April 23, 2007

Hello everyone:

Please share this note with anyone not on the list and if you want me to add anyone to the distribution let me know.

It's Monday morning and I finally have a few minutes to update you as to Fredi's progress over the last few days. It has been a roller coaster.

As previously reported she was admitted to the hospital on Sunday, April 15 with a bowel obstruction that they were clearing and they were expecting to release her on Tuesday, April 17. She also had a UTI at that time and they were treating it with antibiotics. On Monday the 16th she suffered a pulmonary embolism that was promptly treated and brought under control by the hospital staff. The fact that she was already at the hospital may have saved her life.

Now for the update.

While they were getting her stable after the embolism she developed pneumonia which was aggravated by an episode where she aspirated a lot of stomach contents into her lungs. This required that she be intubated again while they suctioned the fluid out of her lungs. She really hated the intubation. I told her that she was better off than John Corzine. She agreed. She is a high risk for aspiration because of a hiatal hernia she has suffered from for a LONG time. As a result she cannot have anything by mouth, she has a tube that goes to her stomach to remove all contents and they will be scheduling her for surgery to correct her hernia. I look at this as a plus because it could and probably should have been treated a long time ago. She hasn't quite come to grips with the fact that on top of everything she will need surgery too.

As for the thrombosis and her ongoing risk of developing clots the treatment for this has changed, for the better I believe. I told her the other day that it is a good thing she got sick in 2007 and 1957 because if it were 1957 she would be fucked. She agreed. So... she isn't a great candidate for coumedin therapy because of her being at high risk for falls as she recovers and regains her strength. They don't want her to bleed out and neither do I. As an alternative they have this cool little filter that is inserted into the femoral artery and travels into the arterial feed to her lungs. There, it opens like a little umbrella and will trap any clots that move northward keeping them from moving into life threatening areas while they dissipate. When she is stronger she can begin coumedin therapy as another preventive measure but they don't think it will be necessary. The filter is being inserted some time this morning. This is great because she will still be able to enjoy arugula and spinach, won't need to be scared of falling (at least any more so than she already is), and won't need the administration of clotting agents if she needs any additional surgery in the future. Clotting agents are made from donated blood and would need to be administered any time there were a likely risk of bleeding. Blood products are expensive and using them does come with risks. Among them allergic reactions and the possibility of contracting HIV. These risks are small but there.

So what is she battling now?
Pneumonia - this is being treated and she is slowly recovering.
Embolism - The embolism is stabilized and we will just wait for the clot(s) to dissolve. I say clots because the one is being forced into a fork in the road and is splitting. The other clot in her leg will be trapped in the filter should it decide to migrate.
Hiatal Hernia - Will be corrected surgically next week.
UTI - She is finishing the course of antibiotics prescribed but is still on them for the pneumonia anyway. There is an additional bacteria in her urine now that is resistant to antibiotics. For her they say that it will clear up on its own but when you go visit her you must wear gown and gloves so you don't take it home, get sick and share the bug with your family.
Bowel Obstruction - Cleared

She still has asked that people refrain from visiting her.

Also since she is in ICU she cannot have any flowers. Don't send any. They won't reach her.

Tracy