4/8 part II

Now that John is back on the levofed to help maintain his blood pressure, he isn't stable enough for surgery to assess him for the peg tube and debridement. We will wait for a few days to see if John can begin maintaining his own blood pressure without the levofed. It's uncertain what this means. It is possible John has another infection that is affecting his blood pressure. Blood cultures have been drawn and sent to the lab; we will see whether the results indicate there is another infection. Even negative results don't completely rule out an infection; John's antibiotics may mask an infection. And, the steroids suppress body temperature so even though John's temp seems normal, it is possible that there is still an infection there. Patients on tube feedings can build up a high sodium level so John was getting a little bit of free water prophylactically to help avoid that. John's sodium level dropped with the free water so it was discontinued and now his sodium levels are almost normal. John has been dealing with low sodium for a while now. Our original treatment was to let me salt his food and then he was on salt tabs. So, it's not really a surprise that the sodium levels dropped. Let's end on a good note tonight. John is still doing well on the pressure support setting of the ventilator; the edema is gone; CMV numbers are down; there is no gvhd rash; the pneumonia isn't worse. Send good thoughts and prayers for John to be able to get off the levofed, that there are no new infections, and a special request for the recovery of brother of honey badger. John wants his brother to be better soon.