Wednesday, April 23, 2008


Arrived at ID for infusion and appointment with DrIV#2. First stop was X-ray. They wanted a new look at the bone for DrIV#2 to look at. I went in with Victoria. Sue and CJ were tagging along and waited in the waiting area.

X-ray Tech was very good but needed some advice on taking a picture through the cast. And given the extra thickness this cast has...that was some doin. Unfortunately, I don't think there was enough contrast to get a good idea what is going on. That said, we got the films and headed for DrIV#2.

We have never met DrIV#2 although we had heard nice things about him. We got to the check in right on time...and waited...and waited...and waited......past the time when Victoria was scheduled to get the IV. I went back up to the desk and got the ball rolling. Being a regular helps.

Off we went to the only private IV room. We got set up and Victoria's IV was started even before the dr came in. They even had time to change the PIC dressing (a weekly task).

Finally, he came in. Nice guy. Introduced himself, got comfy and asked how Victoria was feeling - in a way that suggested, he wanted to know. Discussed how the infection got this bad and the anemia. Sue added that she was concerned that the anemia was not caused by iron deficiency and therefore iron pills may not be useful. While we were waiting, I had one of the IN staff check on the results of yesterday's blood draw. Hemoglobin was 7.6. More improvement!

DrIV#2 asked about the surgeon and his recommendations. I offered them. Then he looked at some of the results of the blood tests and said something wonderful. He said he didn't know what was normal for Victoria so it was hard to tell how much improvement was going on, or could go on. YEA! He gets it!

Some more numbers: Sed rate. This is how much blood goops. I am not going into the details, not important. Enough to know that when a big infection is going on, this number can be very high. 4 blood tests ago, the number was 151. Today it was 38. This is very good. However, normal might be around 10. What is interesting is this number is UP from 33 last week. Now, BugN was all about the infection - this number is a good indicator of a bad infection and it was DOWN 80% last week! What the hell!? Another number deals with proteins in the blood and 4 tests ago, it was over 250. It is 101 today and down from 115 last week. Apparently this number should be nearer 50. So what was BugN going on about infection markers?? Victoria's numbers show dramatic improvement. Perfect? No. But certainly not something to poo-poo.

Oh...RA (arthritis Victoria has) can increase the protein markers too.

I told the doctor to expect dramatic improvement next week. Victoria's insulin has fallen through the floor. I know I suggested it before, but there is no doubt it has over the last 48 hours. Over the weekend and Monday, Victoria's sugar numbers have been going the wrong way. As a diabetic eats, the sugar levels increase and require insulin to control. Victoria has had low numbers and after eating and no insulin, they have been going DOWN further. Yesterday she got 55 units, all in the evening. This is more than 100 units less than her normal dose. Today, so far, she has had 15 units and she has not moved out of the 100's (very good).

With lower insulin doses and better sugars, Victoria's healing with accelerate (hopefully, knock on wood).

DrIV#2 really wanted to see the X-ray from 3 weeks ago, but they couldn't pull it out of anywhere. That said, he wants to look at it and see Victoria in 2 weeks. He would also like to see the wound when it is open. We will see if it is possible during cast work tomorrow.

We both like him. Sue agrees.

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