Today was full of a lot of waiting and worrying. When I went in first thing in the morning, I uncovered his feet to see how they were doing. He has had a lot of swelling and pain in his hands and feet from all the chemo and fluid buildup. His feet were HUGH! I started to freak. I got the nurse in there and started to grill her. She hadn’t noticed them. She called the derm. Drs. and the oncology Drs. and they came in to look at his feet. It looked like the tissue around his feet was swollen but in fact it was hugh fluid-filled blisters around each foot. The combination of the chemo and the fluid buildup from his kidneys not functioning properly caused this to happen. As he tried to reposition himself in bed, the big blister on his right heel burst. The derm. Drs. cut a slit into the blister on his left foot and fluid came out like a facet. I could not believe what I was seeing. His blood pressure and pulse are a little better today on medication. They are trying to slowly decrease the meds and see if Todd can maintain good vital signs. The kidney function is still not good. He did start making urine but not at an adequate amount. They are monitoring his kidneys and hoping to see better function as his blood pressure gets better. Todd is starting to get the mouth sores from the chemo. This makes it hard and painful to talk. He mostly sleeps which I guess is what his body needs right now. I am still praying for a miracle.
What a long, scary day in the ICU waiting room. I have had many people call and come by to comfort me and I really appreciate everything. The ICU Drs. put in an arterial central line today. They are giving him meds. to increase his blood pressure. His pulse is still high. The Drs. think there is an infection somewhere in Todd but they do not know what kind of infection or where it is. They are fighting it with a lot of meds. They have given him blood and platelet transfusions. The Drs. are watching his kidneys closely. All the chemos and meds. have damaged his kidneys. Fluid is building up in his body and causing a lot of pain. He is sleeping mostly. I have fed him a little bit of soup and pudding when I am allowed to see him. Visiting hours are limited but I’m scared to leave the waiting room in case he needs me. I am still praying for a miracle.
The day began with a portable chest x-ray. The dermatology Drs. came by to look at Todd’s blisters. They think the combination of fevers and chemos caused the blisters to develop. Their main concern was, if the blisters open up, there is the possibility of infection. Todd is full of fluid. They have to give him fluids with the chemo and drugs so that his kidneys are not damaged. His body is retaining the fluid instead of expelling it. His hands and feet are very swollen and painful. Infectious disease Drs. came by to talk about Todd’s labs. They are watching his kidney function closely. Todd got a platelet transfusion and 2 red blood transfusions today. Around midnight Todd’s blood pressure was 70/40 and his pulse was 146. The nurse called the on-call Dr. and the on-call Dr. called in the ICU Drs. They told me that they wanted to admit Todd to the ICU to monitor him more closely. They are worried about the possibility of an infection, his kidney function, and also the low blood pressure and high pulse. It is 6:00am on the 6th right now. I have been up all night sitting in the ICU waiting room. I am praying for a miracle.
Today is the last day of this round of chemo. Todd is very nauseous and so he does not want to eat. He is still red all over and his hands and feet are painful. He actually asked for pain meds which is rare for Todd. In the afternoon his temp. went up and they ran blood cultures and labs to look for an infection. The Dr. changed Todd’s antibiotics. At about 10:00pm we noticed blisters all over Todd’s body. His blood pressure was low and his pulse was high. Then he spiked a fever and started shaking with chills. The on-call Dr. had never seen blisters like this before. She was thinking that it was a drug reaction to the new antibiotic. She stopped all the drugs while she researched it. We are all watching him closely through the night.
Todd is now red all over and it hurts. His hands and feet are especially painful. We are trying to keep cream on them to prevent the blistering. He is swelling from all the fluids and so they give him meds to help. At rounds the Dr. said that Todd’s liver function test was high. It went from 40 to over 400. This is not good but the Drs. have consulted and agree that they should continue the chemo. Tomorrow will be the last day for this round. The blood in the sputum is back and so he will be getting more platelets today. This makes 28 platelet transfusions so far. He is sleeping all day because the chemo is so draining. He is having trouble keeping any food down. Nausea and vomiting are relentless problems.
Todd woke up today with his skin red all over like a sunburn. This is probably due to the chemo. His heart rate is up. He has started retaining fluids and swelling. The Dr. is stopping the saline drip to help with the swelling. Nausea seems to be his biggest problem right now. We were looking toward to seeing the kids tomorrow but Hannah thinks she is getting a cold. We miss them but know they are in good hands with my mom. Todd had is 4th chemo treatment of this round today.
Todd is still sleeping and resting most of the day. We had a very encouraging visit with our bishop and district superintendent. Bishop Gwinn and Rev. Chuck Cook lifted our family and our church up in prayer. It was very powerful. I could feel God’s presence in the hospital room. We are truly blessed to have so many people praying for us. Todd is still struggling with nausea. He threw up after lunch and before bed. The bloody sputum seems to be a little better. Maybe all the meds have helped his lungs. The platelets he has received also help stop bleeding. Todd had his 3rd chemo treatment for this round today.
Infectious disease Drs. came by today to talk about Todd’s lungs. The x-rays show something in the lungs. With the bloody sputum and these x-rays, the Drs. here at Duke want to do a chest CT. They have changed his antifungal and antibiotic meds to stronger drugs. At about 10:30pm the CT tech came to get Todd for a CT. Todd got a platelet transfusion in the afternoon. He has a problem with chills and sweats. We keep having to change his clothes because they are soaking wet with sweat. He spends most of the day sleeping. The chemo seems to be going well. His white blood cell count is falling which is good. Duke does not post the blood count numbers like UNC did and so I will not be posting them.
Todd spent most of the day with a fever and chills. He has some nausea and has thrown up several times. He got a platelet transfusion after lunch. Today he began coughing up bloody sputum from his lungs. The on-call Dr. ordered a portable chest x-ray after we showed him the sputum. At 9:20pm Todd began his 4th round of chemo. Dr. Rao chose this chemo combination because of the damage to Todd’s heart caused by the previous chemos. This combination will be less toxic to his already damaged heart. It will be a 6 day regimen of clofarabine and cytarabine. Todd has received cytarabine in combination with other chemos. It is kind of the mainstay of leukemia chemos. Clofarabine has not been given to Todd previously. Dr. Rao says it has shown some promise in treating AML with FLT 3.
I spent the day preparing for Todd’s appt. at Duke set for tomorrow. At 7:00pm I was walking by Todd and I touched his head. He felt hot. We took his temp. and it was 101.7F orally and 102.4F in his ear. I immediately called the Duke Dr. and she said to go straight to the Duke ER. She had gotten a room ready for Todd when we arrived at the ER. They took us up to his room and we met with the on-call Dr. They then began running all kinds of tests. He had x-rays and blood labs drawn. They started IV antibiotics and he got 2 blood transfusions. We finally went to sleep at about 1:30 or 2:00am. We will meet with Dr. Rao tomorrow at rounds and discuss all our options. Todd’s address at Duke is:
Todd S. Krueger, Room #9103
Duke University Hospital
Durham, NC 27710