Laboratory Finding
Sputum Culture (Collected 17 Nov 08 , 6.22am)
Final Report
Heavy growth of Enterobacter cloacae
Tigecycline Etest MIC : > 256 ug/ml (Resistant)
Heavy growth of Stenotrophmonas maltophilia
Tigecycline Etest MIC > 256 ug/ml (Resistant)
Susceptibility Report
E Cloaca
Kirbybauer
Amikacin *S
Augmentin R
Bactrim/Septrin R
Cefaclor R
Cefepime *S
Ceftazidime *S
Ceftriaxone *S
Ciprofloxacin R
Gentamicin *S
Imipenem *S
Unasyn R
Antibiotic Tradenames
Amikacin - Amikin
Cefaclor -Distaclor
Ceftazidime -Fortum
Ceftriaxone -Rocephine
Ciprofloxacin -Ciprobay
Imipenem -Tienam
@2.30pm, Mark Lee contacted Dr.Lye after dialysis but he didn't come.
@5.30pm, given Tienam (500mg) , Bactrim (AM/PM) and Minocylin (AM/PM) , prescribed by Dr. Chiong.
10:15 update:
Dad was stable last nite. BP was on the low end 95-105/40-45 supported by 11ug/kg/min Dopamine. With fever & shivering quite frequent. Not so alert.
This morning,. Fever subside a bit after cool pad treatment.Heart rate fast >90, Breathing a bit heavy & chilling once awhile. BP low, Dr Jong give levophed.
Parameters:(7am)
HR=89-100, BP=87-94/40, BPM=29-31, SPO2=99%, SIMV=6, PEEP=5,Psupp=15,FiO2=35%,Ps=15.
ABG reults (2008.11.18 07:22):
PH7.478, BE(B)=+3.1mmol/L, tHb=8.5g/dL (low), O2Sat=98%, Ca=0.82
-> Dr Stop Bi-Carb @ 7:15am
Lab blood test results:(19.11.2008 @ 6:05)
Haemoglobin=9.4, RBC=3.00, Platelet=111, WBC=21.58, ucleated RBC=6
DRs Comments:
Dr Jong - Stop Sodium Bi-Carbonate as BE(B)=+3.0. BP low hence give levophed.
Dr Teoh - Tummy more bloated.
Dr Cheong - New infection, give Meronem & will see result in 1 or 2 days.WBC high which is no good.
Dr Lye - Fever, WBC high, not a good sign, new infection at tracheatomy entrance, waiting for culture result to identify the type of bateria & meantime cover with a new antibiotic - Meronem.
Dr Ting - tHb=8.5low, may need to transfuse 1 bag of blood.
Dr Tang - Condition not improving & with new infection.
Dr Lam - pessimistic outlook
To summarise, dad is not alert, condition is not improving. New infection at throat area. New antibiotic (meronem)is given to tie over before cutulre result come out.
5:00pm news
4 hours dialysis cut short to 3.5 hours as BP and heart rate were unstable. BP drops below 90. Fluide extraction volume is 500ml which is half of the target. Dopamine was increased to 13ug/kg/min at 2pm, and now lowered to 11. Dialysis finished at 2:30pm. Dad is tired and now sleeping. He has not opened his eyes today but did respond to closing his mouth when prompted. Dr Jong came and ordered ABG test.
Prayer Points:
1)God will strengthen dad's immune system to overcome all the bacteria attack.
2)Overall planning for dad, let God decide what is best for dad.
Wednesday, November 19, 2008
Tuesday, November 18, 2008
2008.11.18 ICU
10:00 am Update:
Dad was stable last nite. BP was on the low end 103-114/40-45 supported by 11ug/kg/min Dopamine. Not so alert.
This morning, dad is a little bit more alert. High fever with temp ranging 38-39oC. Breathing a bit heavy & chilling once awhile.
Parameters:(7am)
HR=79-81, BP=94-100/40, BPM=33-39, SPO2=100%, SIMV=6, PEEP=5,Psupp=15,FiO2=35%,Ps=15.
ABG reults (2008.11.18 07:22):
PH7.302, BE(B)=-11.0mmol/L (acidosis), tHb=8.6g/dL (low), O2Sat=97.3%, Ca=0.93
-> Dr Jong ordered Bi-Carbonate to neutralise the acidosis.
DRs Comments:
Dr Jong - give Sodium Bi-Carbonate to neutralise BE(B).Cleaned CVP line. New infection developed & ponder source is from where?
Dr Teoh - Tummy ok.
Dr Lye - High fever, new infection, add on 1 new antibiotic - Meronem.
Dr Cheong - New infection, give Meronem & will see result in 1 or 2 days.More alert today.
Dr Ting - tHb=8.6low, need transfuse 1 bag of blood.
Dr Lam - no comment.
Dr Tang - New infection, need 48 to culture inorder to know the type. Now cover with Meronem.
