It's been a really bad day... - Page 10

Adrian Wong · 3rd Nov 2009, 01:25 AM

Quote:

Originally Posted by karhoe

Just curious,

1) How does she gets her supply of nutrients for energy?
2) Does anyone give her some sort of massage?

All the best to her, time flies, didn't realize its 2 weeks already

1. They feed her a liquid diet via a tube.

2. They have an automated machine that inflates and deflates rubber sleeves on her lower limbs to prevent DVT from developing.

Adrian Wong · 3rd Nov 2009, 01:32 AM

On my second visit today, her intracranial pressure went up a bit (18-19 mmHg) after they reduced her sedation. However, they must think she's improving because they ordered a further reduction in her sedation. If her ICP goes up though, they will turn up the sedation again.

The good news is that her fever is down... so her infection is under control. And her pupils are still reactive to light.

About the CT and clots, it looks like there was some "miscommunication". The surgeon told me they removed some of the new clot, but in truth, they removed some of the OLD clot during the recent craniectomy operation. No wonder there was such a marked reduction in the size of the old clot!

I don't know why the surgeon told me otherwise. Fear of litigation? Wasn't even in the room (someone else did it)???

Whatever it is... I'm just glad the CT scans showed no visible infarct of the brain, and the brain looks "healthier". Of course, the cerebral oedema (swelling) is still there. It's going to take a while to subside. Oh well, let's just count our blessings!

The_YongGrand · 3rd Nov 2009, 08:50 AM

Hope everything will be all right, Dr!

karhoe · 3rd Nov 2009, 09:57 PM

Great to hear that ICP only increased a little

How come her brain could swell suddenly? Should this be an issue to be concerned off as it could happen again in the future? (touch wood!)

Adrian Wong · 4th Nov 2009, 12:38 AM

Got the dreaded call this morning, urgently asking for consent to do a CT PA (pulmonary angiogram).

They were worried she developed pulmonary embolism - basically blood clots from the legs going up and getting stuck in the blood vessels of the lungs. A bad thing to get.

Luckily, the CT PA came back negative for the blood clots. They also did a doppler test on her legs' blood vessels and found nothing either. Guess we dodged the bullet this time!

They planned to fit in an IVC (inferior vena cava) filter to prevent pulmonary embolism from occuring... a "just in case" measure since they think she's at risk. However, the radio-intensivist, Dr. Lau did another scan of her tonight and found nothing to warrant inserting the IVC filter.

He took the opportunity to do an angiogram this time, and according to him, the AVM isn't actually as big as surgeons made it out to be. Very likely the clot itself obscured the actual AVM, making it bigger than it really is.

Her intracranial pressure was generally very high today, but since the CT appeared good, the EVD tube was probably giving wrong results. As such, they intend to remove the tube either tonight or tomorrow morning. It's worthless now, and will only serve as a source of infection.

Speaking of infection, she responded well to the meropenem antibiotic and her ventriculitis (infection of the brain ventricles) has cleared up.

Still, it was not all good news. They discovered this morning that she has an acinetobacter infection in her lungs. That's a bad bug to catch, although her lungs are still in good shape and the meropenem they are pumping into her is just the stuff to fight it off.

Adrian Wong · 4th Nov 2009, 01:09 AM

Quote:

Originally Posted by karhoe

Great to hear that ICP only increased a little

How come her brain could swell suddenly? Should this be an issue to be concerned off as it could happen again in the future? (touch wood!)

The brain swells up as a result of the pressure (trauma) exerted by the presence of a pool of blood within the confines of the cranium. Blood itself is also an irritant.

Trinity · 4th Nov 2009, 01:12 AM

The_YongGrand · 4th Nov 2009, 09:02 AM

Dr, let's hope and pray for the best recovery!

Ishtim · 4th Nov 2009, 09:13 AM

We are with you guys.

lee_what2004 · 4th Nov 2009, 09:31 AM

3rd Nov 2009, 01:32 AM	#92 (permalink)
Adrian Wong Da Boss Join Date: 10 Oct 2002 Location: In front of my ASUS F8V notebook! Posts: 32,304 Reputation: 3574 Rep Power: 75	On my second visit today, her intracranial pressure went up a bit (18-19 mmHg) after they reduced her sedation. However, they must think she's improving because they ordered a further reduction in her sedation. If her ICP goes up though, they will turn up the sedation again. The good news is that her fever is down... so her infection is under control. And her pupils are still reactive to light. About the CT and clots, it looks like there was some "miscommunication". The surgeon told me they removed some of the new clot, but in truth, they removed some of the OLD clot during the recent craniectomy operation. No wonder there was such a marked reduction in the size of the old clot! I don't know why the surgeon told me otherwise. Fear of litigation? Wasn't even in the room (someone else did it)??? Whatever it is... I'm just glad the CT scans showed no visible infarct of the brain, and the brain looks "healthier". Of course, the cerebral oedema (swelling) is still there. It's going to take a while to subside. Oh well, let's just count our blessings! __________________ Dr. Adrian Wong Tech ARP \| Blog @ Tech ARP \| The Free Trade Zone DYKT : The only offshore account I have is at the sand bank? We need PROGRAMMERS and TECHNICAL WRITERS! Contact us if you are a hot shot programmer or technical writer! My items for sale : 50x SD Card \| Memory Stick PRO \| Cyclone Energy Saver \| Seiko SS watch \| Tiger/Carlsberg beer jugs \| Travel Speakers \| Motorola V600 \| Nokia N90 SOLD! \| New Lowepro Mini Trekker AW Other items for sale @ the FTZ : Zalman CNPS9500 LED @ $20 \| Zalman CNPS7700 Cu @ $20 \| Zalman CNPS7000 Cu @ $20 \| Swarovski bracelet watches \| Dell 17" LCD \| Hi-Fi speakers \| English DIVX movies \| HP LaserJet toners! \| Office chairs

