Yes, Dearie, But At A Price

Not the best TV has to offer, but I did enjoy the series Once Upon A Time.  The oft repeated comment Mr. Gold (Rumpelstiltskin) says rings true.  Yes, you can have what you want, but it comes at a price.  True for magic or medicine.

Two days ago, Dr. Kessler inserted the new, second, tube in Jim's pleural space.  It's working well.  The fluids are draining and Jim is breathing nicely.  Considering the two lungs full of pneumonia, that's a good thing.

Last night and today, Jim has had problems with blood clots in his Foley line.  The clots are blocking the line making an uncomfortable mess.  Gotta fix this problem, but I always like to know the "whys" of a problem.  I haven't run my theory past the doctors yet, but the nurses tell me it makes sense, so I'll share it.

In order to put the tube into his pleural space, Jim had to have a number of platelet infusions.  Can't cut a boy who won't clot. Jim's is constantly getting platelet infusions. As of early this morning, the platelets he got 2 days ago were gone so he got another bag which was particularly effective.  You never know how young or old the platelets in an infusion bag are- yes, the bags are dated, but the platelets collected from the donor are not sorted by age.  The donor gives up platelets that will be a mix of new and old.  Sometimes more of one than the other.

Next factor; kidneys.  The antifungal drug Ablecet is hard on kidneys.  Measuring the creatinine levels tells us how the kidneys are doing, elevated numbers mean that the kidneys are working hard.  Jim's are. Another measurement is color.  I do colors.  The output of the kidneys and bladder, piss, goes from Jim into a bag through a Foley line.  Nice piss is yellow; we've gone through yellow to pink and and now I see red.  Blood.

Putting it all together, I think that the platelets have clotted the blood passing into Jim's urine.  The blood was fluid when his platelet counts were low, but when the platelets were high enough to allow a tube to be put into his chest, they were then also high enough to clot the free blood in his kidneys, bladder or wherever (I don't want to think too hard about "wherever").  These clots are balling up the Foley.

So, in another hour or so, the urologist will insert a new Foley (larger diameter) and a flush system to clean the bladder.  Hopefully this will resolve the issue.  I sure don't want Jim to wake up again and see a wash of red fluid all over his groin.  That was upsetting.

Settle this issue and we can return to devoting all our energy on those white blood cells.  They are the key to everything.