Labs, Fevers, and Pains

When caretakers sit and sit in the hospital with their sick loved one, they may begin to be fixated on certain things (actually happens to doctors with really sick patients as well).  This isn't always a good thing, because it's better to stay focused on the overall health, but hard to fight human nature.  J has three attention grabbers that we are always looking at, and hopefully not missing other important details.


Labs.  Today is the first day since last Wednesday that he has had detectable white blood cells.  The lower limit for the lab is 200 white blood cells per microLiter.  He has been below that level for days now, but today he has about 370.  Progress.  It's abnormal to be below around 4,000, so we have a lot of work to do.  His red blood cells are just bouncing around in the low range.  Yesterday they were up a little, today they were down a little.  His platelets continue to go down.  Would like to see that change.  Today his potassium was low to where they want to replace it.  This is probably because he is not eating nearly enough.

Fevers.  He continues to have fevers off and on.  Fevers suggest infection and suggest that we're not quite adequately treating the infection.  When an antibiotic is started, it's usually OK to have fevers for another 24 to 48 hours, but by then we should stop.  J continues to have fevers, so they broadened his antibiotic coverage last night.  We also just found out the bug that grew in his blood cultures.  Klebsiella pneumoniae.  Exciting.  Pretty common bug. The other thing about fevers is that when the white blood cells start to recover, the patient may have fevers.  Makes it hard to know if you have more infection or just normal response to healing.

Pain.  J has pain in his mouth from the canker sores.  He also still has pain near his surgical incision.  The skin around it looks a little red.  It's getting a little firm.  It has been a limiting factor for what type of activity he's willing to do.  And it's odd that it continues to hurt.  Hope it's not another source of infection, like cellulitis (infection of the skin).

Goals for the day.  Eat more.  Get out of bed and walk around.  Better pain control.