Vivienne had a 102.3-F (39.0-C) degree fever last night. This is a continuation of the trend of her highest fever increasing each day. Our biggest goal is to see her afebrile for 24 hours.
I have gotten more information about yesterday's scans:
- No evidence of fungus in lungs or sinuses.
- Very small spot of pneumonia in lower left lobe of her lungs.
- Small amount of fluid in lower right lobe of lungs which is clinically NOT pneumonia.
- Fluid and air in abdomen of unknown cause.
- The doctors feel confident that once her ANC improves, she will kick this thing's butt promptly.
I had a hard time getting her to sleep last night. She was very angry and uncomfortable - I think a few things were bothering her but the primary issue was an inability to breathe through her nose and the high fever. We gave her ativan (the fevers often make her nauseous) and tylenol, and kept morphine on the table if her discomfort persisted for an hour afterwards.
I also put a warm, wet washcloth on her forehead for about a half hour and suctioned out her nose a bit, to try to loosen and remove some of the congestion. Prior to her sedation, she was given a drug to dry up her runny nose and reduce her phlegm, and in addition I've found that whenever I've had an oxygen mask on it dries me out awfully. So the combination of all these things (loosening congestion so she could breathe, tylenol to bring down the fever and relieve some discomfort, and ativan to calm her nausea) helped her a lot and she fell comfortably asleep by midnight.
As a note, at the time she was having trouble breathing we did rule out that it was her lungs. I knew this, because I could see what was happening, but in addition we monitored her oxygen saturation for a couple of minutes and it was consistently 100%. If the trouble breathing was lung (rather than or in addition to nose), she would NOT have 100% sats. That she continues to do so is a really good positive point.
Once she got to sleep, she slept comfortably all night and remains asleep now.
I have gotten more information about yesterday's scans:
I had a hard time getting her to sleep last night. She was very angry and uncomfortable - I think a few things were bothering her but the primary issue was an inability to breathe through her nose and the high fever. We gave her ativan (the fevers often make her nauseous) and tylenol, and kept morphine on the table if her discomfort persisted for an hour afterwards.
I also put a warm, wet washcloth on her forehead for about a half hour and suctioned out her nose a bit, to try to loosen and remove some of the congestion. Prior to her sedation, she was given a drug to dry up her runny nose and reduce her phlegm, and in addition I've found that whenever I've had an oxygen mask on it dries me out awfully. So the combination of all these things (loosening congestion so she could breathe, tylenol to bring down the fever and relieve some discomfort, and ativan to calm her nausea) helped her a lot and she fell comfortably asleep by midnight.
As a note, at the time she was having trouble breathing we did rule out that it was her lungs. I knew this, because I could see what was happening, but in addition we monitored her oxygen saturation for a couple of minutes and it was consistently 100%. If the trouble breathing was lung (rather than or in addition to nose), she would NOT have 100% sats. That she continues to do so is a really good positive point.
Once she got to sleep, she slept comfortably all night and remains asleep now.