Hi everyone
Just returned from hospital, Andrea was settling down for the night. Last evening and night were not good and when I arrived she was very unwell. At night she had oxygen on for awhile because she felt she could not breathe, a sign of acute heart failure. This morning She had visibly more fluid on board, and the VAD doc Holger Buchholz, a young man from Germany who is very good at his specialty, heart support devices, was there. He was very worried and wanted her transferred to the adult cardio vascular intensive care unit right away and a Prisma machine put on, this is first a double line into the jugular vein in the neck, then to a machine that ran the blood through it and removed the extra fluid and returned her blood. Then the chief adult intensivist was called in and after reviewing her chart and assessing her he thought she was not up the point of the Prisma treatment yet. He rather wanted her started on continuous infusion of Lasix IV, but they are not allowed to do that in the ward she is in now, so they withheld her feeds and soon she was feeling a little better. they were trying to increase the volume of formula through her nose tube but her stomach could not tolerate the very low amount of 45 mls/hour. They wanted at the same time to decrease TPN, her Iv nutrition package, it is a lot of volume quite diluted by water because too strong it is hard on the veinous system. So after they had shut off her feeds pump she began feeling better, now the concern is that she is not really getting enough calories to rebuild her. She will likely be moved to CVICU for the IV Lasix therapy tomorrow so she will be confined to her room there until they can install the Heart Mate II, tentatively planned for a week from tomorrow. If she deteriorates too quickly, they will do it sooner. They apparently are very strict there about visiting hours and no more than 2 visitors at a time. She seems quite resigned to the future, she just wants to get well. Please continue to remember her and us in your prayers.
Thanks, Maynard
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