When we arrived at the hospital on Monday morning, Anya was already up and walking. We weren’t expecting her to be up, let alone walking. Marion captured the moment in this photo:
Yesterday, she had another bronchoscopy. According to the pulmonary doctor, they are going to have to do a bronch every other day to make sure that the dead cells from the lungs are removed and replaced with the healthy ones. He assured us that it was nothing to be concerned about, as it was a pretty normal thing to do post transplant.
She slept for most of the day due to the anti-anxiety drugs, which they gave her right before we arrived for visiting hours. She looked visibly lethargic the three times that we were there visiting, but the nurse assured us that she was up and talking when we weren’t there, so it was most likely just the drugs.
She was on the trach collar for 29 hours straight from Sunday morning until Monday afternoon. Her SATs were great the entire time, which means that her new lungs are working great. They put her back on the vent for a few hours last night because they wanted to give her body a little bit of a break after the bronch.
This morning, when we arrived, she was sound asleep. The nurse told us that she had “a little” pneumonia in both lungs. Also, a bacterial infection called pseudomonas grew out from her bronch on Friday. Pseudomonas is a common bacterial infection found in many cystic fibrosis patients pre and post transplant. The doctors adjusted some of her antibiotics to treat both the pneumonia and the pseudomonas.
Her white blood count was a little lower today (14,400), which means that she still has an infection in her lungs, but her body is doing a better job of fighting it off than the previous day. Her hemoglobin was a low again at 6.7 (below critical level), but the doctors decided not to do anything today. The nurse will recheck her blood tomorrow morning and if it’s still low, then I’m guessing that they will probably give her some more blood. They want to avoid giving her blood constantly because it may cause other problems down the road. Although, anything below 6 and they’ll have no choice.
By the 4pm visiting hours today, Anya looked pretty good. She seemed like she was well rested and back to her normal self again. The nurse told us that she walked 100 feet while we were gone! As far as her drowsiness over the past few days, I think a lot of it was due to the anti-anxiety drug called Ativan, and perhaps Clonazpam (aka Klonopin). The drugs are very similar to Xanax, but much more potent. Both drugs put her to sleep, but the Ativan makes her look like a zombie and sometimes even talk like a zombie. I wouldn’t recommend it to anyone, but for someone 6 days post transplant, recovering, it definitely helps. I’ve talked to a lot of lung transplant recipients and caregivers over the past few months and anxiety is definitely one of the most common themes amongst all patients. It’s also one of the toughest things to control.
I still feel like things are progressing well. The pulmonary doctor informed us that Anya probably won’t be getting out of the ICU until next week some time. They still want to see her on the trach collar for around 48-72 hours straight; they still want to do bronchs every other day; I imagine that they’ll want her white blood count and hemoglobin to get back to their normal ranges; maybe have that last chest tube drain less than it’s currently draining. I think if she’s able to meet all of these criteria by Thursday/Friday, then maybe she’ll be released from the ICU, but I think it’s more likely that she’ll be released next week some time. Maybe Tuesday/Wednesday. We’re in no hurry, but for sanity’s sake, I think the sooner, the better. This ICU is just way too busy and not very conducive to healing. Til tomorrow.