10-14-10 Thursday

Status: 8.5/10.  An interesting day that stared early in the AM.

Events: After continued nose bleeding from the traumatic NG tube placement, the ENT folks were finally called at 2:30AM. They packed both nostrils and lowered the bleeding. Finally got to sleep from about 3AM to 5AM. Received blood and platelet transfusions throughout the night. By the morning my pulse had dropped from 112 to 70, my blood pressure was good and I was hemodynamically stable.

The doctors needed to know where the presumed GI bleeding was coming from and I was sent down to Endoscopy to take a look. Since I couldn’t breathe through my nose and I’d have an endoscope down my esophagus they placed an endotracheal tube into my lungs under anesthesia. The GI docs found two bleeding points – one in the stomach and one in the duodenum. They cauterized the lesions and presumptively solved the underlying bleeding problem.

I have been put on a “nothing by mouth” diet since last night, which will be continued until tomorrow morning. The NG tube placement, plus the endotracheal tube have left me quite hoarse and with a sore throat.

With continued blood and platelet transfusions my hematocrit is back to more than 30, and my platelets an astounding 78,000. (Still half of the normal platelet count, but that is more than the accepted norm in transplant patients.) 

One more surprise. Blood culture came back positive for bacteria. Preliminary results show that it was a Gram + Coccus. That represents most likely a contaminant, what infectious disease doctors would call a coagulase negative staphylococci. That is normal bacteria found on the skin and if the blood culture is not collected properly it will grow up in the laboratory and present itself as bacteria “in the blood”. True staph infections (abscesses, boils, etc) are caused by coagulase positive staphylococci, but if this were in my blood stream I would be extremely sick with a fever and chills. As a precaution, they are still going to put me on IV antibiotics until they better define the bacteria.

Comments: My oncologist wants things to settle down a little and has delayed the start of the transplant for several days. Hopefully this can match up with the donor’s expectations and we can move forward soon. So I will stay in the hospital trying to heal and gain some strength back (and calories after a missed day of food).

Looking forward to getting back on track.

Love,

-Bruce

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12 Responses to “”

  1. Wendi Says:

    Hopefully that is right around the bend. Sending love and healing energy your way.

  2. Reggie & Fred Says:

    Bruce- You’ve had a year of events in one day! We’re looking forward to you getting back “on track” Your strength amazes us! We love you very much! Reg & Fred

  3. Art Ulene Says:

    Okay, Bruce….. Tell the truth: Do you really remember all this stuff from medical school (like coagulase positive staph and coagulase negative, and the clinical importance of the difference)….. or are you taking a refresher course. You blow me away with your knowledge….. not to mention your calm under fire. We’re sending positive stuff your way. Love back…. ART

  4. Marsha Says:

    So glad to hear that today ended up as a better day. We’re all pulling for you! Look at the bright side – this buys you a few days of R and R (ha!) in your lovely ‘hotel’ room. Hope you can enjoy a good night’s sleep tonight. Sweet dreams my friend!!

    Love,
    Marsha and Jerry

  5. Julie Says:

    Bruce -Tell Art Ulene the whole truth- that you read the whole set of encylopedias about age 10. When asked “why?”- You said, “One day someone might ask me a question and I might need to know the answer.” Who would have thought it would pay off all these years later.
    Here’s hoping you don’t have many more “medical terms of infections” to explain

  6. wendy Says:

    P.S. that was wendy – julie had been on my computer.

  7. Jill O'Mahony Stewart Says:

    Bruce: thinking of you and your well-documented ordeal; meanwhile praying for this to get started so it can have an end point. BTW: can lay persons receive CME for reading these blog postings. 🙂 Love, Jill

  8. Tanya Altmann Says:

    Thinking about you and sending good thoughts and positive energy your way. Hope you feel better soon.

  9. joel steinberg Says:

    What a drag. At least you are no longer bleeding. I suppose no one can explain why you would have an upper GI bleed when all your blood counts were reasonably normal. Maybe the Mexican food??? Margaret and I groaned in disappointment when we read yesterday’s blog. Today’s is better. We hope tomorrow’s will be better still and that your transplant can proceed apace. Joel S.

  10. Eileen Breslin Says:

    Bruce,
    We are relieved that they are isolating the problems, one by one. But more than that, marvel at your calm and focus. We are with you sding love to you and your lovely family. Eileen and Bill

  11. Freddy Says:

    Aren’t you glad you became a Dr. instead of a “tarrer” or do you remembe that story? only a dr. could really understand what you are going through!

  12. Tom Linden Says:

    Postscript to Jill Stewart’s posting: can physicians receive CME for reading your posts? I’m learning more from your blog than I learned in my medicine clerkship. I hope the ship stabilizes and that it’s smoother sailing in the days ahead. Best wishes to you, Bruce.

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