To summarise, dad today more alert but develop high fever(38-39oC) which means new infection. New antibiotic (meronem)is given.
11:00pm update.
Dad blood become very acidic, Dr continue to give bi-Carb to neutolise. Fever with temp ranging 38-39oC. Develop new infection.
Prayer Points:
1)God will strengthen dad's immune system to overcome all the bacteria attack.
2)Overall planning for dad, let God decide what is best for dad.
Dad was stable last nite. BP was on the low end 103-114/40-45 supported by 11ug/kg/min Dopamine. Not so alert.
This morning, dad is a little bit more alert. High fever with temp ranging 38-39oC. Breathing a bit heavy & chilling once awhile.
Parameters:(7am)
HR=79-81, BP=94-100/40, BPM=33-39, SPO2=100%, SIMV=6, PEEP=5,Psupp=15,FiO2=35%,Ps=15.
ABG reults (2008.11.18 07:22):
PH7.302, BE(B)=-11.0mmol/L (acidosis), tHb=8.6g/dL (low), O2Sat=97.3%, Ca=0.93
-> Dr Jong ordered Bi-Carbonate to neutralise the acidosis.
DRs Comments:
Dr Jong - give Sodium Bi-Carbonate to neutralise BE(B).Cleaned CVP line. New infection developed & ponder source is from where?
Dr Teoh - Tummy ok.
Dr Lye - High fever, new infection, add on 1 new antibiotic - Meronem.
Dr Cheong - New infection, give Meronem & will see result in 1 or 2 days.More alert today.
Dr Ting - tHb=8.6low, need transfuse 1 bag of blood.
Dr Lam - no comment.
Dr Tang - New infection, need 48 to culture inorder to know the type. Now cover with Meronem.
To summarise, dad today more alert but develop high fever(38-39oC) which means new infection. New antibiotic (meronem)is given.
11:00pm update.
Dad blood become very acidic, Dr continue to give bi-Carb to neutolise. Fever with temp ranging 38-39oC. Develop new infection.
Prayer Points:
1)God will strengthen dad's immune system to overcome all the bacteria attack.
2)Overall planning for dad, let God decide what is best for dad.
Monday, November 17, 2008
2008.11.17 - ICU
10:00 am Update:
Dad was stable last nite. BP was on the low end 100-110/40-45 supported by 10ug/kg/min Dopamine. Not so alert.
This morning, dad looks lethargic and not so alert. Mild fever with temp 38.0oC. Breathing a bit heavy.
Parameters:(7am)
HR=90-95, BP=102-106/40, BPM=29-31, SPO2=99%, SIMV=6, PEEP=5.0, FiO2=35%,Ps=15.
ABG reults:
PH7.362, BE(B)=-5.4mmol/L (acidosis), tHb=8.7g/dL, O2Sat=98%, Ca=0.95
-> Dr Jong ordered Bi-Carbonate to neutralise the acidosis.
DRs Comments:
Dr Jong-blood BE need to be neutralise, give Bi-Car.
Dr Cheong - 2 spikes of fever with temperature about 38.0oC. Infection still on, may be new one. gave a dose of bactrim yesterday afternoon. Consider another dose of Vancomycin but need Dr Lye opinion as it affect kidney function.Dad immune system is low.
Dr Ting - Nucleated RBC =2 means less degeneration of RBC that is good. Haemoglobin 8.7 low, need 1 bag blood transfusion. Platelet 84 ok. WBC=11.xx increased indicate new infection.
Dr Tang - less alert.
Dr Teoh - Tummy ok.
Dr Lye - got fever, will give one more single dose of vancomycin (@11:45am)
Dr Lam - came. No comments 7 said infection is take care by other Dr. (4.30pm)
To summarise, dad is less alert, may be due to blood acidity (ie BE(B)=-5.4) arising from metabolic acidosis . Will neutralise it with bi-carb. Will do dialysis today to remove 1.5 ltr of fluid & toxin & transfuse 1 bag of blood. Dad has mild fever, hence Dr Lye (under the request of Dr Cheong) will give a second single dose of vancomycin to treat the fever.(may be new bateria)
11:pm Update:
Whole day, dad is not alert.Did open eyes when called. Today dialysis remove 2 ltr of fluid. Develop fever with temperature. Breathing with effort.
Prayer Points:
1)Thanks God that kidney start flowing.
2)God will strengthen dad's immune system to overcome all the bacteria attack.
Dad was stable last nite. BP was on the low end 100-110/40-45 supported by 10ug/kg/min Dopamine. Not so alert.
This morning, dad looks lethargic and not so alert. Mild fever with temp 38.0oC. Breathing a bit heavy.
Parameters:(7am)
HR=90-95, BP=102-106/40, BPM=29-31, SPO2=99%, SIMV=6, PEEP=5.0, FiO2=35%,Ps=15.
