Sunday, July 9, 2006 - evening
[Baxter today at the Christmas Tree Shop. Jae, Kylee and I were looking at baskets on the shelf, and when we turned back around, he had put this basket atop his head. For those of you who know of Baxter's Asian heritage, perhaps you find this vision as amusing as we did.]
Mike’s not looking great. I ran into Dr. Evans in the lobby on my way upstairs. I said hello and he seemed pretty lowkey with me. “I know,” He said, “He looks pretty punk today, huh?”
“Shit. He does?” I said. Evans instantly realized that he spilled the beans because I hadn’t been up to see him yet.
Dr. Evans proceeded to tell me that the swelling in Mike’s head is substantial. The ventricles are a bit smushed (not to be confused with smooshed). Mike doesn’t have a large collection of fluid underneath the skull on the left like last time (in April) – just an average sized fluid collection - but his brain has a lot of swelling. His left eye is completely swollen shut and the right one is partially swollen shut. He’s not very responsive.
I’m actually glad I saw Dr. Evans on my way upstairs. It prepared me for the fact that he’s not looking great.
Evans thinks we need to monitor him closely and just give him time. He doesn’t want to remove the bone flap like last time. Especially because Mike has the v.p. shunt already, which is a nice safeguard against hydrocephalus. He really feels like what Mike needs is to let the dust settle. His brain is not particularly “compliant,” meaning, there’s not an awful lot of give, so “a little swelling in Mike’s brain goes a long way.” Perhaps if we give it some time, and start looking seriously at Mike’s condition towards the week’s end, we’ll probably have a better understanding of where we’re heading.
Also, Mike’s sodium is low (in the 120s) so they are giving him 3% saline fluids. His hemoglobin is low (6.5) so they’re giving him packed red blood cells and platelets. His phosphate is low, so they’re giving him IV phosphate.
Evans also gave Mike an additional med for swelling: Mannitol (25 mg). It’s a diuretic which causes you to pee an awful lot. That will help the fluid retention in the brain as well as bring Mike’s sodium down.
Mike also had a slight fever today – between 100 and 101. If it goes over 101.5, they’ll probably take blood to grow culture to check for infection.
So, Friday night may have been a vision of things to come, but we have a lot of work before we get there. Also, I’ve been thinking a lot about the fact that even if/when Mike gets better neurologically, we have a difficult road ahead. Managing his meds, checking on the regrowth of the tumor and cysts and monitoring Mike’s cognitive and physical status day-to-day for signs of problems is going to be a full time job. Just a thought.
For those interested, here are Mike’s current medications:
Hydrocortisone (steroid to supplement cortisol)
DDAVP (For diabetes insipidus)
Mannitol (New: for swelling in the brain)
Ciprofloxacin (for the UTI)