I am just full of great stuff on this blog, eh? You’d think things never go right. Though now that I’m typing that out, it doesn’t seem like much HAS gone right lately.
Last night, we had a good night. BUN 73 this morning, creatinine the same. Took forever to get anyone from nephrology here with anything resembling a plan. Actually, when one of the dialysis nurses came to start setting up for a few passes today, I had asked her if this was the big “it.” Is this It? Is this dialysis now for the foreseeable future? And she didn’t know, either. As it turns out, nobody has really decided.
They were hoping to do a few manual fills and drains today to get that BUN down. But nothing doing. Teddy was having none of it. Not only that, but his catheter was also having none of it. It would fill, it wouldn’t drain. So, after only getting 20 cc in (instead of the 40 x 4 passes), we gave up.
Back to Xray, his catheter is still jammed up where it doesn’t belong. There was some hope that, since he’s been pooping a lot and seems to have gotten that part of his system working again, everything would have settled back down where it belongs. But nope. They were even having a hard time getting anything out pulling with the syringe (as opposed to just draining, where gravity does all the work).
I believe the next step is a trip to the OR to fix that. I’m not sure what “fixing that” means. We were headed there anyway to get the port taken care of, though I’m not sure what the timeline was on getting the port fixed was. No decision has been made on the port (whether we will replace it or whether we will just remove it).
This does buy us another day to let the BUN come back down. If it comes down significantly, then I think we stand a decent chance of getting out of here without starting dialysis. If not, then it’s clearly just time. The sucky thing is that if his BUN had just come up on its own, then I would feel very settled about it. It would have been a clear indication that his kidney with its tiny amount of functioning tissue had finally just given it up, or was finally unable to keep up with him. But because of all the puking, it’s hard for me to feel like it’s that cut and dry. Dehydration causes high BUN (which causes nausea, which causes puking, which causes dehydration), so was BUN high just because he was puking? Or was he puking because of high BUN? So having another day – by the time they make any decisions tomorrow, he’ll have been on IV fluids for a good 36 hours at least – will at least help reassure my mind.