ABG reults:
PH7.362, BE(B)=-5.4mmol/L (acidosis), tHb=8.7g/dL, O2Sat=98%, Ca=0.95
-> Dr Jong ordered Bi-Carbonate to neutralise the acidosis.
DRs Comments:
Dr Jong-blood BE need to be neutralise, give Bi-Car.
Dr Cheong - 2 spikes of fever with temperature about 38.0oC. Infection still on, may be new one. gave a dose of bactrim yesterday afternoon. Consider another dose of Vancomycin but need Dr Lye opinion as it affect kidney function.Dad immune system is low.
Dr Ting - Nucleated RBC =2 means less degeneration of RBC that is good. Haemoglobin 8.7 low, need 1 bag blood transfusion. Platelet 84 ok. WBC=11.xx increased indicate new infection.
Dr Tang - less alert.
Dr Teoh - Tummy ok.
Dr Lye - got fever, will give one more single dose of vancomycin (@11:45am)
Dr Lam - came. No comments 7 said infection is take care by other Dr. (4.30pm)
To summarise, dad is less alert, may be due to blood acidity (ie BE(B)=-5.4) arising from metabolic acidosis . Will neutralise it with bi-carb. Will do dialysis today to remove 1.5 ltr of fluid & toxin & transfuse 1 bag of blood. Dad has mild fever, hence Dr Lye (under the request of Dr Cheong) will give a second single dose of vancomycin to treat the fever.(may be new bateria)
11:pm Update:
Whole day, dad is not alert.Did open eyes when called. Today dialysis remove 2 ltr of fluid. Develop fever with temperature. Breathing with effort.
Prayer Points:
1)Thanks God that kidney start flowing.
2)God will strengthen dad's immune system to overcome all the bacteria attack.
Sunday, November 16, 2008
2008.11.16 Mt E - ICU
2008.11.16 11:30am update
Last nite,dad was tire & not so alert after dialysis but did had a good rest.
BP last nite was on lower end ranging 98-105/40.
This morning 8:30am, HR=75-83, BP=107-110/44, BPM=25-31, SPO2=100%,SIMV=6 (reduce from 8),PEEP=5.
Dad breathing is at ease. Dopamine 10ug/kg/min. Nepro F/S@38ml/hr (liquid food tube feed).
Yesterday lab blood test result:
Potassium=2.7 low but corrected last nite.
Urea=37.5 high (N2.8-7.7)
Creatine=173 high (N53-115)
Haemoglobin=11 ok (N=13.5-18)
RBC=3.58 low (N4.5-6.3)
Platelet=62 low (N140-460)
PT=15.4 (N10-14)
PTT=43.8 (25-41)
This morning 6:36am ABG result:
PH=7.414 ok, BE(B)=-0.8 ok, tHb=9.2 reduce from yesterday 9.8 but still ok, O2Sat=98%ok, all others ok.
Overall haemoglobin is reducing from 9.8 to 9.2, but still ok.(last blood transfusion was on 14/11, 2 days ago.)Dr Ting said platelet=62 is ok for the time being. Dr Lye give Eprex to boast RBC production. He declare today is the rest day for dad so no dialysis or other therapy will be done.Dr Cheong say dad got low grade fever is 37.8oc
Dad is well & alert this morning and breathing at ease.
All Drs ie Lam,Teoh,Tang,Jong,Lye,Ting&Cheong visited.
11:30pm update:
Dad urinated @ 4pm & 8pm. wetted diapers. This mean kidney jump started. Praise the Lord,He has heard our cry.
Experience mild temperature spike 37.oC, Dr Cheong ordered bactrim.
Prayer needs:
1. Praise point: Dr Lam (Cardiologist), Tang (Neurologist), Teoh (Abdominal) all give thumbs up to dad's condition this morning. The comment: dad is holding on well. At least now we can have the parameter to make tentative plan to travel back to Kuching.
2.Pray for the preparatory work in Kuching for dad's return for rehab. Enable different people in laying ground work
Last nite,dad was tire & not so alert after dialysis but did had a good rest.
BP last nite was on lower end ranging 98-105/40.
This morning 8:30am, HR=75-83, BP=107-110/44, BPM=25-31, SPO2=100%,SIMV=6 (reduce from 8),PEEP=5.
Dad breathing is at ease. Dopamine 10ug/kg/min. Nepro F/S@38ml/hr (liquid food tube feed).
Yesterday lab blood test result:
Potassium=2.7 low but corrected last nite.
Urea=37.5 high (N2.8-7.7)
Creatine=173 high (N53-115)
Haemoglobin=11 ok (N=13.5-18)
RBC=3.58 low (N4.5-6.3)
Platelet=62 low (N140-460)
PT=15.4 (N10-14)
PTT=43.8 (25-41)
This morning 6:36am ABG result:
PH=7.414 ok, BE(B)=-0.8 ok, tHb=9.2 reduce from yesterday 9.8 but still ok, O2Sat=98%ok, all others ok.
