taking a leaf from Father's book I ask that you excuse any errors in this post as I am writing and posting it in a rush before
attending Mass and continuing my preparations for Christmas... He has seen this post and allowed me to publish it as it is!
As
you know, Father was admitted to hospital on 17th of November with
“a very nasty pneumonia” and discharged on December 11th. On
admission a temperature of over 38.5oC was accompanied by a high
respiratory rate and a low blood pressure of around 80/60. Intravenous (i.v.)
fluids to raise the blood pressure resulted in marked oedema of the legs and
feet, but successfully raised the systolic pressure to above 100. Additionally,
he was told that “although the white cell Count is high as expected, the cells themselves
are malformed; they look a bit leukaemic, and we don’t know if this predates your pneumonia and
led to it occurring or if it is the result of the pneumonia. We have to wait to
see if the haematology team show concern”. Three days of i.v. Tazocin brought
some positive change to his condition and his vital signs improved, so his
medication was changed to oral co-amoxiclav. Unfortunately this resulted in a
deterioration in his condition, and the i.v. Tazocin had to be recommenced. Culture
and sensitivity of sputum showed Tazocin should have been effective, but it became
necessary to change to seven days of i.v. Meropenem
when a third sputum sample showed he had a pseudomonas infection, which is probably
sitting in the portion of his lungs where Bronchiectasis was noted early last
year. A CT of chest was then taken which showed ‘lung cavities’ (abscess formation).
From
day three of his admission, heavy diarrhoea began and continued for ten days.
Samples showed he was free from Clostridium Difficil, so the diarrhoea probably
resulted from the heavy use of antibiotics. Sadly, even though Father was never
a big man, his weight has gone from 11 stone (c.155 pounds) to just over 9
stone (c.131 pounds), so he is quite debilitated.
His
mood was very low in hospital as all the ‘news’ seemed to be going in the wrong
direction: “you have a nasty pneumonia…the oral antibiotics are not having the
expected effect…your white cells look a bit leukaemic…you have a pseudomonas
infection…you have lung cavities…you need a bronchoscopy so we can determine
what is going on…you need seven days of i.v.’s”. He says his mood was mostly
low as he saw what he (formerly a registered nurse himself) described as
“failures in nursing care and asepsis”, so when it was suggested he could have his
i.v.’s at home from the district (community) nurses or stay in hospital, he
chose to go home.
For
his discharge the antibiotic was changed from Meropenem, which is given three
times daily, to Ciproflaxacin as this can be given twice daily. These seven
days of i.v.’s have now ended; he has had his midline removed (interestingly,
he says he is not aware of having any pressure applied to the site of insertion
during removal of the line, so he is now watching for bleeding, swelling of the
arm, pain, redness and heat in the arm) and his bronchoscopy was carried out on
18th of December, the results of this will be made known to him at
his follow-up appointment on January 22nd.
Father
says he will let you know the result of the bronchoscopy when he has it.
Meanwhile please keep up the prayers. Father
says “for my spiritual health rather than my physical health, though both would
be good!”. He is not well but hopeful that the bronchoscopy will provide
for some positive direction in terms of treatment.
At
present he is feeling drained, is breathless on minimal exertion, experiencing some
upper back pain which he thinks may be due to his cough, and having some soreness
around his midline site. That said, he is looking forward to spending Christmas
with his siblings, though he has over the last couple of days notices an increase in breathlessness and sputum production (which is now yellow) so despite his observations being quite stable he has commenced his rescue Doxycycline).
His
COPD and bronchiectasis will never resolve, and the damage done during exacerbations tends to bring about permanent structural
alterations in the lung and thus predispose to permanently worsened airflow, so
he will never be as ‘well’ as he was three months ago, but there is every hope
of improvement in his condition as it stands today.
