Trying to Maintain Fluid Balance

It is late and the end of another long day, so I'll try to make it short.  Andrea had another relatively uneventful day today.  She slept quite well last night, but this morning her blood pressure was quite low again, so they gave her more blood and restarted her on a blood pressure medication again, and it corrected itself in a few hours.  When her blood pressure is so low it makes her very lethargic and tired.  It was much better in a few hours and she was feeling somewhat better.  The intensivists work a 7 day rotation, and the doctor who came on for her, last had her about 2 weeks ago, and when he came in he thought she was very weak and shaky so he did a bronchoscopy, putting a camera down her trache into her lungs to see if there was infection and mucus there and she was clear, he also did an ultrasound to see whether she had fluid around her lungs and he did not find any, so that was a relief.  Both her pediatrician and another person who last saw her on Friday saw her again today, and both remarked how much better she looked than 3 days ago.  Her pump doctor promised that if she was off the dialysis machine tomorrow, he would get her up in a chair, so hopefully that can happen tomorrow.  She seems to be tolerating her feeds quite well, her physiotherapist also remarked on how much stronger she seemed when she came in to give her a workout.  O yes, the likely reason for the low blood pressure is that dialysis dried her out too much, it runs a constant speed according to how it is set, so night or day, sleeping or awake and active, a person with the heart mate II must maintain a very careful fluid balance and not dry out too much, or else the pump starves of blood, something which those of us with our original hearts, is automatically looked after.  We compensate by  our hearts slowing down when we sleep conserving energy and maintaining fluid balance.  That is why most of us first make a visit to a restroom when we awake in the morning and then we are needing to drink something shortly after.  Well it is getting late so I'll sign off.

 

thanks, Maynard

 

PS Please forgive the short and sometimes inaccurate lessons on plumbing and such like.  I'm quite sure this contains a lot of false information, but this is how my weak and impoverished mind understands most things.