What a roller-coaster on Friday, and Saturday doesn't look to be much better. First, the chest x-ray showed that Marye does, in fact, have a slight case of pneumonia. So they added several new antibiotics that can fight respiratory infection. Then they did a CT scan on her abdomen to get an idea of what is going on with the gall bladder. At first, the doctors told me that it looked like there was no fluid in it and it was almost down to its normal size. Later, though, I read the report and it said that the drain tube did appear to be outside of the gall bladder and that the whole thing was still distended.
Then they started making preps to have surgery on Saturday to either remove the gall bladder or maybe just try to fix the drain tube. We also theorized that they were just reserving the OR in case they wanted to do surgery. Who is "they", you ask? I don't know. At this point, everyone was deferring to Dr. Vitale (at Norton) who was in surgery all day. I also hear a lot about "the surgeons", as if they're some mythical group of super-docs who never show up until the very moment that they're needed to save the day. Sounds a lot like Coast Guard aviators. Anyway, we heard that Dr. Vitale was going to show up and give his blessing (or not) to remove her gall bladder. But by 8:00 pm, he still hadn't. However, one of the (junior) surgery residents did show up and informed us that they definitely planned on doing laparoscopic surgery in the morning. When I asked him who ordered it, he told me the Chief resident did with the blessing of the attending physician, who is a partner of Dr. Vitale's. Ok, then. Sign the paperwork for Doogie Howser and he's gone.
Not five minutes later, Dr. Vitale, himself, walks into the room (it's 9:00 pm by now) and asks, "what's the latest?" So I told him about Doogie and that they're planning on operating in the morning, to which he says "I don't think that's right." One phone call to his partner later, and he confirms that they only reserved the OR in case they want to operate. There are still a lot of reasons NOT to operate at this point, including (but not limited to): the gall bladder is still very infected; she has pneumonia; her WBC count is still very high; her immune system is weakened due to the cancer and chemotherapy. Dr. Vitale tells me there are two types of infection: abscess, which you can see on the CT scan; and infected tissue, which you can't. The only way to ensure that they will get the entire gall bladder and any surrounding infection is probably to open her up, and he doesn't think that that's the right thing to do, yet. So, they may go in and try to re-position the drain tube to get more abscess juice out, or maybe not. At this point, I don't think anyone knows what the plan is.
All I know is, I'm not going to listen to any more residents about what is going on with Marye's health. For now, she's sleeping with the help of her new friend, dilaudin. I'll have more info tomorrow.
Thanks for listening.
-Chris
