Jim didn't sleep well. He couldn't receive anything to help him sleep, had a headache (was given a Tylenol suppository for that) and numerous folk coming in and out throughout the early morning hours. He called me at 7. Of course I didn't sleep well either. Took 2 hours to update yesterday's blog post and then when I went to bed, woke intermittently. Even in sleep, we do better together.
His hemoglobin continues to go up. His blood pressure was down some - 88/40. Doctors came and went and discussed the endoscopy, but no exact time was given for the procedure to move forward.
At one point I called the unit and asked if the procedure was underway, but the unit clerk I talked with, wasn't very helpful. He couldn't answer my question, couldn't find a nurse and couldn't patch me through to Jim. Geeze!
At 11:15 a.m., Jim called. Procedure remains yet to happen.
At 2:05 p.m., Jim called again. If it wasn't for him calling me, I do believe I would know nothing. He had the procedure - around noon or therafter. He was groggy. I called back to the unit desk and talked to a nurse (not his though), who said another endoscopy followed right after Jim's. She assured me the doctor would call me when they were done with the second patient.
The ICU Fellow (I have no clue as to what his name is, other than I can't pronounce it), who did the procedure, called at 2:30 p.m. He said the ulcer is not currently active, but it may rebleed. To help prevent rebleeding, they put 2 clips in. Jim will stay in the MICU today and possibly tomorrow - he will be monitored for signs of possible rebleeding - the symtoms he had earlier - low hemoglobin, black stool. Also will monitor his blood pressure. If he remains stable, he may be able to return home early part of next week. If his hemoglobin drops again, another endoscopy will be done and go from there.
We request prayers for the hemoglobin to continue to increase and no black stool or any other telltale sign of rebleeding going on. We pray there will be no more complications, that Jim be on the mend toward complete healing, strengthened in body and soul.
At 3:30 p.m., nurse practitioner Dana Fowler called and gave me more complete information re: the procedure. She said the doctor clamped the blood vessel with 2 clips to prevent the ulcer from rebleeding. Jim will be watched for 48 hours, will remain in MICU today, and probably will be moved out on Saturday. His hemoglobin at last check was 8.2 and normal for Jim is 10. She said he was doing well. The hemoglobin will be checked again at 4 p.m.
Learned at 5:15 p.m. Jim's hemoglobin had dropped to 6. He will be given another unit of blood and have hemoglobin redrawn. They are not sure the 6.0 figure is correct. If the second draw still shows low, it is possible he will go to interventional radiology to determine where else the bleed may be. When talking to his sister the nurse, she thought perhaps the scope didn't show enough detail.
I arrived at Jim's bedside at 6:45 p.m. He had just started receiving another pint (unit) of blood - it takes 3 hours, so around 10 (which is what it is now that I'm back home), the transfusion should be completed. Two different labs were actually taken of his hemoglobin around 6 p.m. - one was 6.8 and the other, 7.1. Lower than the 8.2 taken earlier, but certainly not as low as the 6.0 taken at 4 p.m. Around 11 p.m., his hemoglobin will be checked again. Jim called at 10:30 p.m. to tell me the hemoglobin was checked a little while ago in a different vein and numbers remain low - at 6.8. It should have been up, given he had just received new blood. Doctor was in, suggesting Jim may need more units of blood. Hemoglobin will be checked again at 4 a.m. Saturday, if not sooner. If still low or lower, he will be heading to interventional radiology to see where another bleed may be.
It would be good if there is no new bleed and that hemoglobin numbers go up and stay up. He may be able to start a liquid diet on Saturday. His blood pressure has remained stable, in the 90s.
I lucked out with free parking in the ramp tonight. The ATM was down and since I didn't have $3 in cash to pay, I got free parking. How nice.
