. This is to "knock him out" (and no, not with a frying pan as CSM and I quickly had Andrews clarify) - but rather put his brain on hold - put it sort of metaphorically "aside" with drugs - and have the miracles of modern medicine regulate heart and pressure. This will eliminate the possibility of another code blue due to this "sympathetic storm" in his head. However, the central cause for all of this - the extreme midline shift in the brain and resulting pressure and problems in the midbrain and brain stem - HAS to be resolved for these issues to come under control without medical assistance. He can't stay "knocked out" forever. I told Andrews that in order to let him go ahead with this plan, I'll need a timeline and a plan looking ahead over the next week.

The problem with "knocking him out" is that it precludes us from doing any sort of neuro exams on Mike to assess his status. But, as I told Andrews, Mike is like INSANE in his ability to respond in the face of major issues in his head. His exams really aren't that indicative of the crisis in his head right now. You look at his scans and they guy should be dead. Not giving thumbs up or squeezing our hands. So, perhaps, putting our ability to obtain neuro status on hold won't lose us anything at all...

Now we're just waiting for the CT scan. Kevin, Beth, Michaela, Susan, Lonia, and I are here. Sash and Dee were here this am. This is going to be a long f*cking day. But one way or the other, Mike is going to make the call here. Mike's going to decide. It's up to him.

7 comments:

Jalena said...

Thanks for the update, Danna. Those of us who cant be there are checking in frequently. Do whats in your heart. That has worked for you both in the past and will see you through again.

Anonymous said...

Danna,

We are praying for you. He has your love and Baxter's. We will pray that will bring him back. His will is obviously there, I don't think I could have gone what he has gone through and find the strength that he has.

Love,

Jenna, Ed, Mason and Odin

Anonymous said...

Mike's strength constantly amazes me, as does yours, Danna. Thank you so much for taking the time to post the update. The web of love surrounding you is huge...

xxoo
Jessie

Dritsas said...

The fact that you are even taking the time to update this... well, I'm speechless.

I'm sitting here at my computer at home (out of work with a stupid cold) and I wish I could do more than hope for the best.

No matter what happens, you two are, like Jessie says, amazing.

-Dr. Itsas

Anonymous said...

Danna,

My thoughts and prayers are with you and Mike. All of us at Magee hope to see him back soon.
-Irene

Anonymous said...

Danna,
We are sending our prayers, thoughts, and good wishes from here in Nebraska. My heart goes out to you, Mike and your families.
Jenny & Doug Lambe

Coleen (Dougherty) McAdam said...

Hi Danna;

Your strength is just amazing...we are praying for Mike every minute. Please know that so many people are pulling for him. Yes, just brreeeeeeeaaaattthhhee.....

And don't forget to take care of YOU. As a mom and wife, that sometimes loses its priority....

Much love and hugs;
Coleen, Scott, Emily and Cara- and also Pat (Kevin's mom)