Overall haemoglobin is reducing from 9.8 to 9.2, but still ok.(last blood transfusion was on 14/11, 2 days ago.)Dr Ting said platelet=62 is ok for the time being. Dr Lye give Eprex to boast RBC production. He declare today is the rest day for dad so no dialysis or other therapy will be done.Dr Cheong say dad got low grade fever is 37.8oc
Dad is well & alert this morning and breathing at ease.
All Drs ie Lam,Teoh,Tang,Jong,Lye,Ting&Cheong visited.
11:30pm update:
Dad urinated @ 4pm & 8pm. wetted diapers. This mean kidney jump started. Praise the Lord,He has heard our cry.
Experience mild temperature spike 37.oC, Dr Cheong ordered bactrim.
Prayer needs:
1. Praise point: Dr Lam (Cardiologist), Tang (Neurologist), Teoh (Abdominal) all give thumbs up to dad's condition this morning. The comment: dad is holding on well. At least now we can have the parameter to make tentative plan to travel back to Kuching.
2.Pray for the preparatory work in Kuching for dad's return for rehab. Enable different people in laying ground work
Saturday, November 15, 2008
2008.11.15 Fighting on ...
11:50am update:
Dad had a good rest last nite.
This morning HR=86,BP=98-102/36-39, BPM=26-30, SPO2=100, O2 supp=35%, Dopamine=6 ug/kg/min. All looks good.
Blood test result : PH7.437, BE=0.6, Hb=9.8 (Yesterday=10.3). Also ok.
No fever & last nite no spike.
Dr Teoh said tummy ok. Stool (diarrhea) lab test not out yet.
Dr Jong said dad is stable.Lung stronger. SIMC reduce to 8 from 10, PEEP reduce from 6 to 5. All these indicate that dad lung is stronger now.
Dr Ting said the RBC breakdown likely is due to dad reaction to one of the drug, so he will find out more.
Dr Cheong & Dr Tand said lung is better & other parameters remain the same
Dr Lam said dad is coming out from DIC (Disseminated intravascular coagulation) which normally has fatality rate of 90%.He presribe potassium as it is on the low side.
Dr Lye said it seems that infection is less as WBC is reducing & haemoglobin is maintaing quite ok. Others parameters remain the same. Today dialysis will target to remove 2.5 ltr of fluid with toxin.
Overall, dad's condition is improving & stable.
Prayer points:
1. Praise point - Stable and bouncing back in all parameters.
2. Dad's spirit will remain high and faith is strong in the One who can heal him.
3. Degeneration of nucleated Red blood cell can be resolved as soon as possible
4. Infection especially chest area will continue to clear
5. Financial needs - favourable response from management board
6. Carers - United and faithful in nightly prayers. Remove our fearful and unbelieving hearts, put on the full armour of God and stand on guard in the intercessory prayers for dad & the medical team.
Scriptural verses to encourage our hearts:
Jeremiah 32:17 "Ah, Sovereign Lord, you have made the heavens and the earth by your great power and outstretched arm. Nothing is too hard for you."
Romans 9:16 "I raised you up for this very purpose, that I might display my power in you and that my name might be proclaimed in all the earth."
Ephesians 6:18 "And pray in the Spirit on all occasions with all kinds of prayers and requests. With this in mind, be alert and always keep on praying for all the saints."
Dad had a good rest last nite.
This morning HR=86,BP=98-102/36-39, BPM=26-30, SPO2=100, O2 supp=35%, Dopamine=6 ug/kg/min. All looks good.
Blood test result : PH7.437, BE=0.6, Hb=9.8 (Yesterday=10.3). Also ok.
No fever & last nite no spike.
Dr Teoh said tummy ok. Stool (diarrhea) lab test not out yet.
Dr Jong said dad is stable.Lung stronger. SIMC reduce to 8 from 10, PEEP reduce from 6 to 5. All these indicate that dad lung is stronger now.
Dr Ting said the RBC breakdown likely is due to dad reaction to one of the drug, so he will find out more.
Dr Cheong & Dr Tand said lung is better & other parameters remain the same
Dr Lam said dad is coming out from DIC (Disseminated intravascular coagulation) which normally has fatality rate of 90%.He presribe potassium as it is on the low side.
Dr Lye said it seems that infection is less as WBC is reducing & haemoglobin is maintaing quite ok. Others parameters remain the same. Today dialysis will target to remove 2.5 ltr of fluid with toxin.
Overall, dad's condition is improving & stable.
