Liz and SICU

Here is an update with Liz.

Sunday morning they started giving Liz lots more saline. She got pretty worked up when pain got a bit out of control. They put her on the PCA (I'm guessing Pain Control Apparatus or something... Not CPA as I thought.) and Liz did better at staying pain free. She slept pretty constantly. Toward evening I encouraged her to try to stay more awake and eat. We ordered her some fish and some milk so she could eat cereal Dad brought. She ate most of a little box of Golden Grahams but only a tiny bit of fish, and drank milk. That night was better for me, with Brad there to take turns getting up when something happened. Her heart rate started jumping up again, and her blood pressure dropped. She also had gotten very pale, slightly yellowish. They gave her some blood to help bring her back toward normal. Then lots of doctors were brought in to consult regarding bleeding in her belly - Should she get surgery, radiation for tumors, or whatever. They moved her to the U of U.

They decided to use angiography - inject dye and watch where it goes with X-rays - to locate bleeding. The liver was the most likely place for the bleeding source, or maybe the bowels. Dr. Kinikini did the angiograms, Dr Mulvihill was the surgeon ready to explore if needed. They did not see any bleeding from any of the 5 major arteries near the belly, so they decided her body had stopped it with a clot. They did not explore, as they thought any washing might dislodge a clot. Liz was intubated so they could go right back in for surgery if bleeding began again, and because they had pumped her with 4 or 5 units (a liter) of blood and lots of saline. Her neck was swollen so they said she wouldn't be able to breathe on her own.

When I said, "She looks uncomfortable," Liz nodded her head. We helped her move a bit more. I asked if she wanted more pain meds - nod yes. Her eyes stayed mostly closed but she occasionally made a face or moved a hand (restrained so she wouldn't pull out any tubes), so we tried to pay attention and guess what she might want. I stayed till 11:30 and helped the nurse give her a sponge bath and change sheets. Phil came to take a night shift, so we had someone watching for those hints. (The nurse has two patients to watch and sits at a window where she can see beds and monitors when not in the room.) I had a good long time to sleep in my own bed. :)

Brad went in the morning. He was there to ask the doctor when they would extubate (remove the breathing tube). They watched her breathe a bit and said, "let's try now." She was still dazed a while, and said she saw bread and steak all around the room and wanted to eat, and drink. They wouldn't let her because her stomach and bowels shut down, and she would just end up throwing up. She could have a tiny ice chip every ten minutes if she tried to keep it in her mouth instead of swallowing it. (a teaspoon an hour)

We spoke to Dr. Grossmann about the scans. They show a large section in the middle of her liver has changed dramatically. The doctors aren't sure if the tissue was damaged from radiation and the B-raf drug interaction (as it affected Liz's skin very much, so it could to other tissues), or it could be tumor growth. Either way, it isn't working as it should. Blood tests show liver functions are down too, and the liver produces the proteins that help hold the blood in arteries, so that is probably why she was losing saline fluid into her tissues today. We can treat the liver as if it is inflammation with high dose steroids, and see if it improves. If it was really tumors it won't help, but there isn't much else doctors can do for tumors. There may be more SRS on a couple of new tumors in the brain later on.

About 5:30 they took Liz to try more angiography. They wanted to see if she is bleeding now. She looked good, so they removed the two access lines in her upper thighs so she can move more. She is back in her room but now it is the shift change so visitors are not allowed in again until 8:30. I plan to stay tonight to watch her. Liz will be here till tomorrow at least, then probably back to Huntsman.

JD and his parents came by to visit tonight but didn't get to see her. Diana Tibbs also visited with us in the waiting room. Yesterday the bishop came by, and Dar (my sister) & Jim, and Jacob Fluckiger (nephew, writing dissertation on tumor leakage) were here for a while. Liz, Brad and I received priesthood blessings which gave us comfort and a sense of peace. Despite crying earlier, I know things will work out as our Father in Heaven has planned. I love the gospel that gives me peace.