Since Saturday things have been fairly stable with Marye and her various conditions. You may remember that the plan was to observe her until Monday to decide whether to take out her gall bladder. What they're looking for is how she responds clinically to the antibiotics for the infected gall bladder as well as the pneumonia. There was a bit of excitement around 3:00 am Sunday morning as her heart started to display a slightly irregular heart beat. She was never in any real danger, although I admit that my heart rate went up as they paged "stat response" and four nurses appeared in about six seconds with the fibrilator machine. Anyway, it turns out that her magnesium was low, and magnesium regulates heart rhythm. Who knew? The doctors and nurses do, apparently. I won't dwell on this episode since it was over as soon as they gave her a magnesium supplement infusion; but I learned more about the heart in that hour than I ever even knew existed. I think it was former SECDEF Donald Rumsfeld who made a comment about how we "don't know what we don't know." I also would like to take this time to point out that the nurses on this floor are incredibly competent and caring. I'm thankful that there are people in this world who are so caring and dedicate their lives to the well-being of others. I know this is their job and they are getting paid, but they obviously do this for reasons other than money.
Back to our story... We heard conflicting reports through the weekend on whether they were going to do a procedure to either reposition the drain in her gall bladder or just remove the whole thing. However, today we were completely underwhelmed with the amount of activity from the various doctors. But Dr. Riley came in a few times and put everything together for us. The plan was for the radiology team to fix the drain tube. But they have been looking at the scans and the gall bladder appears to be completely deflated at this point. So it is both impossible and futile to try to get the drain tube back in there. Dr. Riley thinks they should just remove the tube, since it's not draining anything at this point. Also, they cannot rule out that the gall bladder is ruptured. My question was, if it's a possibility, then why are they not going in to find out. Dr. Riley explained that there really is no point, since the risk of open surgery is fairly high, given Marye's condition. So, even if they were to see a rupture, they would not want to open her up as long as she is improving clinically, which she is. Also, it's not at all certain that they could even see the gall bladder without open surgery, since there is a lot of scar tissue and fluid around it. So, without being forced to open her up due to acute complications, it's safer to leave it be. Again, Marye is showing slow improvement, so we're just going to stay the course.
And that's the plan... stay the course. She is on antibiotics for the pneumonia and the infected(?) gall bladder. Of course, the problem is that with the chemo and cancer, she is weaker than most people, so whether to do surgery is a matter of risk management. Unless they absolutely have to, they will hesitate to cut her open; but that makes her recovery slower than it might otherwise be. We're kind of between a rock and a hard place.
-Chris