Prayer points:
1. Praise point - Stable and bouncing back in all parameters.
2. Dad's spirit will remain high and faith is strong in the One who can heal him.
3. Degeneration of nucleated Red blood cell can be resolved as soon as possible
4. Infection especially chest area will continue to clear
5. Financial needs - favourable response from management board
6. Carers - United and faithful in nightly prayers. Remove our fearful and unbelieving hearts, put on the full armour of God and stand on guard in the intercessory prayers for dad & the medical team.
Scriptural verses to encourage our hearts:
Jeremiah 32:17 "Ah, Sovereign Lord, you have made the heavens and the earth by your great power and outstretched arm. Nothing is too hard for you."
Romans 9:16 "I raised you up for this very purpose, that I might display my power in you and that my name might be proclaimed in all the earth."
Ephesians 6:18 "And pray in the Spirit on all occasions with all kinds of prayers and requests. With this in mind, be alert and always keep on praying for all the saints."
Friday, November 14, 2008
2008.11.14 HE Is Wonderful
8:00pm Update:
Dad had a good rest last nite as BP is stable & breathing is at easy pace.
Today whole day dad is doing well, BP 110-120/45, HR=70-80, BPM=25-32. (N4.5-6.3).
Today blood parameters are also very good. Haemoglobin increase to 10.4 (N13.5-18) from 7.6 yesterday. WBC also down to 9.27 from 11.55 (N4-11) which means less infection. RBC also increase from 2.53 to 3.5. X ray show lung is better. No dialysis is required today.
Overall, Drs are happy with dad condition today. Dr Tang said it seems that dad condition is bouncing back. Dr Teoh said dad's abdominal discomfort is ok, nothing serious for now. Dr Cheong said lung is better & Diarrhea may be due to antibiotic. Dr Lye said infection activities is reduced but still there hence continue to give 3 antibiotics & monitor closely. He also confident that dad's urine will be back when things are more settle. Dr Jong said dad is getting better & try to lift him to sitting position, Dr Lam also said dad is more alert & well.
All Drs, Jong, Teoh, Cheong,Tang, Ting,Lam and Lye visited & positive about the progress.
At 9am, The Methodist Church Healing Room ministry's director Mr Ronnie Yeo came with Ms Doreen (consultant lawyer) & her husband Pro Dr Lim. They laid hand over dad for healing. During healing time, Doreen saw Jesus in white glow came to dad. It was a great moment. We read scripture & sing hym to dad. It was a great moment. They left about 9:45am
This morning, Dr Jong reduced the respirator pressure & switch on talking mode to allow dad to talk. Dad told us that he still have stomach discomfort, and also said Praise The Lord and Amen (in Foochow). It was a great moment which lasted about 10 minutes. Dad was surround by mum, Ai Yiing, David & myself.
We have moved to #05-03 Elizabeth Tower A from York Hotel. God really provides.
We know, God is with us.... & He is unfolding his power & wonder to us every day. Praise be to God.
Dad had a good rest last nite as BP is stable & breathing is at easy pace.
Today whole day dad is doing well, BP 110-120/45, HR=70-80, BPM=25-32. (N4.5-6.3).
Today blood parameters are also very good. Haemoglobin increase to 10.4 (N13.5-18) from 7.6 yesterday. WBC also down to 9.27 from 11.55 (N4-11) which means less infection. RBC also increase from 2.53 to 3.5. X ray show lung is better. No dialysis is required today.
Overall, Drs are happy with dad condition today. Dr Tang said it seems that dad condition is bouncing back. Dr Teoh said dad's abdominal discomfort is ok, nothing serious for now. Dr Cheong said lung is better & Diarrhea may be due to antibiotic. Dr Lye said infection activities is reduced but still there hence continue to give 3 antibiotics & monitor closely. He also confident that dad's urine will be back when things are more settle. Dr Jong said dad is getting better & try to lift him to sitting position, Dr Lam also said dad is more alert & well.
All Drs, Jong, Teoh, Cheong,Tang, Ting,Lam and Lye visited & positive about the progress.
At 9am, The Methodist Church Healing Room ministry's director Mr Ronnie Yeo came with Ms Doreen (consultant lawyer) & her husband Pro Dr Lim. They laid hand over dad for healing. During healing time, Doreen saw Jesus in white glow came to dad. It was a great moment. We read scripture & sing hym to dad. It was a great moment. They left about 9:45am
This morning, Dr Jong reduced the respirator pressure & switch on talking mode to allow dad to talk. Dad told us that he still have stomach discomfort, and also said Praise The Lord and Amen (in Foochow). It was a great moment which lasted about 10 minutes. Dad was surround by mum, Ai Yiing, David & myself.
We have moved to #05-03 Elizabeth Tower A from York Hotel. God really provides.
We know, God is with us.... & He is unfolding his power & wonder to us every day. Praise be to God.
Thursday, November 13, 2008
20081113 Maching on
2008.11.13 7:15pm Update:
Dad finished dialysis at about 4pm, added 2 pints of blood & 500ml of Plasma, 1 ltr of fluid was removed.
