New Day, New Concerns

Please continue to pray. This is Day 7 in ICU for me. Several new and puzzling concerns have arisen.

First, overnight 10 attempts were made to begin a new IV and all failed. My veins are simply failing me. The nursing supervisor called off that vein search party and I am trying to make it through today's IV's with the same line. The general consensus is an indwelling port needs to be surgically inserted into my chest - definitely not without risks for me. High on the agenda will be locating a vascular surgeon for this task.

Today is Day 7 for me in ICU. The current plan is to complete this mornings's Tygacil IV antibiotic, desensitize me to yet another oral antibiotic, Doxycycline (to replace the Tygacil upon discharge) and to infuse today's IV Micafungin before release. I will transition the IV Tobra to intranasal Tobra and I will continue IV Micafungin as an outpatient for two additional weeks.

At last, my temperature did return overnight to my normal 97 range and it remained there this morning. This is a praise.

I remain on 20 mg prednisone (twice daily) as I taper off of the earlier IV steroids given to prevent drug reactions and due to the suspected bout of adrenal failure Sunday evening (I have secondary adrenal failure due to chronic steroid use). Glucose levels have been slightly elevated from the steroids, but nothing overly concerning (110-160). Long acting insulin has been used (Lantus).

However, my family physician was just in and she had several bits of puzzling and concerning information.In the last 24 hours, my WBC increased from 70,500 to 136,000. Neupogen was given yesterday and is being given when the ANC drops below 10,000 as I fight these infections.

We cannot locate any specific reasons but my potassium level has been steadily increasing this week from 4.4 on admittance to 5.6 today. I have researched all of these drugs and see no specific reference to hyperkalemia (elevated potassium) from them. My doctor said one or more of these 3 drugs can induce hemolytic anemia (that could increase potassium) but my hemoglobin is improved, not declining. She also mentioned a very high glucose level could increase potassium levels but she wouldn't think so at these levels. She wants this potassium level checked daily and if it reaches 6 she said I will have to be readmitted and treatment against the elevated potassium initiated. I know hypercalcemia can be an oncology emergency and related to the disease process - the many pieces of the puzzle grows more confusing.

Please also pray for my kidneys and liver as these drugs are difficult on them and my related kidney counts are worsening.