June 26, 2004

Dear All,


It was 5:00 AM on Friday, June 25th when the phone rang.  All I could think of as I woke up enough to find the phone was that Ivy's nurse was calling.  Unfortunately, I was right.  She told me that Ivy was having such a difficult time breathing that she had called the pulmonary doctor and he decided to put Ivy back on pressure control mode on the ventilator and that it was set back on 100% oxygen, which only got her saturation levels to 93%.


Half an hour after the phone call, Kathie and I were in the car heading for the hospital.  When we arrived, Ivy was totally sedated to keep her calm and try to reduce her breathing rate.  She had become very anxious and was over-breathing the ventilator so much that her saturation levels had dropped to the high 80's on 100 % oxygen.  The heavy sedation was necessary to control this.


All day Friday, they tested everything they could think of.  Ivy was scanned for blood clots in her arms and legs (nothing was found).  Numerous x-rays were taken and found to be the same as the day before.  At the end of the day I think all of the doctors got together to determine what the day's tests had shown them.   The only thing that they could tell us was that Ivy had sepsis, a very bad infection (her white blood cell count was 38000) and that the sepsis was responsible for her decreased saturation levels.


The pulmonologist removed the two picc lines that had been put in Ivy's arms back in December.  They were afraid these might be the source of infection that is plaguing Ivy.  She has had fevers almost constantly since the accident occurred.  He also put in a new central line (to replace the picc lines for access), plus a new A-line to allow arterial blood gas tests to be drawn.  This, unfortunately, had to be put in her femoral artery, meaning that she cannot have her legs exercised for the time the A-line is in place. 


The renal doctor needed the A-line to be able to do ABG's (arterial blood gases) to be able to monitor her Ph and oxygenation levels.  Because of the sepsis, Ivy's Ph is very low and this has dramatic effects on her pulmonary function as well as cardiac and liver functions.  Ivy had blood removed, tagged with radioisotopes and put back into her system so that a scan could be done to determine where the infections may be located.


Last night, Ivy's Ph had dropped to unsafe levels that would alter the chemical balance in her body and cause her additional distress.  Because of this, the renal doctor ordered that the CRRT system be brought back online last night and that Ivy will continue this 24 hours a day until this sepsis is cleared up.  There was a bit of an issue with nursing staff to operate the unit, but this was addressed.


The rad-scan test was performed today, along with another CT scan to check on the pneumo that was found in her upper right chest during an earlier scan.  We are still waiting for the results at this time.  Preliminary talk is telling us nothing we did not already know.  The on-call pulmonary doctor is on his way down to talk to the radiologist who read the films.

Ivy had been on hemodialysis for the four days prior to this incident and we had noticed a gradual decrease in her energy levels during this time.  She did appear to be tolerating it much better than she had in the past, but she was still very tired and worn-out after the sessions.  I can't say that this had anything to do with her set-back, but I have to suspect it may have added to the issue.


We are now right back where we were almost four months ago.  Just on Thursday we were feeding Ivy tomato soup, protein shakes and even ice cream.  This morning Ivy was begging me to give her a drink and I could not even let her have a sip of water.  Kathie and I are devastated with this turn of events.  Ivy is even more distressed than we are…she is very depressed about all of this and it worries me very much.


These have been some very trying days for all of us, but most especially Ivy.  She has been in pain almost constantly and now she can't even have a drink of water to quench her thirst.  Ours heart break every time she asks us for a drink and we have to tell her no.  When she cries in pain, we are devastated to the point of tears ourselves.  We have to wonder if it will ever end.  Moreover, what must be going through poor Ivy's mind…


Please say an extra prayer or two for Ivy she really needs the help.  Your kind wishes, thoughts and prayers inspire us all…God bless every one of you.


With My Best Wishes Always