CT scan (without contrast) done at about 5pm and now waiting for report.
Now, dad is sleeping peacefully, BP130/45, HR=75, SPO2=100%, BPM=29, Breathing is easy.
I notice that this evening dad's tummy a bit bloated & firm. Dr Lam didn't visit dad today.
---------------------------------------------------------------
2008.11.13 4:15pm update:
Dr Lye came about 12:30pm. Culture from tubes from all the 3 sites are free from bateria. So he suspect the infection may from from abdominal. Hence he ordered CT scan without contrast to be done today 4:30pm. He also confirm to transfuse 2 bags of blood as hamoglobin id low (7.6) and 2 bags of plasma. Due to excess fluid going in, hence he ordered dialysis to start at 12:30pm.
----------------------------------
2008.11.13 11:20am update:
Dad last nite went thru a tremor... BP drop to 57(systolic) and heart rate below 60. There was a panic call about 11:30pm. Arterial Blood Gas (ABG) test was done and found that dad's blood is too acidic. PH7.286 (N7.35-7.45) and Base excess -13.8 (N=0). Sodium Bicarbonate was administered to balance the acidity. Dad BP back to normal about 105/45 about 45minutes laters. PTL. The cause likely is due to metabolic acidosis.
Dad slept about 2:30am peacefully & restful till the morning. This morning, he is more alert when Dr Tang tested him. All Drs are happy about his alertness. All parameters about the same, x ray show lung is clearer now, but haemoglobin is low (7.6) despite 2 pints (700ml) of lood was transfused yesterday. Hence, today 2 more pints of blood will be given. Dr Ting ordered G6PD test to find out the cause of RBC disoder. Dr Cheong suggested to use bactrim antibiotic to wipe the bacteria infection but was worry about the IMPACT on the kidney, hence Dr Lye advise is needed. Dr Teoh said dad abdominal condition remain the same.
Dad still on antibiotic minocycline,tygacil & flagyl. Heart still supported by Dopamine(7ug/kg/min).
Parameters:
HR =78, BP =116/40, BPM=32, SPO2=100%, O2 support=35%.
Haemoglobin=7.6, RBC=2.53, WBC=11.55,Nucleated RBC=28,
Prothrombin Time Patient =18.6(N10-14), PTT=48.3 (N25-41)
Reported by Simon
---------------------------------
Dad finished dialysis at about 4pm, added 2 pints of blood & 500ml of Plasma, 1 ltr of fluid was removed.
CT scan (without contrast) done at about 5pm and now waiting for report.
Now, dad is sleeping peacefully, BP130/45, HR=75, SPO2=100%, BPM=29, Breathing is easy.
I notice that this evening dad's tummy a bit bloated & firm. Dr Lam didn't visit dad today.
---------------------------------------------------------------
2008.11.13 4:15pm update:
Dr Lye came about 12:30pm. Culture from tubes from all the 3 sites are free from bateria. So he suspect the infection may from from abdominal. Hence he ordered CT scan without contrast to be done today 4:30pm. He also confirm to transfuse 2 bags of blood as hamoglobin id low (7.6) and 2 bags of plasma. Due to excess fluid going in, hence he ordered dialysis to start at 12:30pm.
----------------------------------
2008.11.13 11:20am update:
Dad last nite went thru a tremor... BP drop to 57(systolic) and heart rate below 60. There was a panic call about 11:30pm. Arterial Blood Gas (ABG) test was done and found that dad's blood is too acidic. PH7.286 (N7.35-7.45) and Base excess -13.8 (N=0). Sodium Bicarbonate was administered to balance the acidity. Dad BP back to normal about 105/45 about 45minutes laters. PTL. The cause likely is due to metabolic acidosis.
Dad slept about 2:30am peacefully & restful till the morning. This morning, he is more alert when Dr Tang tested him. All Drs are happy about his alertness. All parameters about the same, x ray show lung is clearer now, but haemoglobin is low (7.6) despite 2 pints (700ml) of lood was transfused yesterday. Hence, today 2 more pints of blood will be given. Dr Ting ordered G6PD test to find out the cause of RBC disoder. Dr Cheong suggested to use bactrim antibiotic to wipe the bacteria infection but was worry about the IMPACT on the kidney, hence Dr Lye advise is needed. Dr Teoh said dad abdominal condition remain the same.
Dad still on antibiotic minocycline,tygacil & flagyl. Heart still supported by Dopamine(7ug/kg/min).
Parameters:
HR =78, BP =116/40, BPM=32, SPO2=100%, O2 support=35%.
Haemoglobin=7.6, RBC=2.53, WBC=11.55,Nucleated RBC=28,
Prothrombin Time Patient =18.6(N10-14), PTT=48.3 (N25-41)
Reported by Simon
---------------------------------
Wednesday, November 12, 2008
20081112 - Battle on with God
20081112 morning
Dad had a good & restful sleep last nite.
7:20am - Dr Jong(ICU) - Stable & maintaining well. Reduce respirator support from 18 to 15
8:30am - Dr Cheong(lung) - Blood, culture & others parameters indicate some improvement, Haemoglobin low - need 1 bag of blood transfusion. Lung is clearer
9:10am - Dr Ting (blood) - Haemoglobin low, today need to give a bag of blood transfusion. WBC9.39 (N4-11), its a good sign indicate that less infection.
9:20am - Dr Lye (Kidney) - Parameters are improving, no urine yet, pain at right abdominal reduce a bit, will do dialysis & 1 pint blood transfusion will do good to dad. Dad seem to have some improvement.
9:45am - Dr Lam(Cardiac) - Dad stable & maintaining well. Equired whether received the hospital & Drs bills? I told him we received Hospital bill but not from Drs. I mentioned this is a long haul - expect bill 30% discount.
10:00am - Dr Tang(Neuro& physician) - All lines are clear & are not likely the source of infection. Ponder where is the infection from? Suggest to get one infection specialist to examine, Dr Lam will be contacted regarding this. He called Dr Ting to enquire about blood test. The test finding shows bone marrow produce lots of nucleated Red blood cells but does not sustain (ie mature to haemoglobin). Dr Ting said he will look into the blood film to see where it goes wrong.
10:45am - Dr Teoh (intestine surgeon) - Abdominal pain on right hand side when press hard is ok. Don't have to woory too much now.
Summary:
Generally, all parameters shows sign of improvement. WBC is in normal range. This may mean less infection than yesterday. Corncern area is in the young red blood cell. It dies prematurely & Drs need to find out the cause. Dr Ting is the doctor to take care of this.
Prayers:
Dad had a good & restful sleep last nite.
7:20am - Dr Jong(ICU) - Stable & maintaining well. Reduce respirator support from 18 to 15
8:30am - Dr Cheong(lung) - Blood, culture & others parameters indicate some improvement, Haemoglobin low - need 1 bag of blood transfusion. Lung is clearer
9:10am - Dr Ting (blood) - Haemoglobin low, today need to give a bag of blood transfusion. WBC9.39 (N4-11), its a good sign indicate that less infection.
9:20am - Dr Lye (Kidney) - Parameters are improving, no urine yet, pain at right abdominal reduce a bit, will do dialysis & 1 pint blood transfusion will do good to dad. Dad seem to have some improvement.
9:45am - Dr Lam(Cardiac) - Dad stable & maintaining well. Equired whether received the hospital & Drs bills? I told him we received Hospital bill but not from Drs. I mentioned this is a long haul - expect bill 30% discount.
10:00am - Dr Tang(Neuro& physician) - All lines are clear & are not likely the source of infection. Ponder where is the infection from? Suggest to get one infection specialist to examine, Dr Lam will be contacted regarding this. He called Dr Ting to enquire about blood test. The test finding shows bone marrow produce lots of nucleated Red blood cells but does not sustain (ie mature to haemoglobin). Dr Ting said he will look into the blood film to see where it goes wrong.
10:45am - Dr Teoh (intestine surgeon) - Abdominal pain on right hand side when press hard is ok. Don't have to woory too much now.
Summary:
Generally, all parameters shows sign of improvement. WBC is in normal range. This may mean less infection than yesterday. Corncern area is in the young red blood cell. It dies prematurely & Drs need to find out the cause. Dr Ting is the doctor to take care of this.
Prayers:
1. Praise points: (Edited by Freda)
General slight improvement through parameters indication and doctor's confirmation. Lung clear, BP good, chest infection improved, abdominal pain reduce, no fever, lower white blood cell count (no new bacteria growth)
Prayer points:
1. Lung infection: Antibiotics (Tygacil & Minocycline) administrered will be able to combat the beteria infection. Improve immune system is needed.
2.Renal function: Need immediate jump start. Remove dialysis dependency & prevent septic bank build up. Drought started since 31st october
3.Abdominal: Pain will subside.
4.Red Blood cells: Identify the cause of degeneartion of young red blood cell (nucleated red blood cells )before growing to full maturity. Pray for Dr Ting (Haematologist) and the team's wisdom and skill to treat the problem.
5.The CVP (central venous pressure) line will continue to be bacteria growth negative. Need protection over the punctured entrance spot.
6. Medical Team: Good medical judgement, sharp, professional skills and knowledge, good coordination among the team.
8. Carer's team: United, perservering and positive spirit. Be clear minded, self controll, alert so that we can pray. 2 Peter:7,8,
9. Financial: The Lord's provision. Seeking favourable approval for discount on the bill. This is the 9th week of Mt E Stay.
