When I arrived at the SICU, Derek was catching some zzzz’s. He woke up just in time for his doctors to come in and chat. Here’s the latest: (updates added at 12:00pm)
GI wants to do another scope just to make sure everything looks nice and tidy in his esophagus. While they’re in there, they will put the feed tube back in so they can be sure it gets placed in a good spot and doesn’t irritate anything. They had initially discussed giving him IV nutrients, but in general it’s better to use the gut, if the gut is working. He is on a clear diet for today, but they may move him to softs later.Ok, change of plans. GI docs duked it out with Derek’s docs and they decided not to do the scope. They want to give the esophagus a chance to heal. They also are going to hold off on the feed tube and instead give him TPN or IV nutrients. Soft foods are in effect & Derek is currently munching on some kids snack bars. Thanks Em & Gregg!
- They are giving him 2 additional units of blood. His hematocrit levels are pretty good, but they are treating him with kid gloves and want to make sure he’s all pumped up and not at all anemic.
- Because of the blood transfusion, his bilirubin went back up to 12, but that was to be expected. The byproduct of cell destruction is bilirubin, so as the body digests the blood more bilirubin gets into the blood stream. They assume it will go back down in a couple of days.
- I asked about maybe putting him back on nadalol (the blood pressure medication he had been on prior to transplant) and my question was met with thoughtful expressions and even a couple of, “Well. That’s a very good question. That might be a good idea. We’ll discuss it when we meet up and talk about it on rounds.” Yay! Gold star for me! I don’t want Derek to have to take yet ANOTHER pill, but if it keeps the pressure down, maybe that’s a good thing? We’ll see. —->Nadalol suggestion was well received but they are going to wait to start until after he finishes the IV octreotide which is 4 days from now. The octreotide will help with pressure.
Provided the EGD goes well, and there’s a bed available, Derek should be back on 6 Central early evening. No EGD so now we wait for a bed up on 6 Central!
He’s currently hanging out on a chair right now, playing with the new fancy phone I got him. I’m sitting by the window soaking in the blue skies. Today feels like a better day.