Thursday, August 20, 2015

Myrna Begins to Struggle with More Congestion

Facebook post August 17, 2015

Myrna is going through difficult phase today. Breathing rate was up Sunday and didn't respond to more torsemide. Rate was 60 at six am. Gave meds and .4ml lasix injection. Vomited meds at 7:30 am. BR did come down to 48. Was down to 44 at 10:30 am. Gave more meds at 9 and she vomited those in 15 minutes. Gave more at 11:30am today which she's keeping down so far.   I think a clot moved in her today and may be causing stomach problems since she's vomiting. She was eating until one am this morning. She digested all her food since she did not vomit up any. She is drinking a lot and keeping it down and urinating enough. I'm not sure if and when she may need to see the cardio. If she keeps down her meds; if she responds to meds and injection she can remain at home. Otherwise she may need to be tapped to have fluid removed from her lungs and to make her more comfortable. Fluid needs to decrease to make her more comfortable. If she can keep down the Valium then she can rest a bit. But fluid removal is key. But the tapping process is difficult for her due to sedation so that's why I'm hesitant.

Myrna saw the cardio this afternoon.  They removed 5 oz of fluid, the most ever from her.  Her body is learning to tolerate more fluid in the pleural effusion as her breathing rate was still a decent 44. But that doesn't mean she was comfortable or able to breathe well enough. They will drain and then we will leave. Will do blood and X-rays.

The cardio found that the left leg has no pulse because it was killed off by a clot that occurred in the last two months. I have no idea as to when that occurred. We've had no signs. She was appearing to be unsteady on her legs last week so I gave her more potassium supplement PO (by mouth).  So , I don't know if it was in the last week or before. However, the other blood veins around the leg are supplying enough blood to keep the leg viable. 

Facebook post Tuesday, August 18, 2015

Myrna is still struggling to breathe. Rate is 48 and only goes down to 44 after Torsemide.  The cardio doesn't yet want to see her to try to withdraw fluid but I don't know.  I can't see us spending the next few hours injecting lasix continuously and then struggle to get her to keep down her meds. She vomited last night, and almost again today. She is again low on sodium (141) but-unlike last time, when she was breathing fine but was just very sick-she is too congested so I can't supplement.
However, kidney values in blood work looks good: potassium 4.1, creat 2.8 (high but stable, the same in July) ,and BUN is 34 (down from July 36.)
She hasn't eaten since 1 a.m .Monday. I gave Mirtazpine today, extra Pepcid and Cerenia last night. Until she keeps down things, I can't yet begin feeding her by mouth. She is drinking well enough. I will start with some tuna juice soon and see how it goes.

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