3rd Nov 2009, 08:50 AM	#93 (permalink)
The_YongGrand Hyperactive Join Date: 12 Feb 2005 Location: Somewhere in 甲洞... Posts: 2,744 Reputation: 1144 Rep Power: 18	Hope everything will be all right, Dr! __________________ Intel Core 2 Duo E7200, 2GB DDR2-667 RAM, Gigabyte 945GCMX-S2, Sapphire ATi Radeon HD4850 512MB DDR3 Intel Pentium Dual Core E2140, 2GB DDR2-667 RAM, Asus P5B-E Plus, nVidia Geforce 7950GT 512MB DDR3

3rd Nov 2009, 09:57 PM	#94 (permalink)
karhoe Active Join Date: 29 Nov 2006 Posts: 601 Reputation: 11 Rep Power: 3	Great to hear that ICP only increased a little How come her brain could swell suddenly? Should this be an issue to be concerned off as it could happen again in the future? (touch wood!) __________________ My Blog SPM Timetable 2009

4th Nov 2009, 12:38 AM	#95 (permalink)
Adrian Wong Da Boss Join Date: 10 Oct 2002 Location: In front of my ASUS F8V notebook! Posts: 32,304 Reputation: 3574 Rep Power: 75	Day 15 Got the dreaded call this morning, urgently asking for consent to do a CT PA (pulmonary angiogram). They were worried she developed pulmonary embolism - basically blood clots from the legs going up and getting stuck in the blood vessels of the lungs. A bad thing to get. Luckily, the CT PA came back negative for the blood clots. They also did a doppler test on her legs' blood vessels and found nothing either. Guess we dodged the bullet this time! They planned to fit in an IVC (inferior vena cava) filter to prevent pulmonary embolism from occuring... a "just in case" measure since they think she's at risk. However, the radio-intensivist, Dr. Lau did another scan of her tonight and found nothing to warrant inserting the IVC filter. He took the opportunity to do an angiogram this time, and according to him, the AVM isn't actually as big as surgeons made it out to be. Very likely the clot itself obscured the actual AVM, making it bigger than it really is. Her intracranial pressure was generally very high today, but since the CT appeared good, the EVD tube was probably giving wrong results. As such, they intend to remove the tube either tonight or tomorrow morning. It's worthless now, and will only serve as a source of infection. Speaking of infection, she responded well to the meropenem antibiotic and her ventriculitis (infection of the brain ventricles) has cleared up. Still, it was not all good news. They discovered this morning that she has an acinetobacter infection in her lungs. That's a bad bug to catch, although her lungs are still in good shape and the meropenem they are pumping into her is just the stuff to fight it off. __________________ Dr. Adrian Wong Tech ARP \| Blog @ Tech ARP \| The Free Trade Zone DYKT : The only offshore account I have is at the sand bank? We need PROGRAMMERS and TECHNICAL WRITERS! Contact us if you are a hot shot programmer or technical writer! My items for sale : 50x SD Card \| Memory Stick PRO \| Cyclone Energy Saver \| Seiko SS watch \| Tiger/Carlsberg beer jugs \| Travel Speakers \| Motorola V600 \| Nokia N90 SOLD! \| New Lowepro Mini Trekker AW Other items for sale @ the FTZ : Zalman CNPS9500 LED @ $20 \| Zalman CNPS7700 Cu @ $20 \| Zalman CNPS7000 Cu @ $20 \| Swarovski bracelet watches \| Dell 17" LCD \| Hi-Fi speakers \| English DIVX movies \| HP LaserJet toners! \| Office chairs Last edited by Adrian Wong : 4th Nov 2009 at 01:07 AM.

4th Nov 2009, 01:12 AM	#97 (permalink)
Trinity Little Kiki Join Date: 5 Jan 2003 Location: Ohio,usa Posts: 7,131 Reputation: 5836 Rep Power: 72	__________________ (\__/) (-. - ) (> < )

4th Nov 2009, 09:02 AM	#98 (permalink)
The_YongGrand Hyperactive Join Date: 12 Feb 2005 Location: Somewhere in 甲洞... Posts: 2,744 Reputation: 1144 Rep Power: 18	Dr, let's hope and pray for the best recovery! __________________ Intel Core 2 Duo E7200, 2GB DDR2-667 RAM, Gigabyte 945GCMX-S2, Sapphire ATi Radeon HD4850 512MB DDR3 Intel Pentium Dual Core E2140, 2GB DDR2-667 RAM, Asus P5B-E Plus, nVidia Geforce 7950GT 512MB DDR3

4th Nov 2009, 09:13 AM	#99 (permalink)
Ishtim Super Moderator Join Date: 14 May 2003 Location: Alabama, USA Posts: 3,765 Reputation: 3333 Rep Power: 43	We are with you guys.

4th Nov 2009, 09:31 AM	#100 (permalink)
lee_what2004 Super Active Join Date: 28 Dec 2007 Location: Melaka Posts: 1,313 Reputation: 1106 Rep Power: 14	__________________ Once a wise-man said : Chapter 1: Don't ever compare if you want to stay constant..... Chapter 2: Whatever you have done in the internet, you will never get away from it... Chapter 3:To be continued after I thought another one