32
   

good news and bad news for BBB

 
 
JPB
 
  1  
Reply Fri 8 Jul, 2011 05:58 am
@Butrflynet,
Checking in. Hoping everything is ok for BBB and BFN.
Butrflynet
 
  2  
Reply Fri 8 Jul, 2011 09:22 am
@JPB,
They haven't run any follow up labs since the latest transfusions. BBB had a lot more energy and less pain yesterday and was able to walk twice as far as she's been able to. She achieved a 70 percent bend in her knee yesterday too.

When I go see her today, I'm going to request they do at least one more follow up lab test of everything so I can be convinced that the latest transfusions have resolved whatever problem there was.

One thing I thought of is several months after her first episode of blood clots about a year and a half ago, they did a follow up doppler before removing her from the Coumadin. The doctor said there were no clots detected, that she had one small spot in her leg that had a dried up clot.

Could it have been dislodged due to the surgery/physical therapy and could it be the bits of dried blood that her liver is trying to process?
ehBeth
 
  1  
Reply Fri 8 Jul, 2011 09:39 am
@Butrflynet,
(checking in - reading along daily - sending good thoughts)
roger
 
  1  
Reply Fri 8 Jul, 2011 01:43 pm
@Butrflynet,
Oh boy! Any progress is good progress. This sounds like great progress.

I've got to say that when I talked with her a few days ago, I was enormously impressed with her attitude.
0 Replies
 
Roberta
 
  1  
Reply Fri 8 Jul, 2011 01:58 pm
More energy, less pain. Outstanding.

0 Replies
 
msolga
 
  1  
Reply Fri 8 Jul, 2011 11:10 pm
@Butrflynet,
Very good news, Butrflynet.
More mobility, minus some pain, plus more energy!


You take such good, loving care of your mother.
If someone hasn't already said that, then I will! Smile
JLNobody
 
  1  
Reply Sat 9 Jul, 2011 04:40 pm
@msolga,
Good, to me the most important thing is ENERGY.
0 Replies
 
ossobuco
 
  1  
Reply Sat 9 Jul, 2011 04:46 pm
@ehBeth,
Me too.
0 Replies
 
Butrflynet
 
  1  
Reply Sat 9 Jul, 2011 06:39 pm
@Butrflynet,
Well, it seems the rehab hospital staff don't think it is necessary to keep monitoring her blood at this point. They gave BBB the two additional units of blood Tuesday night and did this last lab work Wednesday morning (7/6). They say they see a great improvement in the numbers and unless BBB starts showing signs of trouble again, they won't be continuing the daily lab tests other than for her INR and protime. Today's results for that have me concerned.

Here's the last CBC lab results. I responded to my old post with the previous lab results if you need to see those again for comparison.

https://lh6.googleusercontent.com/-8j5lFDtrOAc/ThjyNKPtf_I/AAAAAAAABtw/KqnxKm3Wuwg/s512/momtest3.jpg

And here's today's INR info. I sure hope BBB doesn't have a fall with her Coumadin levels so high:


Quote:
Standard Range 0.80-1.20 RATIO 11.1-15.2 secs

7/9/2011 INR=2.07 H Protime=23.4 H



Do the results look like improvement to you? Should I insist they do periodic blood monitoring and not wait for BBB to show signs of distress before deciding to start monitoring it again?


Yesterday, BBB walked about 200 yards one way with her walker to their physical therapy room and did some exercises with the equipment there. She's definitely getting stronger now that she's had the additional blood transfusions and they've removed those surgical stockings from her legs that were cutting off the circulation.

ossobuco
 
  1  
Reply Sat 9 Jul, 2011 07:11 pm
@Butrflynet,
I would also have been freaking re the cut off stockings, so I'm with you there.

I am from early years, I clicked a counter when I read my many (many many) slides in my clinical years. I'm so odd that cbc meant just that in my time, including looking at a smear. That was routine, not some special test.
I don't know the variabilities with the machines.
ossobuco
 
  1  
Reply Sat 9 Jul, 2011 07:16 pm
@ossobuco,
On the results, quick look, improvement.
0 Replies
 
roger
 
  2  
Reply Sat 9 Jul, 2011 07:18 pm
@Butrflynet,
Fantastic walking distance. I remember trying so hard I had big blisters at the base of both thumbs.
0 Replies
 
JPB
 
  4  
Reply Sun 10 Jul, 2011 08:54 am
@Butrflynet,
Her cbc results look great. You may want to ask them to do an H&H (hematocrit and hemoglobin) to verify that she's not bleeding or hemolyzing the newly transfused cells. It's a standard test that's cheaper than a CBC and will tell you everything you need to know about her rbc counts. Otherwise, it's all looking good.

