A day of major setbacks. Arrived to find that the vasopressor Levophed was up from 8 mcg to 25 mcg/min to maintain his blood pressure. Pretty high. Heart rate high too. By the end of the day Rich was on 2 IV meds to lower heart rate, and 2 to maintain his blood pressure. Apparently earlier in the day he had a fever. When I felt his head I thought he seemed warm, but by this time he was down to 99.9 temp. So the doctors ordered more blood cultures to see if he has a new infection that is not coverd by the antibiotics he is on. It is like going through the sepsis drill all over again. Kidneys starting to fail again. Creatinine up to 3.4 and BUN 97, both bad. Signed a consent tonight to insert another catheter for dialysis. They did an ultrasound of kidneys looking for more clots/dead tissue, don't know results yet. The weekend pulmonary fellow and ICU resident were absolutely awesome, they get A+ for family skills. They know the gravity of the situation, but willing to do whatever the family wants. They are not sure if Rich's heart can take another assault, and feel that the clot by his mitral valve may still be showering his organs with debris (clots). Just don't know what to say. The only good thing that happened was a friend of ours (we are the godparents of his twin daughters) and his wife stopped in to see Rich tonight and we had a nice visit. They are just now moving to Miami. I hope Rich knew Terry was here, and how much Terry loves him. I tell Rich each day about all of your emails and well wishes. And I tell him often, not knowing his mental status. Have to say today he was in sleep cycle, but when one eye open and he was staring straight ahead, I asked him to look at me and he did, and appeared to focus on me, followed my voice etc. So not sure about anything. When his eyes are wandering, I am pretty sure that is really just reflex.
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