It’s going on 9:30pm here in Detroit.  I just left Emerson &, although a bit agitated, she’s mostly resting quiet on the vent this evening.  The procedure to place her central line was quite an undertaking – a relatively quick procedure that took over 2 hours!  The intubation went smoothly, but the line was very difficult to place.  She’s dangerously close to losing ALL IV access.  There are IO kits near her bedside “just in case”.  Already one lumen is clotted - they’re attempting to open it with TPA tonight.

Emerson’s blood pressure is still soft & I expect it may become a problem again overnight.  Her electrolytes are messed up & they're working on correcting them this evening.  She’s oxygenating in the mid-90s on 60% O2 support – not super, but certainly okay with room to go up if she should need it.  Her pain has been a bit difficult to manage, but frequent doses of dilaudid seem to be helping some.  

Infectious Disease started a collection of strong antibiotics – her usual “cocktail” - & ordered a CT scan for tomorrow.  In addition to the suspected infection around her abdominal tubes & wound, Emerson also had a very suspicious urinalysis.  I’d guess the infection in her wound seeped into her bladder via her vesicostomy (the hole on her abdomen through which she passes urine).  She has so many holes & wounds & tubes in one small area – it’s nearly impossible to control the spread of infection amongst them all.

As for me, it turns out this Ronald McDonald House may actually be a blessing in disguise… a private sleeping room – no nurse interruptions, no beeping pumps – hours & hours of peace and quiet.  I can’t wait to crawl into bed!  It’s been a long couple days!!

Hoping for a quiet night all around… I’ll update again tomorrow.  Thanks so much for all your prayers & well wishes!