Wednesday Night Update on Marian

Marian is still in ICU tonight, but she is continuing to improve. We still don't have a definitive conclusion on what caused the pneumonia. All the test results thus far have been negative. The only thing that has shown up is a low level of active CMV in her blood. The infectious disease doctor was in today and said that the CMV could have caused the pneumonia and they are treating it with an antiviral. Dr. Flinn said that he would be surprised if the pneumonia was caused by CMV at that low level.

The PCP test result that I had asked about (because I had found a rare case of PCP being accompanied by hypercalcemia) came back negative. Dr. Flinn said that was good because it's a particularly nasty bug.

Marian's hemoglobin dropped to 8.6, so they gave her two units of blood today. This is standard whenever hemoglobin drops below 9. Her hemoglobin already ran a little low from her CLL. So it's not surprising that her marrow has been affected by severe illness.

Marian seemed just a little less perky to me today. Although she still looked better. They gave her steroids to help her body fight the infection and they are backing off of those now. So some of her spunk yesterday could have been a result of the steroid. It also probably helped her appetite. Steroids are known to make you hungry.

Probably the biggest news today was that Marian was able to come down on her oxygen requirements. They are still giving her oxygen, but now she's getting 50% oxygen instead of 100% through the mask. And her saturation level is at an acceptable level. When I left, I asked her nurse if she would be back on the bi-pap machine tonight. And she said, "Maybe. Maybe not. It just depends on what her oxygen saturation does while she's sleeping." If it falls, they will hook her back up. It's exciting to think she might be done with that machine.

I asked Dr. Flinn for a vague estimate of how much longer Marian might need to stay in the hospital if she doesn't have any setbacks. He said he would expect her to be there another four or five days based on today's evaluation. She will move from ICU back to a regular room on the oncology floor before she is discharged.

I got to Marian's room today just before Dr. Flinn came in. As usual, I had several questions. When he left, I wondered if I was wearing him out with my questions. (He has never seen me this many days in one week.) If I am there tomorrow when he comes in, maybe I'll surprise him by not having any for a change. As of this moment, the only unanswered question any of us has is what caused the pneumonia. And once he knows that, I know he'll tell us without being asked.

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