Don't worry about her INH. She's barely in the therapeutic range of 2-3 and still not meeting the target of 2.5. The standard range levels you're comparing her results to are for someone who isn't on anti-coagulant therapy. The goal here is to prevent clotting. Those references levels are for folks with normal clotting capabilities and not on anti-coagulant therapy. You don't want her to have normal clotting capabilities at this point.

http://www.surgicalcriticalcare.net/Guidelines/coumadin.pdf

I'm glad to hear she's improving and getting stronger.
JLNobody
 
  1  
Reply Wed 13 Jul, 2011 03:35 pm
@JPB,
Good news!
0 Replies
 
JLNobody
 
  1  
Reply Wed 13 Jul, 2011 03:35 pm
@JPB,
Good news!
0 Replies
 
Butrflynet
 
  1  
Reply Wed 13 Jul, 2011 11:28 pm
BBB had a bit of a set back today. She had one of her diarrhea episodes in the morning and then had the Coumadin chills for about 5 hours before she was finally able to get warm. She also felt very weak, too weak to do any PT today, and had a very brief slight pain in her chest again.

They did a bunch of lab tests again. Thank you in advance, JPB. You've done wonders toward helping us understand these things.

Here are the results from today's tests.

https://lh4.googleusercontent.com/-3FfhQRT0ZMM/Th58Pf4YePI/AAAAAAAABuM/caokO7gKIo8/s640/troponin.jpg

This is the same test they did a few months ago when she had severe chest and jaw pains. Here's the historic test results for that:

https://lh3.googleusercontent.com/-_7Vr-W0e6qc/Th58NPO4jJI/AAAAAAAABuA/W5dMVlyDugQ/s640/troponin%252520history.jpg

Here's a link that explains what the test is and what it is used for.

http://labtestsonline.org/understanding/analytes/troponin/tab/test

They also did another CBC and metabolic test. A lot of highs and lows, but I don't know what it is indicating.

https://lh3.googleusercontent.com/-3R65ebre9Ks/Th58N_KpbjI/AAAAAAAABuE/3IkTxZTUOIo/s576/metabolic.jpg
https://lh6.googleusercontent.com/-4MuSkDNqv_4/Th58OiDFwvI/AAAAAAAABuI/ebx8Auv8dpM/s512/cbc.jpg

Here's a link to my last post with her previous test results:

http://able2know.org/topic/171302-6#post-4660921
0 Replies
 
Butrflynet
 
  1  
Reply Thu 14 Jul, 2011 04:14 pm
Just got word that they are going to release BBB on Saturday morning so she can come home.

I guess that means there isn't anything to be concerned about in her last series of tests.
Roberta
 
  1  
Reply Thu 14 Jul, 2011 04:27 pm
@Butrflynet,
This is good news, Butrfly. It will be difficult, I'm sure, but good news. It's good to be home.
0 Replies
 
firefly
 
  1  
Reply Thu 14 Jul, 2011 04:40 pm
@Butrflynet,
That does sound like good news, Butrflynet. Continuing to mend at home should be less stressful for your mom. I bet the doggies will be happy about it too.
0 Replies
 
BumbleBeeBoogie
 
  3  
Reply Sat 16 Jul, 2011 03:43 pm
@JPB,
I'm home!!! I just finished reading all of the posts since I entered the hospital. Thanks so much for all your caring and your support to Butrflynet. It helped both of us.

Got released at 10 am. The staff thought they had to pack up everything we had to take home. But I surprised them by reaching everything and packing the stuff into three bags so it would be easier for Burtflynet to get them into the car and house.

Yesterday, I walked outside for the first time in three weeks. Boy it was hot!

I will be so glad to sleep in my own bed tonight. I hated to have to sleep on my back for 19 days.

I met so many wonderful people who were a great help to me. I also was in the mercy of three nurses and should be a better nurses. One man put the most painful elastic socks on my legs (they only had one size) that caused my knee to swell between two and three larger than it was after my surgery. He refused to remove it when I complained about the swelling and the sever pain. On the third day, ordered him to get a physician to me IMMEDIATELY. When the physician arrived, his first words to them was to "remove those socks immediately!" It took four days for the swelling down to get to the appropriate size and delayed the exercises I needed to heal my knee.

The last two days in the hospital, I encountered the worst bully of a nurse I've every had to endure. She had been a nurse for thirty years and should have stopped twenty-nine years ago. When I declined exercising after I endured a five-hour episode of blood thinning freezing in my body that weakened my physical ability to walk, she accused me of not wanting to do the required exercises. Among other accusations, she got nasty saying I was lazy and I better start doing all exercises I was there for, or else!. She knew nothing about my history and how I had worked so hard to get my leg well. She messed with the wrong woman and I told her to get out of my room and bring a physician to me immediately! The physician, who knew my conditions I was trying to overcome got really angry at the bully. I had a new nurse immediately. She was reported for her behavior by higher up nursing. I hope, but doubt she learned a lesson.

These idiots made me appreciate the other staff members who were wonderful in their professionalism and their kindness to me. They liked doggies Dolly and Madison visits too. I've learned that I get very silly in a hospital and get surprised at some of the things that come out of my mouth. They teased me that I was the funniest patient they ever had.

My butt is getting sore from sitting on my office chair so I will get to a softer one for a rest. Love and kisses to all of you.

BBB
 

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