Re: Liver Bulletin: Update #3

[Guest guest]

Dear Shaunna,

My prayers are with you.

Ali

Ali Lingerfelt-Tait

alisoikias@...

411 charlotte st.

asheville, N.C. 28801

828 253-8996

-Recycle yourself -

become an organ and tissue donor

[Guest guest]

I am sending many good thought's her way. Please let Shauna know that I

am praying for her.

Lee

On Monday, September 20, 2004, at 11:32 AM, Shauna Saunders wrote:

> Update #3

> Monday, September 20, 2004

>

> Dear Friends and Family:

>

> It is now Monday morning, and we wanted to share with you the latest on

> Shauna'9s condition.

[Guest guest]

Bless her heart...tell her all of our prayers are with her and to hang

in there!!!!

Anne & Bobby

Liver Bulletin: Update #3

Update #3

Monday, September 20, 2004

Dear Friends and Family:

It is now Monday morning, and we wanted to share with you the latest on

Shauna'9s condition.

On Friday, the doctors tried to remove fluid from her abdomen by

paracentesis. They were minimally successful. Based on an ultrasound,

the

radiologist marked a spot for the insertion of the needle and tubing,

which her doctors believed was too close to major arteries. They refused

to pierce her where the radiologist indicated that she had the most

fluid

and chose instead to make ``blind'' attempts in safer spots - not easy

to

find given Shauna'9s massive spleen. After two attempts to drain off

fluid, in two different locations, the doctors determined that Shauna'9s

fluid is localized in small pockets throughout her abdomen, which cannot

be removed in a continuous flow. In the end, they managed to empty a

couple of these pockets. Because the fluid they removed only amounted to

approximately 700 ml, the procedure was unable to provide Shauna with

much

relief in her abdomen. The swelling in her hips, legs and feet is due to

edema, which cannot be tapped off.

Throughout this time, Shauna was still receiving IV fluids, and not

getting rid of any water, therefore her pain intensified on Friday and

Saturday. In total, she has gained about 30 pounds of fluid since

arriving

in hospital. Her breathing was also quite laboured and chest xrays

revealed some pleural effusions. (Katy thinks this sounds like a

rhetorical strategy not fluid in the chest.) They increased her pain

medication but it wasn'9t clear whether anything else could be done

until

her sodium levels improved and the diuretics could be retried.

Thankfully, her sodium levels did improve. She had been given

substantial

dosages of albumin as part of the SBP treatment and to replace the fluid

removed during the paracentesis, and doctors believe the albumin was

largely responsible for the elevation of her blood sodium levels. They

reached 133 on Saturday, and on Sunday tapered off somewhat to 129. With

her sodium relatively stable, the doctors thought that re-introducing

diuretics would be an option. Yesterday they gave her 20 mg of Lasix, by

IV. Previously, Shauna'9s dosage had been between 80-120 mg by mouth. As

a

result of the diuretics, Shauna lost approximately 2 litres of fluid.

She

is much more comfortable even from this small change. With her sodium

levels more stable, they have stopped giving Shauna IV fluids. This has

also helped make Shauna more comfortable.

She is still on the antibiotics for her SBP infection, which after

running

tests on a fluid sample from Friday, seems to be clearing up. Today

should

be the last day of IV antibiotics and then onto the prophylactic

antibiotic

treatment.

Today, we are still waiting for word on the latest bloodtest results. We

will see whether the small dose of diuretics negatively affected her

sodium levels and whether is it possible to give her another small dose

today. Her MELD score will also be determined (let'9s hope it'9s high!).

There is a possibility that Shauna could be re-listed as early as today.

Shauna will likely be discharged on Tuesday or Wednesday.

All things considered, Shauna is feeling better today. She is still very

tired and her appetite is poor but she is much more comfortable. We have

been taking daily walks around the hospital and now that Ivan has

passed,

may even venture outside today.

