8-23-10 Monday

Status: 7.0-8.0.  What’s a weekend without some excitement.

Events:  Trying to let my “raw” GI tract heal when I had another GI bleed Sunday.  I knew it instinctively when I had a moment of weakness and sudden fatigue, and climbing a flight of stairs was accompanied by shortness of breath.  Vital signs at Hopkins today showed a low blood pressure and high pulse rate, and my hematocrit dropped 6 points.  Felt much better after blood and platelet transfusions. [I’m using up a lot of blood products, and they only come from one source.]  So consider donating blood, it’s truly a life-saving gift.

 Comments:  Whether from an occult GI bleed or a knife wound in a back alley, a sudden loss of blood initiates a series of compensatory physiological events.   As the blood pressure drops (just as puncturing your garden hose will diminish the stream), the heart has to beat faster in order to deliver the same amount of blood to tissues, so the heart rate increases.  Then, to keep the vital organs (brain, heart kidneys, etc.) supplied with oxygen-containing blood, a large number of vessels in the body constrict to shunt blood preferentially to those critical organs.  The blood supply to areas that aren’t critical (such as the skin) are shut off – thus the sudden paleness (“he turned white as a ghost”).

  The kidneys virtually shut down in order to keep as much fluid (and pressure) in the body as possible.  Signals are sent to the brain to spur the thirst mechanism, since drinking fluids substitutes for the lost blood volume.  But in substituting water for blood, you dilute the blood and decrease the percentage of red cells (the hematocrit falls).

  So, my sudden weakness  and fatigue were from lack of blood flow to my brain.  The shortness of breath was because my cardiac output suddenly decreased, and I could no longer exert myself to the same extent.  And my pulse rate was 100 (should be more like 70), my blood pressure was 99/50 (120/70 would be more like it), and my hematocrit had dropped from 27 to 21.

  I should also say that blood in the GI tract acts as a laxative, causing not only diarrhea, but when digested results in black, tarry-looking stools.  And if the bleeding is brisk, bright red blood is not uncommon.

  So, the priority now is to get whatever spot is irritated to clot over and heal, and avoid any more of these incidents.  Lisa has been with me continuously, and we’re tentatively scheduled to be at Hopkins every day this week to watch my hematocrit closely and give any needed transfusions.

  Good news (we could use some, huh?) is that my white cells and neutrophils continue to climb.  My red cells would be climbing, too, if I’d just quit managing to lose them!

Love to all,

-Bruce

Advertisements

6 Responses to “”

  1. Ed Baker Says:

    Wishing you the best Bruce….and Lisa is a saint!

  2. Judy and Larry Says:

    Wow, such a roller coaster ride you are on, Bruce….and not a thrilling one. We love reading your blogs….you are a wonderful writer and make it so easy to understand the human body. Thank you for taking the time to keep us informed. We continue to keep you in our thoughts and prayers.
    Love, Judy and Larry

  3. wendy Says:

    imagine… healing over,… you need to do some serious Imagery to get this going in the right direction.. the mind has a way of doing things that would be unimaginable… so “Bruce – heal thyself”

    as always sending prayers your way… ps did the toothbrushes arrive and do they work for you..if so let me know…love wendy

  4. wendy Says:

    PS – I gave blood this past Saturday and am trying to find out if your get credit for it/ as replacement credit.. As of now, it seems they think it stays local to CA and that doesn’t make sense… did anyone figure out how to get a National blood drive for you.. I have one person to call to double check if it gets credited or not.

  5. Wally Schlech Says:

    You’re too “bloody” stubborn to not get through this..hope today is better!

  6. Bill Israel and Eileen Breslin Says:

    Too blasted much excitement from that end, folks. We’re wishing you more peace, and healing, and dullness of the home body variety….and lots of it. Enough of these ups and downs — but what models you have become for us, in bearing through it all with such humor, good spirits, and willingness to teach us along the way. Big Hugs to both of you, and the kids. — Bill and Eileen

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s


%d bloggers like this: