9/28/21

Ethan had lab work done. Finally, we are in a therapeutic range with Ethan’s rejection medication.   Ethan gets to have a lab work break for 16 days. Wow! I think that is the longest break in 10 months. Wow!

Ethan’s anemia is resolved. His body LOVES and appreciates the iron infusions.

Last week Ethan’s neutrophils (his soldiers of his immune system) we quite low. It put him at risk for any hint of a virus to completely take over his body.  His neutrophils have come up, and while still low, are not in as much of a danger zone.

His platelets, while still making a slow army crawl toward the normal range.

This bloodwork to me was wonderful! His transplant team as well as hematology are glad he is headed in a good direction.

Ethan feels good. He is eating. He is gaining stamina. He is able to juggle more things he wants to do. 

Today I got in touch with my BFF dialysis nurse.  Ethan posed me a real problem this evening. I use a formula that takes Ethan’s current weight and subtracts it from his “dry” weight or target weight without fluid collection to come up with the number of liters of fluid to clean and/or remove.

We typically do between 1 and 1.5 liters 4 times a week. Tonight he measured in at at 7.2 pounds over his dry weight. This is a hefty amount. It can become dangerous to have a huge fluid shift and can goof up his hydration, blood pressure etc. with such a huge change, one should assume that it is mostly fluid. Ethan should not be retaining that much fluid.

I checked for fluid under his skin. His blood pressures were great. His breathing was clear. He felt and looked good. I hooked him up and set the machine like normal but bumped it up a smidge. Then I called my fabulous nurse to see what he would do. 

We had a great chat that included each thought process. I also got the “I have never had a patient that has been this hard to regulate a dry weight.” Of course not. My medically challenged, smells like a rose today, disaster. 

We came to a volume solution and I knew the signs of dehydration if I started pulling too much off. Onward and upward. As we ended his treatment, his blood pressure was going down and his pulse was going up, indicating that we were flirting with the dehydration line. 

Tonight’s session ended well after 10:00. I started at a little before 5:30. It has been a long day. I am ready for a night of rest with the windows open. A nice cool slumber. Yes!