Lea is resting pretty soundly tonight, as she had a very busy and tiring day. When I first arrived at the hospital this morning, there was considerable buzz going on about Lea’s CATSCAN last evening. Evidently, the scan didn’t show any deposit of fluids inside or outside the lungs that could cause her breathing difficulty. There was fear that there may be some other cause.

Dr. Mah, however, was pretty certain that there had to be fluid outside the lungs causing her problem, since there weren’t any other problems indicated. He had ordered a ultrasound-guided-probe as soon as it could be scheduled and completed. The process would use a hand-operated transducer moved over the suspected area used to guide the real-time insertion of a large needle into the chest cavity. If fluid was found, it would drain through the needle into a tube and delivered to a collection bottle.

Dr. Mah had told me that the radiology department didn’t like to do this procedure, and would drag their feet hoping that an alternative would be decided upon. Evidently there is a big risk of hitting a vessel and causing internal bleeding, and the only way to stop internal bleeding is to put more fluid back in and squeeze it off. He continued to insist that there was fluid in the cavity, although it didn’t show up in either the ultrasound nor the CATSCAN, and the procedure was completed in the mid-afternoon.

Lea’s nurse, Nick, had her rolled over onto her left side, and he held her there for several minutes while the radiology team ran the transducer over her back, in the area of the left lung. They found three potential areas that may have been be pooled fluid, but could be other conditions as well. After several minutes of this examination and discussion about which area to do the insertion from, Nick asked me to hold Lea in position, while he prepared a second fluid collection bottle in case we needed it.

As the technician inserted the needle into her chest cavity opened the valve in the drain, a stream of fluid began rapidly flowing into the bottle as though under considerable pressure, filling the bottle about ¾ full. The technician asked me to let Lea shift back toward him a little as the stream slowed, and a few more mililiters were drained off. In total, about a liter of fluid was taken out of her chest cavity, and her breathing immediately got easier.

No attempt was made to adjust her ventilator down afterwards, as this procedure followed closely after the dressing change in her abdomen, and she needed to rest. The attempts to have her take over more of the breathing will probably start in the morning, however. I observed though, that the volume of air she was able to take in during each breath went from less than 400 to almost 700 immediately after removal of the fluid. I don’t know exactly what that measurement means, except that she was taking almost twice as much air in with each breath after they took the fluid off. Dr. Mah was right, again. Thank God!

Additionally, Dr, Mah told me that he plans to do another dressing change on Sunday, and that if it still looks clean and healthy in there, he will plan to close up her incision Tuesday morning at 11:30 in the Operating Room. If he closes her at that time, he is going to put two drains into her abdomen. One to put fluid in, and one to take fluid out. That way he can force continual rinsing of the abdomen until all internal bleeding has stopped. Other details of the closing are still being discussed, such as the style of closing and the material to be used, etc.

Dr. Mike Ivy assisted Dr. Mah today at the dressing change today, and agreed that the time has come to get her closed up. Dr. Ivy operated on Lea on August 1, and has kept tabs on her progress all along. I am so grateful for the surgical team here at Hartford. They have been so attentive, and have involved me in the process of deciding the course of action to take. I have felt that they have taken great steps to keep me informed of the good and bad in each step we’ve had to take, and each decision that has had to be made.

So, all in all, I think this was an “up” day, although I sure feel drained tonight. I left Lea in the capable hands of the night crew, after reading to her for a while after supper, singing her a little love song, and praying with her for God’s healing blessings. I also reminded her that you are praying for her, and that we will owe you a big hug when we are on our feet again.

Thank you, and bless you,

Larry

 

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