December 7, 2010
This morning as I was walking into the Bone Marrow Transplant unit at around 6:50 AM I sensed things weren't going well in Bonnie's room as I saw one of the RNs walking about 100 feet ahead of me carrying what looked like ice packs. As I arrived at the room and saw the attending night physician in the room with two other nurses I learned that the fever Bonnie had spiked to 101 last night had crept up over 103. In addition her blood pressure was very low (70s over 40s), blood oxygen low (81) and heart rate elevated (150ish). The team worked vigorously to improve Bonnie's vital signs but in a short period of time determined she needed to be immediately moved to ICU, where she is now.
To say she is on "life support" sounds so terminal, but in reality, it is IV meds that are artificially keeping her blood pressure at acceptable levels and her heart rate moderate. The ICU team had to insert a breathing tube (intubation) to get Bonnie's blood oxygen at or near acceptable levels. So tonight Bonnie rests under heavy sedation and pain meds, in addition to the other meds, including antibiotics and her ongoing meds since the bone marrow transplant.
Chest xrays show some lung infiltrate which could be a number of things. Blood cultures from this morning have returned positive for an infection that is being narrowed down currently and may be determined by tomorrow morning.
She may have an infection in her lungs, it may be in her blood, it may be both and what is currently being analyzed. Once the infection has been identified, the doctors feel the status is reverseable, however there may be damage to her lungs or possibly other organs, due to a number of things, including the low blood pressure and meds being pumped through her.
Key in all of this is Bonnie's immune system or lack thereof. In normal situations the doctors believe this is reverseable, but the variable in this case is that Bonnie doesn't have a normal immune system, but rather a compromised system. As of this morning her white blood cells had dropped to .1 or 100 (as a refresher 4000-12,000 is considered normal range).
The prayer is that her bone marrow will start to produce new white blood cells and that her numbers will come up to an acceptable level. Bonnie knew the best place for her was Karmanos, but once we arrived over a week ago, she shared with me a concern of her failing and being stuck in Detroit, 90 miles away from home. For now, her concern is being realized, as she lies in ICU unaware of her situation.
Tomorrow Karmanos plans to do another bone marrow biopsy. If you have followed this blog in the past you are aware of the anxiousness Bonnie has in anticipation of this procedure. Because she is under heavy sedation, she has no clue this is going to happen and won't be awake during the actual procedure to care. Hopefully the biopsy will give the BMT doctors a clue as to why Bonnie has been neutropenic (no WBCs) since the Wednesday prior to Thanksgiving.
At this stage, there isn't any indication how long she will be in ICU. I was told it could be days or weeks, depending on how she responds to treatment. So, please continue to pray for God's will. Obviously our desire is for the reversing of her current status so she can return to Lansing.
Thank you for your faithfulness in keeping us in your prayers.
Love, Steve (and Bonnie too!)