Blood
Before Bob was cleared to have surgery #3, he received a unit of blood in the morning to bring up his hemoglobin.
Surgery #3 completed
Before Bob was cleared to have surgery #3, he received a unit of blood in the morning to bring up his hemoglobin.
Surgery #3 completed
Bob's third surgery was cleared to take place today, and it lasted from 4 to 5pm. The surgeon opened up Bob's abdominal cavity, flushed it out, but wasn't yet able to rejoin the two intestine ends, since they are still too swollen. So he left the wound open, and placed another wound-vac sponge to continue to drain his abdomen.
The hopes are that they might be able to go back in again on Monday (11/27), and possibly reattach the intestine ends, but right now it is too soon to tell. After next Monday's operation, there may still need to be yet another surgery to hopefully close up the muscle and skin.
The hopes are that they might be able to go back in again on Monday (11/27), and possibly reattach the intestine ends, but right now it is too soon to tell. After next Monday's operation, there may still need to be yet another surgery to hopefully close up the muscle and skin.
This is going to be a LONG HAUL. A marathon, not a sprint.
Post-Surgery Vitals/Stats
-Fever: Post surgery temp is only 38.1C/100.58F. Hoping it will remain in this range since the antibiotics that were started two days ago have been doing a good job fighting the infection.
-Blood pressure: Maintaining 100/60. Even with the anesthesia, his BP hasn't been dropping; and no pressor medications being administered, either. This is very good news!-Fever: Post surgery temp is only 38.1C/100.58F. Hoping it will remain in this range since the antibiotics that were started two days ago have been doing a good job fighting the infection.
-Heart Rate: His pulse is 100 (normal is 80bpm), which is only slightly elevated due to just having surgery again.
-Hemoglobin: Hemoglobin at 8.1 (normal is 13.5 - 17.5). This morning it was down to 6.6 before he received a unit of blood. This number is going UP, which is what we want!
-Fluids: The third-spacing issue still exists. All of the extra fluids that have built up in the tissue in Bob's body have not yet been absorbed/removed. Much of this happened because of the sepsis - the body was defending using every method it had to try to rid itself of the infection. That is a large reason why the intestines were still too swollen and couldn't yet be joined back together in today's operation. The edema is still in all areas below his waist, and also beginning to show in his hands. This may take a while to handle and resolve.
*Concern regarding the fluids - There continues to be some additional fluid collecting in the lowest lobe of Bob's right lung. This is the same side where Bob's ascending colon was removed, where his largest incision was, and where the greatest amount of fluid has also collected in his abdomen and flank. In an over-abundance of caution, they removed a sample of mucous from that area of his right lung and sent it off for culturing. So far, it doesn't look like pneumonia, but is rather more third-spacing fluid. The respiratory therapist comes in every two hours to suction the ventilator tube, to listen to Bob's lungs, and to check his oxygenation levels. They are very diligent about managing every aspect of Bob's condition, always.
*Concern regarding the fluids - There continues to be some additional fluid collecting in the lowest lobe of Bob's right lung. This is the same side where Bob's ascending colon was removed, where his largest incision was, and where the greatest amount of fluid has also collected in his abdomen and flank. In an over-abundance of caution, they removed a sample of mucous from that area of his right lung and sent it off for culturing. So far, it doesn't look like pneumonia, but is rather more third-spacing fluid. The respiratory therapist comes in every two hours to suction the ventilator tube, to listen to Bob's lungs, and to check his oxygenation levels. They are very diligent about managing every aspect of Bob's condition, always.
-Kidney Function: Urine output is still concentrated, but each time they have to go into his abdomen, the kidneys are going to "go to sleep" somewhat and remain sluggish. This is going to take some time to be resolved.
-Blood Sugar: Latest level was only 133 - no insulin needed! This may increase after the insult of another surgery, but will be addressed with injected insulin as needed.
-Blood Sugar: Latest level was only 133 - no insulin needed! This may increase after the insult of another surgery, but will be addressed with injected insulin as needed.
Back into his room in the ICU after operation #3
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