Posted by Becky
Leif has had a low-grade fever off and on, last night and this morning. The nurses have been giving him Tylenol to keep it somewhat suppressed. He's up and about, but not feeling too great, still has a fairly high pulse rate and feeling headachey. He was able to get a pretty good night's sleep last night. They're experimenting with a new pain management approach; a low dose of fentanyl seems to help more with the low-level "crappy" feeling than the morphine or oxycodone do; those two drugs seem to help more with sharp pain from a definite source. If small doses of IV fentanyl continue to work well, they can put him on a patch that releases small amounts over the course of several days. Fentanyl is a strong painkiller and can make a person loopy, so Leif will work with the Palliative Care team to work out the details.
The doctors are now pretty sure that he's just dealing with one infection, the source of which is his bottom. They believe that removing (aspirating) the purulent fluid from his bottom yesterday helped remove the source of infection. The blood cultures and the aspirate are both growing the same microbe, bacteria that can be generally described as gram-negative rods. They hope to have a more definite identification later today, at which point they'll talk with Infectious Disease about whether to change or add any antibiotics. Meanwhile, the take-home is that the bacteria in his blood is being seeded by the infection in his bottom and causing the fevers. It looks like the trend of his fevers is downward, so if Infectious Disease thinks he's on the right antibiotics, they may watchfully wait and expect the downward trend to continue.
He's getting a unit of platelets this morning; they're still trying to keep his platelets at a higher level because of the fevers. The unit of blood he got yesterday evening bumped his hemoglobin level up one point, and it held steady through this morning. They will check it again later this morning, but as of now he's not scheduled to get any blood today.
Leif has had a low-grade fever off and on, last night and this morning. The nurses have been giving him Tylenol to keep it somewhat suppressed. He's up and about, but not feeling too great, still has a fairly high pulse rate and feeling headachey. He was able to get a pretty good night's sleep last night. They're experimenting with a new pain management approach; a low dose of fentanyl seems to help more with the low-level "crappy" feeling than the morphine or oxycodone do; those two drugs seem to help more with sharp pain from a definite source. If small doses of IV fentanyl continue to work well, they can put him on a patch that releases small amounts over the course of several days. Fentanyl is a strong painkiller and can make a person loopy, so Leif will work with the Palliative Care team to work out the details.
The doctors are now pretty sure that he's just dealing with one infection, the source of which is his bottom. They believe that removing (aspirating) the purulent fluid from his bottom yesterday helped remove the source of infection. The blood cultures and the aspirate are both growing the same microbe, bacteria that can be generally described as gram-negative rods. They hope to have a more definite identification later today, at which point they'll talk with Infectious Disease about whether to change or add any antibiotics. Meanwhile, the take-home is that the bacteria in his blood is being seeded by the infection in his bottom and causing the fevers. It looks like the trend of his fevers is downward, so if Infectious Disease thinks he's on the right antibiotics, they may watchfully wait and expect the downward trend to continue.
He's getting a unit of platelets this morning; they're still trying to keep his platelets at a higher level because of the fevers. The unit of blood he got yesterday evening bumped his hemoglobin level up one point, and it held steady through this morning. They will check it again later this morning, but as of now he's not scheduled to get any blood today.
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