Sun, October 17, 2010 - Day 13, Dianne is Home

Dianne arrived home from the hospital and plans to stay home the next few days.  Her energy level is pretty low.

I tried to do a better job at keeping the house picked up so she didn't feel the urge to come home and starting cleaning up.  She headed for the shower soon after we arrived home while I headed outside to do the fall pruning of our trees and shrubs.

Dianne has been at the hospital 29 days since June 7th, including 8 days in the ICU and 1 day of outpatient surgery.  See the 2010 Overview.

We appreciate everyone's support, thoughts and prayers.
-Jeff

Sat, October 16, 2010 - Day 12

9:30 am

• Dr. Tangle arrived at 6:30 am and told Dianne that things were continuing to improve and that she would probably be able to go home tomorrow.
• Dianne said that she slept well last night but she continued to sleep most of the time since I arrived at 7:00 am.

11:00 am

• Dr. Gill said that things were looking really good and that tracer blood cell test done by the nuclear medicine team looked normal.  Also, said that her lungs were improved from previous test & that she should be able to go home tomorrow.
• Dianne's bladder seems to be overactive so a urine test is being done.  Hopefully, this wouldn't affect Dianne's ability to go home.

Fri, October 15, 2010 - Day 11

3:00 pm

• Dianne has been doing a lot better.  Sunday is the new target for going home.
• The nuclear medicine team did not find anything abnormal in the white blood cell tracking.  They did another scan today but the results are expected to be the same.

Thur, October 14, 2010 - Day 10

9:00 am

• Dianne is doing much better today & will be moving from the ICU into a regular hospital room.
• The MRI to evaluate the flow of the Indium-111 tagged white blood cells is scheduled for sometime between 11:00 am and noon but we don't expect to know any results until tomorrow.

Definition of Indium-111:
A cyclotron-produced radionuclide with a half-life of 2.8049 days and with gamma ray emissions of 171.2 and 245.3 kiloelectron volts. In a chloride form, it is used as a bone marrow and tumour-localizing tracer; in a chelate form, as a cerebrospinal fluid tracer.

Wed, October 13, 2010 - Day 9

10:00 am

• Dianne seems to be better today.  Her temp was down when I arrived at 6:30 am, but then started to rise.  She ate some food for the first time since breakfast on Monday.
• Dianne started on prednisone this morning.  If I understand this correctly - the prednisone could feed the infection but will fight the Lupus.  
• The Labeled White Blood Cell Scan has been started.  Her blood is on the way to Denver so that the white blood cells can be tagged with radiation. Later today, they will re-inject the tagged blood and then do a MRI to determine the path of the white blood cells.  This will help determine the location of the infection.

7:30 pm

• Dianne improved throughout the day as her temperature came down to normal.
• She had a very small breakfast and no lunch, but then sent me out for a Red Robin burger for dinner.
• They kept her in the ICU today, so hopefully they'll move her to a regular hospital room tomorrow.
• The 'nuclear medicine' team arrived today, extracted blood, tagged with white blood cells with radiation, then re-injected these 'special' white blood cells back into her.  They need to wait for 12-24 hours before they can scan her to see where the cells go.
  

Tuesday, October 12, 2010 - Day 8

9:30 am

• Dianne remains in the ICU.
• Dr. Tangle stopped by and mentioned that her blood cultures are all coming back negative, so they aren't growing anything, which would show an infection. They did do another series of blood cultures yesterday at the peak of one of Dianne's episode.
• Dr. Gill (infectious disease) has ordered a Labeled White Blood Cell Scan. This will take 3 days to complete so if they can get everything started today, they should have results by Thursday/Friday.
• Dianne's temp was at 98 last night at 8pm. Her temp went up a little bit each time they took her temperature. It's now at 100.4 which is not as high as previous spikes. She still has shivers, headache, and the fever, which are all symptoms we have seen before.
  
• Dr. Tangle and Dr. Gill mentioned a possible case of Lupus Cerebritis. This might have been detected on the MRI that was done, but we have not clarified this with Doctors yet. They also mentioned doing a double-stranded DNA test.
  
• There has not been a Rheumatologist involved, these are the Lupus Doctors, so they are bringing one in. We aren't sure when they will be here, or if they have to come from another hospital. The Longmont hospital does not have a current Rheumatologist.

7:00 pm

• Dr. Nguyet-Anh (Theresa) Tran - the new Rheumatologist - examined Dianne.  Dr. Janelle Laughlin was Dianne's prior rheumatologist and moved to China in July.  Her husband works for IBM and was given a temporary assignment in China.
• Dr. Tran believes that Dianne is having a Lupus Flare.   She said that with Dianne being on 4 antibiotics and 4 antifungals that it is unlikely of any other infections.
• The plan is to start Dianne on prednisone in the morning.  Dianne absolutely despises the prednisone drug because of it's terrible side affects.

We thank everyone for their love, thoughts, and prayers.  