Thanks for your thoughts and prayers. We keep hoping for the best.

Please

hope with us.

Love,

Shauna, Anita, Ken and Helen.

--

Think you're an ORGAN DONOR? Click here to find out:

http://www.shareyourlife.org/become.asp

[Guest guest]

Hi Shauna,

I will keep you in my prayers.

Regards,

Bob

Liver Bulletin: Update #3

> Update #3

> Monday, September 20, 2004

>

> Dear Friends and Family:

>

> It is now Monday morning, and we wanted to share with you the latest on

> Shauna'9s condition.

>

> On Friday, the doctors tried to remove fluid from her abdomen by

> paracentesis. They were minimally successful. Based on an ultrasound, the

> radiologist marked a spot for the insertion of the needle and tubing,

> which her doctors believed was too close to major arteries. They refused

> to pierce her where the radiologist indicated that she had the most fluid

> and chose instead to make ``blind'' attempts in safer spots - not easy to

> find given Shauna'9s massive spleen. After two attempts to drain off

> fluid, in two different locations, the doctors determined that Shauna'9s

> fluid is localized in small pockets throughout her abdomen, which cannot

> be removed in a continuous flow. In the end, they managed to empty a

> couple of these pockets. Because the fluid they removed only amounted to

> approximately 700 ml, the procedure was unable to provide Shauna with much

> relief in her abdomen. The swelling in her hips, legs and feet is due to

> edema, which cannot be tapped off.

>

> Throughout this time, Shauna was still receiving IV fluids, and not

> getting rid of any water, therefore her pain intensified on Friday and

> Saturday. In total, she has gained about 30 pounds of fluid since arriving

> in hospital. Her breathing was also quite laboured and chest xrays

> revealed some pleural effusions. (Katy thinks this sounds like a

> rhetorical strategy not fluid in the chest.) They increased her pain

> medication but it wasn'9t clear whether anything else could be done until

> her sodium levels improved and the diuretics could be retried.

>

> Thankfully, her sodium levels did improve. She had been given substantial

> dosages of albumin as part of the SBP treatment and to replace the fluid

> removed during the paracentesis, and doctors believe the albumin was

> largely responsible for the elevation of her blood sodium levels. They

> reached 133 on Saturday, and on Sunday tapered off somewhat to 129. With

> her sodium relatively stable, the doctors thought that re-introducing

> diuretics would be an option. Yesterday they gave her 20 mg of Lasix, by

> IV. Previously, Shauna'9s dosage had been between 80-120 mg by mouth. As a

> result of the diuretics, Shauna lost approximately 2 litres of fluid. She

> is much more comfortable even from this small change. With her sodium

> levels more stable, they have stopped giving Shauna IV fluids. This has

> also helped make Shauna more comfortable.

>

> She is still on the antibiotics for her SBP infection, which after running

> tests on a fluid sample from Friday, seems to be clearing up. Today should

> be the last day of IV antibiotics and then onto the prophylactic

antibiotic

> treatment.

>

> Today, we are still waiting for word on the latest bloodtest results. We

> will see whether the small dose of diuretics negatively affected her

> sodium levels and whether is it possible to give her another small dose

> today. Her MELD score will also be determined (let'9s hope it'9s high!).

> There is a possibility that Shauna could be re-listed as early as today.

> Shauna will likely be discharged on Tuesday or Wednesday.

>

> All things considered, Shauna is feeling better today. She is still very

> tired and her appetite is poor but she is much more comfortable. We have

> been taking daily walks around the hospital and now that Ivan has passed,

> may even venture outside today.

>

> Thanks for your thoughts and prayers. We keep hoping for the best. Please

> hope with us.

>

> Love,

>

> Shauna, Anita, Ken and Helen.

>

>

>

> --

> Think you're an ORGAN DONOR? Click here to find out:

> http://www.shareyourlife.org/become.asp

>

>

>

>

>

>