Monday, May 29th 8:30pm - Pressure back under control
Dad's ICP is back under 20. :)
His latest lab results showed a further reduction in his sodium level (good), and an improvement in the serum osmolarity (Serum Osmolarity is a measure of how hydrated or dessicated his cells are). The improved osmolarity made it possible to give him another dose of Manitol. Manitol is a diuretic, so it helps reduce pressure in the brain. The danger is that is also drains fluid from other tissues - hence the relationship with serum osmolarity.
The Manitol brought Dad's ICP back into a safer range. Also, he is gradually being pushed deeper into a coma to minimize his brain activity.
The medical team is now closely observing him and considering options to deal with the fluid in his lungs. Left untreated, it forces them to keep up the pressure in the ventilator so his pulseOx stays high. Additionally, the fluid serves as a breeding ground for bacteria and can lead to pnumonia. He is on two antibiotics as a preventive measure against the pneumonia and other possible infections through his various wounds, etc. (remember there is still an open egress to his brain through one of the skull fractures).
One possible next step to treat the fluid would be to perform a treachotomy to enable better access to his airway. This could help them suction out the fluid.
Also - one amendment to the previous post: In addition to moving his leg and coughing when he was coming out of the coma this afternoon, his pupils were reactive (a good sign).
Dad is fighting for his life, and - complications not withstanding - we think he's winning.
His latest lab results showed a further reduction in his sodium level (good), and an improvement in the serum osmolarity (Serum Osmolarity is a measure of how hydrated or dessicated his cells are). The improved osmolarity made it possible to give him another dose of Manitol. Manitol is a diuretic, so it helps reduce pressure in the brain. The danger is that is also drains fluid from other tissues - hence the relationship with serum osmolarity.
The Manitol brought Dad's ICP back into a safer range. Also, he is gradually being pushed deeper into a coma to minimize his brain activity.
The medical team is now closely observing him and considering options to deal with the fluid in his lungs. Left untreated, it forces them to keep up the pressure in the ventilator so his pulseOx stays high. Additionally, the fluid serves as a breeding ground for bacteria and can lead to pnumonia. He is on two antibiotics as a preventive measure against the pneumonia and other possible infections through his various wounds, etc. (remember there is still an open egress to his brain through one of the skull fractures).
One possible next step to treat the fluid would be to perform a treachotomy to enable better access to his airway. This could help them suction out the fluid.
Also - one amendment to the previous post: In addition to moving his leg and coughing when he was coming out of the coma this afternoon, his pupils were reactive (a good sign).
Dad is fighting for his life, and - complications not withstanding - we think he's winning.
posted by Nadav Kaufman at 5/29/2006 08:43:00 PM
5 Comments:
Dear Yoram, we all ache for your health and wish you to enjoy convalescing soon. Sure, everything will be OK. Your colleagues from Russia
Panchenko, Sakerin, etc.
I just heard about Yoram and found your blog; you are such a wonderful, caring family - Yoram knows that; l'chaim - that's what counts, gail
My thoughts and prayers are with you and your family.
Karen Hrank (Amy's coworker)
Bracha, Nadav & Daphne,
I just heard about the accident from my mom (Ziva, Bracha’s cousin), and read the blog. I hope Yoram will fight hard and will get better and stronger. Be strong, stay optimistic, and thanks for updating everyone, we all read and hope.
Sharon Hemran, NYC.
Bracha, Nadav & Daphne,
I just heard about the accident from my mom (Ziva, Bracha’s cousin), and read the blog. I hope Yoram will fight hard and will get better and stronger. Be strong, stay optimistic, and thanks for updating everyone, we all read and hope.
Sharon Herman, NYC
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