Ron seems to be better today.  He has been able to cough up a lot of stuff for them to suction out of his lung.  He actually has his eyes open a little, and was moving his foot.  Bp was 95/54 when I came in, but after I sat and talked with him a while, it was up to 105/55, as if he sort of perked up. Heart rate is 81-82; peep is 15.  He's still on 50% O2 input, and his O2 saturation is at 95%.  Respirations are 33-35.  His white count is 9.5, and hemoglobin is up to 8.  They have started a new antibiotic, Cefepine, and stopped the Cleocin and Cipro.
 
Thanks, everyone for the prayers and good wishes!
 
Love,
EJ

As of this evening the respiratory therapist said both of his lungs sound better...meaning there is some activity in his right lung now. His oxygen input is down to 50% which is improvement since this afternoon!!! Thanks again for all the comments; mom reads them to him everynight. ~ Laura
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They actually gave him 3 units of blood today.  He's still on the Cleocin antibiotic, and they are adding Cipro.  His left lung is clearing up.  :) White count is down a little at 12.5, which Dr. said is good.  His fever was up a little after the transfusion, which is normal; it was 102*, so got Tylenol for that.  They have him down to 55% O2 input, and all the numbers look good.  Heart rate 91, peep 16, 96% O2 saturation, respirations 29, bp 98/64. Still completely sedated with Fentanyl and Atavan.  They also have him on Lasix (sp?) to get rid of some of the excess fluid. His CVP (Central Veinous Pressure) was up to 21, so started Lasix to bring that down, and next check it was up to 22!  Started giving more Lasix to try to get that down a little.
 
Thank you, Nancy for all your help!  The dogs miss you!
 
Thank you, Dawn for your help letting the dogs out! 
 
Thank you, Jamie for your help with the business!
 
Thank you, Lauren for your beautiful pictures!
 
Thank you, everyone for all your offers of help and supportive thoughts and prayers!
 
Love,
EJ

No major changes this morning but his hemoglobin count is down to 6.6 so they plan to give him blood transfusions today. his O2 saturation levels were down last night a bit but they are back where they should be today.

Not much to report for Thursday, no real change.  They did change his antibiotic to Cleocin.  Lung secretions are still very thick, and right lung is still completely full, and not working.  He is doing the same numbers-wise.  Temp was still around 100* when I left this evening.  BP and heart rate are good.

9:00 am update. Not many changes since yesterday evening. The nurse said his temperature did spike last night but they gave him some tylenol and it's back down to 97.1. She also said he is only getting tylenol when he has a fever- so he is not currently on it right now and isn't running a temperature- which is great! They haven't been suctioning much out of his lungs this morning. The doctors haven't made rounds yet today- we'll update again as we have more.

He was taken off the Nimbex as of 12 noon.  They have upped the Atavan and Fentanyl, from yesterday (when he was actually on no Fentanyl) and he is quiet and looks comfortable.  He is able to cough up some stuff when the RT comes in to suction the tube, which is good to get that out of his lung.  His temp is down to 99.4*, and seems to be staying down this evening.  His heart rate is 109; bp is 135/65; O2 saturation is 89%; O2 input 60%.  His respirations are 28-30, peep 16.  His white count is up to 16.1, which is good because it means he's starting to fight off the infection. Hemoglobin is 7.4, potassium 5.3, which are both a little better.  He is tolerating the tube feeding well, and is up to the ideal level of that.  He is still on the very high levels of penicillin
 
All in all, a good day...
 
Thanks for all the comments; I read them to him every evening.
 
All of the prayers and well-wishes are so appreciated!
 
Love,
EJ 

His temperature is 99 this morning down from 102 from last night. They are still slowly weaning him off the paralytic and he should be completely off it sometime this afternoon.

The comments have not been working for some of you. I have made a change and it should be working now. If you are still having problems please email me at andy.stout@gmail.com to let me know so I can fix it. We really appreciate all your support and want to make it easy for you to leave messages!

They had to change his breathing tube at about 12:15 pm today.  The one that had been put in last Tuesday night at Wood County Hosp. developed a small leak in a part that is like a little latex balloon.  They had the whole room full of doctors, nurses, and respiratory therapists.  The switch went very smoothly -- hardly missed a beat.  He had to be put temporarily back on 100% O2, but they have already backed off to 80%, and his O2 saturation is still up at 96%.  Heart rate is steady at 112, peep is 18, respirations at 26, bp at 102/61, and temp still at 98.8 (which we are very happy temp is still down today.)  The respiratory therapist said having to have the new tube is sort of a blessing in disguise since after a week there had been some build up of secretions on the first one. 
 