Monday October 11, 2010 - Day 7

10:30 am

• Waiting for the Infectious Disease doctor (Patricia Gill) to arrive.
• Dianne is currently having a MRI of the brain.
• Lungs: has some scar tissue but nothing that should be causing problems.  Dianne had a lung x-ray done again this morning so we should know something later today.
• Heart: has some calcification on a valve which is not alarming. 

8:00 pm

• Things took a turn for the worst today, especially since we were hoping that she could return home.
• Dianne called her mom this morning at 11:07 am.  According to the phone log - the call lasted 8 mins 25 secs.  A CNA came into the room at 11:15 and asked Dianne if she was on the phone, since she was still holding it at her ear.  There was no reply so the CNA repeated her question.  Our quick observations yielded that she slipped into an incoherent state.  Within minutes, the whole room was filled with doctors and nurses.
• Dianne was shivering, but did no have a fever for about 45 minutes but then spiked to a temp of 102.4.  She stayed at this temp for about 5 hours.
• The results from the MRI of the brain were negative - which was very good.  They did a CT scan to ensure that she didn't have a stroke.
• She was moved to ICU room #4 - so we're back to the same place as a week ago.
• Doctor returned later in the day and talked about trying to do a biopsy of the lungs tomorrow.
• Everyone is still trying to determine the cause.

Sunday, October 10, 2010 - Day 6

10:10 am

• Happy 10-10-10 @ 10:10
• Not much new to report.  All doctors should be back in tomorrow (Monday) and they will brainstorm on the next steps.

Saturday, October 9, 2010 - Day 5

7:00 am

• Dianne was moved out of the ICU into room 3108.
• Doc apologized for yesterday's problems.
• The transesophageal-echo-cardiography (TEE) test is scheduled for 10 am.

9:00 am

• The sputum culture showed negative results.

12:00 noon

• Test results of the TEE were very good.  No bacteria or fungi.  What was seen on the previous test was calcification on the mitral valve.
  

Friday, October 8, 2010 - Hospital Day 4

7:00 am

• There's a concern about one of her heart valves.  They will be doing another echo-cardiogram using dye to highlight any problems.
• They plan to move her "upstairs" to a regular hospital room later today.

9:00 am

• We should clarify the type of test that will be done this morning.  It is a transesophageal-echo-cardiography.  The link provides pretty nice detail.  It should be completed before 11:00 am.

6:30 pm

• A disappointing day since no tests were done and Dianne waited for 15 hours without eating or drinking.  We're unsure why this occurred.  It has been rescheduled for tomorrow.

Thursday, October 7, 2010 - Hospital Day 3

10:00 am

• We missed the Doctors this morning but they did an ex-ray on Dianne's lungs around 6 a.m. and are still seeing a "mass" in the lung, and they are unsure of what this is. They don't say that it's a tumor/cancer. They also say that there is still an infection in the lungs, and are not sure why it's still there or what type of infection it is.
• We didn't get any answers on the blood work that was drawn yesterday. They did draw more blood again today.
• Good news! They are moving Dianne to the regular hospital as soon as a room becomes available. So we will keep everyone posted when this happens.

7:00 pm

• There are apparently no vacancies in the regular hospital so Dianne is staying in the ICU.  
• There have been no other changes since this morning.

9:00 pm

• Dianne had an echo-cardiogram late this afternoon.  The nurse said that they received the results and that she'll be NPO at midnight.
• She needs to stay in the ICU ... no longer eligible to be transferred to a regular hospital room.
• We are hopeful that this discovery will help in Dianne's recovery.

Wednesday, October 6, 2010 - Hospital Day 2

9:00 am

• Doctors are unsure of the problem since most of the tests are not yielding any results and the symptoms are going away - making them believe that sepsis is unlikely.  This is very good news.
• She will remain in the ICU today. 

1:00 pm

• The Doctors ordered a sputum test this morning as well as some blood work. The sputum test should show if there is fungus or bacteria in the lungs. They said that the blood work and sputum results should be in by tomorrow. Once they have these results they can make a game plan or decide what steps to take next.
• Her fever has subsided. 

Tuesday, October 5, 2010 - Hospital Day 1

On Monday evening, Jeff visited with a former IBM colleague from Rochester, MN.  Dianne was doing fine before he left (cooked dinner & cleanned up), but was running a fever of 101.6 when he arrived home.  Then on Tuesday morning, she was unable to communicate & function.

We arrived at the ER around 7:15 am and they moved her to the ICU around 9:30 am.  They are unsure of the problem but started to treat her for sepsis.  Blood & urine samples were sent to the lab.

She wasn't coherent for most of the day, but started to respond sometime between 5-7 pm with short but understandable messages. 

Friday, October 1, 2010 - Hospital Day 4 & Going Home

Dianne has arrived home from the hospital. She's picking up the mess that I created while she was away. Nothing abnormal with that process. We sincerely appreciate everyone's thoughts and prayers.