Sunday, December 3, 2017

Going in the Right Direction

Carlos had a great night.   He got some rest and his numbers started to improve a good bit.   Yesterday after posting,  I ran into Dr Steidley, and he was very positive.   Nice to start seeing that reflected in labs and vitals.  The girls and I came to visit last night after Libby's sand tournament.   Carlos was quite chatty, lots of volleyball talk (big surprise)  but I made them all shut up because I could see he was getting fatigued.  His cardiac output index was dropping.   Endocrinology visited and he got his plasmaphoresis done during the afternoon.

Today they have started weaning down the balloon pump.   It now only pumps every other beat.  He's tolerating that well so far.   The hope is to have it shut off by tomorrow so he can get up and start moving around a little more, which will lead to getting out of the bat cave and on to 4w.   His labs are improving as well.   His creatinine is down to 2.3 so hoping to see that continue trending downward.   His liver enzymes have decreased as well.   Yay!  They are continuing high dose steroids but that well skew down a bit tomorrow and he continues to have milnirone, which helps the heart to pump more effectively.   Will probably be a few days on that once balloon pump is gone.   I think he's going to have echo tomorrow to look at his heart function.   No one knows whether function will improve or not, that remains to be seen.   He will also have his second round of plasmaphoresis. 

His type of rejection is the 'good kind' I guess.  Comes on fast but able to get rid of it fast.   I guess the other type tends to smolder and never fully resolve.

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