7-21-2010 Wednesday

Status:  7.5/10. Blood cultures came back positive for gram-negative bacilli.  The condition, of having these types of bacteria in your blood is called gram- negative sepsis.  This is not unexpected when your white counts are zero.  The hard shaking chills (rigors) are part of the usual picture,  as is disorientation.  They started broad spectrum antibiotics right after the cultures and I was afebrile by morning. 

Events:   After they gave me morphine and Ativan last night to stop the rigors,  I tried to get out of the bed to go to the bathroom.  Unsteady on my feet,  I started to fall,  Lisa tried to hold me up but all I wanted to do was get to the ground to prevent any injury.  You can tell patients all you want about not getting out of bed by themselves,  but when they’re stuporous they cannot make rational decisions.   In talking to the charge nurse,  who studied falls over the last several years,  almost all of them involved patients attempting to get up to go to the bathroom. 

In order to make sure my Hickman catheter,  laying vulnerable to bacterial contamination in my blood stream,  would not cause problems if it were contaminated, they removed it today.   The physician’s assistant, who was to remove it,  said I would just feel a pinch,  although he’d have to use brute force.

He was wrong about the pinch.  He was right about the brute force.  They replaced it in the other arm with a PICC line(Peripherally Inserted Central Line Catheter).  It took them several tries to get it in the right position,  but it is now my venous access for all drugs and transfusions. 

Comments:  When old microbiologists looked at bacteria through their microscopes they would stain them in such a way that some stained purple and some stained pink.  It was Dr. Gram who perfected this technique,  and allowed physicians to divide bacteria into those that took the purple stain (gram-positive) and those that did not and remained gram-negative (pink).  They could also see if they were shaped like rods (bacilli) or tiny little circles (cocci).  A good proportion of the bacteria in your GI tract is gram-negative rods,  and consequently most women’s urinary tract infections are caused by these same organisms (such as E. coli). Your GI tract is releasing these bacteria into your bloodstream all the time but with adequate white cells it is not an issue.  If left untreated,   this bacteremia can lead to septic shock and death.  They will keep me on antibiotics until my white cells return.   

Good news today,  reports are that the liver lesions are shrinking with the anti-fungal treatment. 

Although I have been through a lot,  I am feeling better.   Hoping to get out of here by the weekend barring any further complications. 

Love,

-Bruce

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17 Responses to “”

  1. frank Says:

    Trying to keep track here. I’ve read about blood vomiting, now rigors, and disorientation with falls. There’s a bunch of needle referencecs and you’ve thrown in purple rods and pink circles. Admit it. You’re a former heroin addict. Lisa’s secretly a dealer who wants to see you after detox. Sounds like these last few days have been awful. Better ones are ahead. Thinking of you and sending much love. -f

  2. joel steinberg Says:

    This all reminds me of the Book of Job. One bad thing after another. But with all the good meds you will pull through this. We hope the donor search is fruitful Joel and Margaret

  3. darya Says:

    Dear Bruce, We think about you every day, we read your blog everyday, we pray for your well being every day. I don’t know where you find the courage and strength to write the blogs, but I admire you. And I admire Lisa. You two are one couple made of steel. Hang in there both of you. We look forward to seeing Ethan soon.
    Love,
    Darya and Vali

  4. Margot Mahoney Says:

    Bruce – no stupor in THAT explanation. I think you can sell this as a ready made case study now to medical schools. It will be an invaluable learning tool. When you are back home – start looking for an agent! (In your spare time.) Keep fighting but do it from bed and not from the floor of your room please! I hope more normalcy will return VERY soon. Elizabeth says to tell you “YOU ROCK”!!

  5. Ashby Says:

    These old Anglican hymns sometimes just bubble up:

    Lord of all gentleness, Lord of all calm,
    whose voice is contentment, whose presence is balm,
    be there at our sleeping, and give us, we pray.
    your peace in our hearts, Lord, at the end of the day.

  6. winnie Says:

    you are unbelievably strong .Your mental attitude is your savior.
    Keep up the good work
    affectionately winnie

  7. Judy and Larry Says:

    We are so sorry for what you are having to go through. Happy to hear that you are actually feeling better even though you have been through the ringer.
    I was wondering if you would address the following in your blog: because you are brilliant and know so much about the medical issues that you are going through, is it a help or a hinderance to you? Do you wish you knew less or does it help to know so much?
    We continue to think of you and pray for your good health.
    We hope that tomorrow will be a better day and that you get to go back home as planned.
    Love, Judy (and Larry)

  8. Judie Davidson Says:

    Cycled into Fargo ND today and will go home tomorrow. Wish you were too. Thinking of you and Lisa – hugs. Judie

  9. Judy and Ken Freedman Says:

    Bruce,
    How can you so clearly explain and teach us so brilliantly what is going on when you have been through what you have???? You are more than AMAZING! Praying and hoping that tomorrow will be a better day and that you will home for the weekend.
    Love,
    Judy and Ken

  10. wendy Says:

    I have three words… Shit shit shit….But do believe that you haven’t gone through all this without good reason.. I feel a CURE coming on!!!!Let’s sing that song.. all together now…let there be a cure . we know Bruce is on his road to a cure.. God Bless Bruce’s cure!!

    Having seen the terror that sepsis reaps on patients……I’m greatful that you are being watched over so closely. Ever so closely.. glad that Lisa is your guardian angel..
    love wendy

  11. Judi Golding-Baker Says:

    Oh my dear Bruce
    I’m so glad you’re feeling a little better…and I’m hoping and praying you’re outta there by the weekend. Much love to you and Lisa.

    Judi

  12. Joe Robertson Says:

    Bruce, you must be feeling somewhat better because we’ve gotten a brief medical lesson for the first time in a long time. Hooray! Let’s hear it for Dr. Gram. Keep those nuggets of info coming, but we’d all rather you were writing them from the comfort of your own home.

    All our love to you and Lisa, and don’t forget:
    GO BRUCE!!

    Joe, Catherine, Claire and Antoine

  13. Donna Hill Howes Says:

    Hi Bruce and Lisa. Back in the U.S. following 10 days abroad…WITHOUT my BB! Yeap, one of the conditions for the family reunion was that we park our BBs and laptops at the door when we arrived in Switzerland….ugh. Took me 3 days to get over my tic of reaching for the darn thing. It was hard to read through the ordeal of your past week but then it was harder to live through it….and like so many others, I marvel at your strength, wit and wisdom through it all….you set the standard for all the rest, dear ones. God be with you. Love, Donna

  14. Michael & Greta Says:

    One more reason to look to the weekend! We are hoping you’ll be in the comforts of your home with Lisa & the kids. Yours and Lisa’s strength is amazing. We love you!!

  15. wendy Says:

    Grow little new healthy white cells grow…

  16. John Seng Says:

    Hi, Bruce, Christine and I are in New York today. Our 30th anniversary was July 20, so we’ve been visiting good friends from when we lived and worked in the New York area. Saw “Jersey Boys” yesterday, a terrific show.

    Just wanted to check in on you. Hope you get out soon. Hang in there, pal. John

  17. Lynn Oliver Says:

    Well even with GN bacteremia, neutropenia, delerium, stupor, Hickmans and PICCs coming and going, fungal (?) hepatic lesions, falls, GI bleeds and all the rest your brain is better than mine. As is your spirit. This post tells me that things are LOOKING UP! YES!!!! YES!!!!! YES!!!!!! (And thru all this Lisa sent ME a card. Amazing. I am in awe.)
    Love,
    Lynn

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