He seems to be tolerating the new tube feeding better, kidneys are still doing fine, and they are keeping close watch on the white count (12.1 early this a.m., then 10.9 when retested), hemoglobin (7.3) and potassium (5.7 early, 5.1 when retested, which is a little high,. 3.5 to 4.5 is normal)
 
Dr. said not to expect any major improvement for some time.  This will be a long, slow process of baby steps.  There will be ups and downs like a roller coaster, but they are certain that they are on the riight track.  He will be critical and on a ventillator for probably at least another week or more.
 
Thank you everyone for all your positive thoughts and prayers!
 
Love,
EJ

They had a rough time between 5-6pm last keeping his oxygen levels up, but his numbers look much better this morning.  They had him on 100% oxygen input in the late evening but they were able to lower that to 50% through the morning.  They have to lower it slowly and each time they do his blood pressure, heart rate, etc. fall off a little, then slowly stabilize.  

Right now he is on 50% oxygen input and has 95% saturation which is a huge improvement from yesterday.  His blood pressure is good, his temp is 98.7 and his heart rate is 104.  They also were able to turn down his sedative a bit but he is still on a paralytic to keep his O² levels up.  

Dad has been put back on a paralytic for now as he did not have an easy night with his oxygen saturation. His hemoglobin count is 7.3 and his white count is 9.6 which is a little down but can be due to his blood being diluted. They have cut down his fluid intake and changed his tube feeding to a more concentrated formula. His temperature is still down to 99.6 and they are giving him Reglin to improve stomach motility. Those are all the updates for now ~Laura
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I spoke with his nurse this morning and she said that although they were able to lower his oxygen intake to 50% late yesterday, he did not tolerate it and they had to raise it to 60% overnight.  They had to raise it again to 70% this morning and yet again to 80% when that still did not keep his oxygen saturation up high enough.  She said that anytime they move him, change breating tubes, etc, his oxygen saturation drops.  

He is also not taking the tube feedings well so they may try again today one more time before switching to an alternate method of getting him nutrients.

His temperature is down today which is good.  It is 37.1C (98.9F) this morning conpared to 39.4C (103F) yesterday all day.  

His x-rays still show the right lung completely white and the report from his CT scans from yesterday isn't available yet.  The nurse guessed that they won't be available until later today.

CT technician saw enlarged liver pressing up on diaphragm.  Liver problems might explain low hemoglobin and white cell counts.

IDC Dr.ordered VERY hi doses of pennicillin and diff.bloodtests. Wondering why white count so low.Checking 4 other microorganisms.

CT scan ordered for sinus,chest,abdomen.and pelvis this afterenoon. Also an Infectious Disease Control consult. Temp is still 103º

He is virtually the same this morning.  His chest x-ray looks just the same as yesterday.  His bp and kidneys are still doing OK, which the nurse said is sort of surprising for as sick as he is.  His respirations still go way up any time they move him, etc., and take a while to go back down.  Hope to talk to Dr. today to see what comes next if he's not getting any better.
 
Thank you all for the prayers and good wishes.  They all help.  It is so comforting to have such wonderful friends!
 
Love,
EJ

His triglycerides are very high (in the 1000s)so they are giving him something to bring that down. Temp 101º

Red blood cell count is back down to 7 something, but could be due to dilution from all the fluids he's getting.  

Heart rate 111 

peep 14 

O2 level 94 (O2 input is down to 50% which is better)

resp rate 26 

bp 128/ 77 

9:30 am: He spent the night OK.  Kidneys are still doing fine.  He is still on very high levels of phentenol (sp?) and adavan (sp?).  If not, his heart rate and blood pressure go way up.  They are getting quite a bit of mucous out of his lungs, having to suction the breathing tube more often, which is a good thing. 

It's been a pretty good day- we finally got some news that things are looking up a little.  Ron is still very ill but is stable and not getting worse!  He still has the breathing tube because it is necessary for him to get enough oxygen due to his decreased lung capacity.  He will remain sedated for as long as the breathing tube is required.   The doctors say he can probably hear us when we are in the room but won't remember anything.    

You may notice that some of our entries are brief.  We are adding posts by texting updates through our phones while we are at the hospital.  Some of the updates are his vital stats or blood counts - these are also for Ellyn, Laura and myself so we can keep each other updated as to what is going on at the hospital when we are not there.  

