post rounds

Usually, rounds are very exciting because we learn so much- about Emerson and the medical world- and we get to ask questions.  Today, it was slightly subdued- on our part- because so many of the questions and curiousities weighing us down can only be answered by the surgical team and can only be answered AFTER her 4:00 surgery.  Nonetheless, here is what we discussed at rounds this morning:

Emmy's highest fever last night was 101.8.  She had a fever at 10:00 this morning of 101.3.  It is being managed with Tylenol.  We are also managing her pain with Adavan and Morphine.  I am grateful that in rounds, they said to just speak up and we can give her as much as it seems she needs to keep her from wincing and waking up etc.  I never want to be a pain/bother to the people here who are trying to do their jobs, who know way more than I do about what is best for Emerson, but I was feeling this stress about wanting her to be more sedated but not wanting to interfere with what the doctors and nurses think is best.  All this to say, I was greatly relieved when they said to just speak up and they will give her more today.  I am relieved by the idea that the next 24 hours will be about making sure she is resting and allowing us to rest as much as we can, too. 

Some good news hemotologically during rounds :).  Until now, Emerson's white blood cell count was high- probably because of the infection- and her platelets were low.  She was experiencing,we think, a slight case of  DIC- disseminated intravascular coagulopathy.  Essentially, Emmy's coag levels were good, but we couldn't understand why she was not producing more red blood cells.  DIC, as I understand it, means that the red blood cells that were being produced by the bone marrow were being consumed.  This has not been a huge problem for her, but when she has a procedure, it has meant that she needs to get platelets.  So... yesterday, during rounds, we discussed how she will need to receive platelets over night because the surgeons want her platelet count at 100 for the surgery.  We were thinking a count of 100 would be unlikely- even with the platelets,  because Emerson's platelet count, while up from 19 on Tuesday, were still only 26 yesterday.  We were hoping to get them in the 50s or something before surgery today.  Well, guess what?!!  Emmy seems to be recovering because her platelet count after receiving platelets last night is at 134.   AND her white cell count is lower, which could mean that the worst of this infection is past.  Overall, she totally surpassed our expectations.

This is the trend I want to end on.  Yes, there are times when we receive unhappy surprises while here, but there are also many, many times that Emerson totally surpasses our expectations and we get very happy surprises- breathing so well above the vent, moving more than expected, waking up, urinating more than a drunken fraternity brother.  I am hoping that after surgery, our very happy surprise is that Emerson continues to surpass expectations:  that we will be able to close her or almost close her without complications during or after the procedure; that Emerson's recovery will be minimally hindered by the surgery; that Emmy's progress with weaning from drugs and withdrawal and progress on the ventilator will be minimally hindered by the recovery.  Emerson has surprised us many times with her fortitude- she could do it again.