[Oasfaa] FW: Wednesday Update/Vicki

[Emerson, Kristina K]

Hi Everyone...

I am forwarding an email that Vicki's cousin wrote which will explain to
you what is going on...
On Monday she had a kidney biopsy and they took some bone marrow...as I
am sending this I just received a call that they are taking her back
down to remove fluid from her lungs again.  This was extremely painful
for Vicki so please pray that this time will go much smoother for her.  

Thank you all for your calls and support!!!

Kristi
 
  Her internal medicine doctor had been by with a preliminary diagnosis 
around 11:00.  Shortly after I arrived, the kidney doctor came in and 
said that the results of the kidney biopsy had come in and Vicki has a 
condition called TTP (Thrombotic Thrombocytopenic Purpura).  This 
condition is very rare and depletes large numbers of platlets.  Another 
condition, HUS (Hemolytic Uremic Syndrome) goes somewhat in hand with 
this.  The treatment for this is to insert a catheter in collarbone 
area and being plasma exchange.  We talked at length to the doctor 
concerning Vicki and how concerned we were and he said if hind sight 
were 20/20, he should have done this biopsy last week, but her levels 
did not present itself to be this condition.  Vicki is what they refer 
to as an Atypical Presentation.  Three different doctors used that 
exact term yesterday.  She is NOT a text book case so therefore, they 
were puzzled by all the things going on.  She did not present the 
classic 5 symptoms they were looking for with TTP.  This is associated 
with ecoli as well.

After visiting with this doctor, they immediately got her ready for 
this cath insert.  We went down to the CT area and the Physicians 
Assistant who removed the fluid off the sack of her lung area several 
days ago was going to do the procedure.  His name is Tom and he is a 
saint.  The Radiologist that performed the kidney biopsy on Monday saw 
us in the holding area and wanted to know what was up.  He and Tom 
worked closely together and he said, this is serious and I want to make 
sure that Vicki is taken care of and that we get this done immediately. 
They took her in and got the cath inserted.  Both of these men are 
wonderful and have the greatest bedside manner and truly have Vicki's 
utmost interest at heart.

When we arrived back upstairs, they indicated that Red Cross would be 
coming at 6:30pm to begin the Plasma Exchange.  I have never seen the 
process of what this procedure.  The Red Cross sends a person to do it. 
  A huge machine was brought in the room and the lady came with her 
little red/white ice chest with FFP (Fresh Frozen Plasma).  It is quite 
an ordeal to get it all going.  They had decided to do a 1 gallon 
exchange, so therefore, 13 bags of plasma were brought in.  Each bag 
has to be matched with paperwork and logged in.  She finally got 
everything hooked up and began the process.  This actually takes the 
blood out of Vicki and runs it thru a machine where the old plasma is 
separated from the blood thru a centrifuge and as it is processed to go 
back in, the new plasma goes back into Vicki.  We were able to be in 
the room for the whole procedure and we got to see the old plasma that 
came off her.  It was a greenish pond colored looking yuck.  The Red 
Cross lady said it was pretty yucky and that each day it will improve 
as the old comes out and the new goes in.  The doctors have ordered 7 
treatments of plasma exchange.  They do one per day.  This can also be 
done as out patient if Vicki goes home and still requires more 
exchanges.

In addition to the plasma exchange, she will be treated with steroids, 
Prednisone.  She may have some more swelling but the doctor said it 
would actually help with her breathing.  They have not made a decision 
to dialysis as yet, but the cath is in, so if they do decide to do it, 
she is ready to go.  Her creatinne was 3.8 yesterday.  It has been 
going up since last week.  Her kidney output is still weak and they 
have stopped the Lasix.  They may put the foli cath back in today.  She 
was not to thrilled about that but the kidney doctor indicated he may 
want to do it again.

A new doctor came on board yesterday that is a Hematologist/Oncologist. 
  He came in the room yesterday around 6:00pm and talked to Bill and I 
extensively about Vicki.  He is very concerned.  Because he is new to 
the case, he wanted some info about how all this came about.  He did 
tell us that this is very serious and the plasma exchange and steroids 
is the proper treatment for TTP, but he is still wanting to get the 
results of the Bone Marrow.  Those results should be in today.  The 
bone marrow culture will take a little longer to get the results.  He 
did tell us she did not have leukemia but he is anxious to get the 
other tests results in.   

If you are interested in learning more about TTP, you can go the the 
Mayo Clinic web site:    www.mayoclinic.com and click on Diseases and 
Conditions......scroll down to the word Thrombocytopenic and you can 
pull up all sorts of information about this condition.

I do want to remind you that even though Vicki may start showing signs 
of improvements, the doctors have indicated that she is a very very 
sick person.  Please  realize that they are still asking for No 
Visitors as she always tries to talk even if you are just sitting there 
and she feels so badly if someone comes and they are asked to not stay 
or limit their visit.  Vicki is always concerned that she is hurting 
someones feelings if she is not able to visit.  I have assured her that 
she should not worry about that and that everyone certainly understands 
that SHE comes first and that we all want her well again.  Only Vicki 
would be concerned about everyone else as she lies there so sick 

I hope that this e-mail is able to explain a little more and if you 
have any concerns, please feel free to call or e-mail me back.  I do 
give Vicki the messages that many  of you have via my e-mail.  You 
should see her room, every doctor that walked in yesterday said, Oh my 
Gosh, she must be loved.  TU students made a huge banner that is 
hanging on one wall and we have hung cards over practically every bare 
space we can find.  She continues to have her flowers in the room.  I 
try to exchange the water and clean out each time I am there.  She has 
pics of the kids and she has probably received well over 100 emails.

Again, that you all for your prayers and please continue to pray that 
this procedure will be successful and that all other results will come 
back good.