Spoke too soon

This picture is from a few days ago. I haven't uploaded any new pictures since then.

My last report was a little premature. When I got to the hospital around 2:00 and talked to Janiece, Scott, and the nurse, I was told that his day started out pretty good but has since gone down hill.

Late this morning Scott got up to sit in the chair. He sat in the chair for about 75 minutes, when it was time to get up he was feeling terrible. He was very nauseated and weak. So weak, in fact, that he could not get up from the chair on his own and had to be lifted back into bed with the special chair lift they used a day or so ago.

He has been sleeping a lot since then with small moments of being awake. When he was awake, I asked him how he was feeling and in his words he said "shitty."

Some background information--Scott's leg has two "vacuum" type drains that come out of it, these are in place to rid his body of the excess fluid/drainage. One comes out the center of the amputation and one comes out of his upper thigh. When he got up today with the physical therapist the drain coming out of his upper thigh got pulled a bit and hasn't worked well since. They had a wound specialist come in and look at it, and the little suction pad had been completely pulled off and had to be replaced. This was VERY painful for Scott. It was terrible to watch. Prior to this happening he had had A LOT of drainage coming out of these little pumps today, about twice as much as a normal day and it's only 3:30... Now that both of them are working he is having even more drainage come out.

Please pray that the amount of drainage coming out is acceptable and that Scott's leg is healing. Please pray that this will not delay his surgery tomorrow.

Here's today's lab results:

Scott's WBC (White Blood Count) was 10.6 today..so just very slightly elevated compared to yesterdays result of 10.5. Again, a normal is below 10.0. It is good that it is not dramatically increasing but we would prefer to see this trending downward. An elevated WBC count can mean that Scott still has some infection going on.

His potassium is low today at 3.1 (normal is 3.5- 5.2). So IV potassium is being given to him today. Having a low potassium can sometimes result in an abnormal heart rhythm (among other problems) and if you remember Scott's heart "acted" up a few days ago.

To recap...on Saturday Scott's heart rate spiked to the 180-200's. We were told that it was SVT (Supraventricular Tachycardia-basically a high heart rate), then just yesterday his nurse mentioned that he had gone into Atrial Fibrillation (an abnormal heart rhythm-basically his heart muscles were quivering instead of having coordinated contractions) He was put on the medication Amiodarone, which completely resolved this problem. He remains on this medication but was switched to an oral form today instead of having it through his IV. His heart has been completely normal since that episode.

I talked to his nurse today to ask if he truly had had a-fib or if it was just SVT and she said that there is "controversy" over it. Some of the docs thought that it looked like a-fib, while others thought just SVT. Either way, he is being treated correctly and has not had any problems since. The doctors believe that this was an isolated event and will not cause Scott any further problems. We just want his potassium to get back into the normal range to not put any increased risk on his heart.

Another interesting fact is that sodium levels and potassium levels have an inverse relationship-meaning generally when sodium is low, potassium goes up and when sodium is high, potassium goes low. If you remember Scott's sodium has been low, today it is 136 which is completely normal. His potassium has been normal until today (when his sodium increased to "normal") and now his potassium is low. So at least Scott is following the textbook! :) Again, they are trying to correct these abnormalities by giving IV electrolytes.

We haven't seen the transplant team since Scott was admitted to the hospital. His issues are separate, but we would like to speak to them to ask some questions. Janiece asked again and the case manager spoke to the transplant team today to ask when they could come. They will either round tomorrow or Friday. I think Janiece was going to ask for them to come on Friday, as tomorrow Scott will be in surgery and we will be in the surgical area, to speak to the surgeon. We don't want to miss + We will wait and see...we're anxious to speak to them and get some answers to some questions.

In other related liver news...every few months Scott has had lab work to tell what his MELD score is. A MELD score is a calculation based on lab results that tells us how Scott's liver is functioning. It can also give us a clue of when Scott will need a liver transplant. Among other factor's the MELD score can determine where you fall in the wait for a liver. There are four categories:

1-A MELD score of 10 or less-means your liver functioning is fair. Most don't have any symptoms of anything being wrong at this point.
2-A MELD score of 11-18 means that liver functioning is decreasing. This is when most people are diagnosed with liver failure. Symptoms have started.
3-A MELD score of 19-24 means liver functioning is very compromised.
4-A MELD score of 25 and above means you need a new liver ASAP.

According to what we learned when we meet with the liver transplant team in October of 2010- most people are "at the top" of the waiting list when their MELD score is 21. Scott's MELD score has been anywhere from 17 to 18. The last result was 18, according to Scott. Since we haven't seen the transplant team yet, we haven't heard the "official" news from them. I really wanted to know what Scott's MELD score was now. I got all his lab results today and figured out how to calculate Scott's MELD score. I've done it a few times and gotten the same result each time and feel confident that this is accurate. According to my calculations, Scott's MELD score is 17. This is good news, Scott's liver is maintaining its current function and not decreasing. It will really help Scott to be able to heal from this before he needs a liver transplant. Still though, it will be great to hear the transplant teams opinion.

His vital signs are stable, with his blood pressure only mildly elevated 150-160s/70-80s, today. He is not confused at all anymore.

More updates later.