We've Got Urine!

After going another 24 hours without any evidence of urine they decided to insert a foley catheter this morning at 5:00am. They got nearly 200cc from her which is an excellent sign, but that's still a rather low volume considering all the IV fluids she's been receiving.  Her urine was also dark brown, so that's still a concern too.  They seem to think she's still trying to recover from such severe dehydration.  They did more blood work last night around 10:00pm and everything was normal, so they are not worried about her kidney functions at all. Having the catheter in is good to make sure she is emptying her bladder, but they are also concerned about leaving it in too long--having the catheter in with all her diarrhea puts her at a higher risk of developing a UTI, especially since she is not receiving any prophylactic antibiotics for that anymore.  They stopped her cipro yesterday and had planned to start bactrim prophylactically, but the doctors can't all agree on whether that is in her best interest or not.  The c-diff might be better treated if the bactrim is not in her system, but developing a UTI is yet another complication.

I pushed to have her ativan stopped since she hasn't been having any seizures and hasn't been vomiting, so her vigabatrin that she's been getting via g-tube should be starting to work.  But they still aren't sure if her body is absorbing the vigabatrin since she still has frequent diarrhea.  So we're continuing to monitor her seizures.  The ativan has been making Annie incredibly sleepy and along with the dehydration, is causing her blood pressure to drop to the 70s/40s.  She's been receiving bolus IVs about every 12-24 hours and her blood pressure comes up to normal range after those boluses.

As for pain, Annie actually never did receive any morphine yesterday.  They connected it to her IV line, but Justin had disconnected that line of tubing from Annie to the morphine syringe when he got her in her chair for a while yesterday.  Annie has continued to receive acetaminophen and ibuprofen alternating every 3 hours.  But no one has to watch the clock for those meds--Annie lets us know when they have worn off and it breaks my heart to feel so helpless for 40 minutes until the meds start working again.

Annie has started to get some swelling, mostly in her face, hands, and feet, but they seem to think that's a natural side effect of the diarrhea.  She's not keeping the natural salts and proteins in her body that would allow her blood to maintain the fluid, so a lot of the fluid is going into her tissues.  It's something they are monitoring, but don't seem too concerned about right now.

Annie is still pretty sedated.  She did open her eyes to just a small slit this morning when she was crying.  I tried to let her see me and talk to her, but I'm still not sure she knows I'm here.  Hopefully the ativan can get out of her system today and we'll see her perk up just a bit.