We appreciate everyone's thoughts and prayers and all the posts you've been making.  We will be printing them out and reading them to him as they come in.  

They have him down to 55% oxygen feed from 100% .. He is moving in the right direction :)

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Switching to Adavan /sp? New sedative, less fat in it. Changing over slowly. Also going to start tube feeding.

Heart rate 100.  

peep 16.    

O2 96%. 

Resp rate 24 

bp 112/73

Slight Improvement

Ron's red blood cell count is up slightly (9.5 from 7.4 yesterday) and his white blood cell count finally went up (it doubled from 11.4 yesterday to 22.5 this morning).  These are good signs that the antibiotics are doing their job and that his immune system is finally fighting the infection as well.

His nurse reported that his vitals remained stable overnight

What, Why, When, Where and How

This blog is going to be used for updates on my father, Ron Stout, who is at St. Vincent’s medical center in Toledo, OH with severe pneumonia and a blood borne bacterial infection.

 

The story so far...

 

Ron was admitted to the Wood County Hospital ER on Tuesday, Feb. 17th at 7:00am after being sick for about 3 weeks with various symptoms.  

 

His first symptoms were flu-like, and he was given a weak antibiotic by his family doctor.  After 10 days of the antibiotic, he wasn’t much better.  He was coughing a lot and getting tired often.  He scheduled another appointment with his family doctor and they did a blood test and gave him prednisone (a steroid) because of congestion in his right lung.  The blood test showed that he was anemic (red blood cell/hemoglobin was low) and his family doctor suggested that he be checked for internal bleeding.  They planned to test him for signs of bleeding and sent him home for the weekend.  

 

He went to work that Sunday and Monday but was getting worse.  He went into his doctor on Monday Feb. 16th to tell them that he was getting worse and was worried, and they told him that they might not be able to squeeze him in.  They told him that they would call if they could get him worked in.  They never called him.  

 

Monday night my mother urged him to go to the ER because he was pale and he had a lot of pain in the right side of his chest.  He refused to go in that night, but promised to go in the morning.  That morning, Tuesday Feb. 17th, he was admitted to the Wood County ER at 7:00 am.  

 

They immediately identified the pneumonia and gave him oxygen.  They did a CT scan and saw that his entire right lung was white with either fluid or mucous.  That right lung was not working at all and his left lung was already slightly infected as well.  He was admitted and put in a room at around 9:30am and put on oxygen while they checked his blood and tried to get his oxygen levels up.  The combination of his right lung not working and his low hemoglobin had lowered his oxygen levels to about 80% (very low).  

 

Wood County Hospital moved him to their ICU at around 11:00 am because they were struggling to keep his oxygen level up.  They put him on a CPAP-type machine with a mask to help him breathe.  He was awake and "being Ron" for most of the day on Tuesday with the breathing machine and mask helping to keep his oxygen level up around 92%.  Late Tuesday night, however, he was having to work too hard to breathe with his severe pneumonia so they decided to put him on a breathing tube.  This meant that they had to sedate him and they told us that he would probably remain sedated and on the breathing tube for several days.  

 

Wednesday morning brought us bad news.  The lab at WCH found that his blood had tested positive for the streptococcus pneumonia bacteria.  They had also found this same bacteria in the material in his lungs and this meant that he now had a very serious blood infection that could easily spread to other organs.  They were keeping a close eye on his kidneys because they appeared to be dehydrated but they were concerned that they may be infected as well.  

 

At this point we decided that he needed to be moved to a different hospital.  We consulted with his ICU doctor and decided to have him moved to St. Vincent’s Medical Center in Toledo.  Wood County decided to give him a unit of blood transfusion before having him sent via ambulance to St V's in an attempt to get his red blood cell count up.  They moved him at around 1:00pm on Wednesday and his vitals were dropping when they arrived at St V's.  They admitted him to the St V's ER to get his vitals up and then moved him to their ICU.  

 

He was received by the top doctor in the St V's ICU (he actually oversees their ICU) and they put him on their breathing machine and 2 antibiotics right away.  He has a nurse stationed literally next to his door keeping an eye on him 24/7.  Since Wednesday his heart rate, blood pressure, breathing rate, etc have been stable, but his red blood cell count has still been low (7.4 on Thursday) and his white blood cell count has not been elevated as it should be (it's been 10-11 which is what it should be when we aren't sick).  

 

We will use this blog to post updates.  You can subscribe to the blog to receive updates via email and you can leave comments here as well.  Keep in mind that as he recovers he will be able to read this blog and your comments.