It’s been a rough night. So rough, in fact – I’m still in the middle of it.
It’s almost 3am.
And he’s bleeding. He’s been bleeding for over 2 hours now. A steady volume out of his NG tube. 50, 100, 150, 200 mls of bright, fresh blood.
They gave him platelets at the beginning. He’s getting a blood transfusion now. He received 3 units of platelets Saturday, along with blood and plasma. It’s been less than 36 hours since his last transfusion.
I hold David’s hands. I rub his poor distended belly. I lay my hand on his head and talk softly to him. Shoooshing softly when he rouses, telling him it’s okay, sweet boy, it’s okay. I tell him he is loved and that the universe is waiting.
Waiting with bated breath for him to get better.
He’s not getting better.
I need to stay awake. David needs my comfort, as much as I need his. It breaks my heart when he opens his eyes. Beseeching me to do something. Anything to relieve his pain and confusion. How do I explain to him that I am helpless?
I am helpless to comfort him. Helpless to stop this never-ending disaster.
Tears stream down my face as I talk to him, soothe him, providing what small bit of respite I can, for myself and him. He still calms to my touch, for that I am grateful. He’s been without for so long, I feared it would upset rather than sooth.
Our goal for the day was to get David to pee. And not just pee, but to pee aggressively. He had received so much volume on Saturday, that come daily weight time, Sunday morning, he was up almost 2 full kilos (4.4 lbs). His chest x-ray was a hot-mess. Hazy and fluid over-loaded. They started him on a bumex drip to help his kidney’s along, then lasix and diuril throughout the day to squeeze out more.
And he was peeing, so much he actually soaked a diaper – he’s got a foley catheter in place, so that’s a lot of pee! This morning he was down 1.1 kilos (2.3 lbs). Which is good, but given the amount of blood he’s losing and the fact his x-ray isn’t any better, they will continue with the diuresis.
I slept from about 4am – 6:30am. I woke to the Nurse speaking in hushed tones to the Resident about the non-stop flow of blood. By 7am his total output was well over 350 mls, which is equivalent to a can of soda. From the tummy of an 8 month old babe – that’s a lot of blood. His usual transfusion amount is roughly half that.
It’s going to be a long day.
They will now give him ‘cryo’, a blood product made from pooled donor plasma. It contains fibrinogen, which is found in plasma and helps facilitate the clotting process. His fibrinogen level has been drifitng down and with the significant amount of bleeding he’s having, it’s an attempt to get things under control.
As if things will ever be under control again.
They lab screwed up yesterday and didn’t report the adeno count. It was frustrating to not know. Was it down? Was it elevated? Was there anything to be hopeful about? They’ve already drawn blood for today’s count, so yesterday’s is irrelevant.
Yesterday is irrelevant.
It’s almost 3pm. A full 24 hours after I started writing this. He’s stable for the time being. Although he now has bloody stools, in addition to the bloody NG output. His diuretic dose is pretty well maxed out and he still hasn’t pee’d out enough from the weekend over-load to help his lung status much.In fact, if he should need more blood products tonite, it could push his ventilator status over the top.
Today’s adeno count is back at 1.7 million. Yes, it’s down. I should be shouting from the rooftops. But even this shred of hope is difficult to grasp on to and hold close in the face of everything else.
In the face of this black hole he’s sinking deeper and deeper in.