-------------------------------------------------------------
2008.11.12 - 9.30pm Update
Dad started dialysis around 11am and finished about 2pm. Removed 2 liter of fluid with toxin. Dr Lye originally intend to remove 3 ltr of fluid but change his mind when dad's BP start to fall when fluid is removed in excess of 2 ltr.
Right after dialysis, dad feel weak & but he is much more alert. His eyes are wide open and when we call him, he will turn his eye or head to have eye contact with us. Halleluja.
Dr Ting will do more test to find out the cause of hemolysis of RBC.
Freda was enjoying some light & spiritual moment with dad
Dad BP tonite (9:50pm) is irregular 85-105/45. But we are all at rest because Our mighty God is with him. Halleluja.
Reported by
Simon Lau @10pm
Tuesday, November 11, 2008
Our Prayer
Heavenly Father, we thank you for Your Living and Active Word. You said that Your Word is life to those who find it and medicine to all their flesh. Today, by our confession we apply Your Word to our dad's body by giving voice to it.
You said in Psalm 139:14 that our dad is fearfully and wonderfully made and that Your works are marvellous. We declare that our dad was created by You and he is a marvellous creation.
We speak to sickness and disease today and proclaim that according to Philippians 2:10 they must bow down to the mighty name of the Lord Jesus Christ. Every name in heaven, on earth and under the earth bows to Jesus' name.
We speak to our dad's body today and declare that we have authority over it. We command it to receive the Word of God. Matthew 8:17 proclaims that Jesus bore our dad's sicknesses and took his infirmities.
Heavenly Father, we thank you that the same Holy Spirit that raised Jesus from the dead dwells in our dad and makes alive his mortal body.
We speak to dad's immune system and command it to line up with the Word of God. Dad's immune system will destroy sickenss and disease in his body and perform its job, for this is what God created it to do.
We thank you Father that every cell in dad's body responds to Your Word. Your Word permeates dad's body from the top of his head to the bottom of his feet. We confess that the Word of God is being made flesh in dad.
Psalm 103:3 declares that You, Father, forgave all dad's iniquities and heals all his diseases. Father, that is your confession and we make it our confession also. We don't judge by the sight of our eyes or the hearing of our ears. We judge by Your Living Word. It is Your Word that lives in us and brings health and healing to every part of dad's body.
Heavenly Father, we rejoice at Your promise of divine health. You said it and we believe it! Today, we declare that we will see Your promise of healing manifest in dad's body.
Healing is ours because Jesus paid the price two thousand years ago. God so loved dad that He sent His Son to die on the cross so that dad could experience life on God's terms: His abundant life manifesting in us, making my dad whole - body, soul and spirit. In the mighty name of Jesus Christ! Amen!
You said in Psalm 139:14 that our dad is fearfully and wonderfully made and that Your works are marvellous. We declare that our dad was created by You and he is a marvellous creation.
We speak to sickness and disease today and proclaim that according to Philippians 2:10 they must bow down to the mighty name of the Lord Jesus Christ. Every name in heaven, on earth and under the earth bows to Jesus' name.
We speak to our dad's body today and declare that we have authority over it. We command it to receive the Word of God. Matthew 8:17 proclaims that Jesus bore our dad's sicknesses and took his infirmities.
Heavenly Father, we thank you that the same Holy Spirit that raised Jesus from the dead dwells in our dad and makes alive his mortal body.
We speak to dad's immune system and command it to line up with the Word of God. Dad's immune system will destroy sickenss and disease in his body and perform its job, for this is what God created it to do.
We thank you Father that every cell in dad's body responds to Your Word. Your Word permeates dad's body from the top of his head to the bottom of his feet. We confess that the Word of God is being made flesh in dad.
Psalm 103:3 declares that You, Father, forgave all dad's iniquities and heals all his diseases. Father, that is your confession and we make it our confession also. We don't judge by the sight of our eyes or the hearing of our ears. We judge by Your Living Word. It is Your Word that lives in us and brings health and healing to every part of dad's body.
Heavenly Father, we rejoice at Your promise of divine health. You said it and we believe it! Today, we declare that we will see Your promise of healing manifest in dad's body.
Healing is ours because Jesus paid the price two thousand years ago. God so loved dad that He sent His Son to die on the cross so that dad could experience life on God's terms: His abundant life manifesting in us, making my dad whole - body, soul and spirit. In the mighty name of Jesus Christ! Amen!
Spiritual Battle is still on
2008.11.11 @ 9.45am
Yesterday, I had fever & my whole body ache, mouth & throat with inflamation, and I know that its a satanic attack.The evil one want to bolt me down, but haleluja, HE is biger than the one who disturb me. Today I woke with feeling well & even with a higher spirit. I know in my heart today is a brighter day because God is with us. When we reach the end of our way, that is when God's way begin ...
All parameters are good today.
- Breathing Frequency =29 ok
- BP 118-122/48 v good. with Levophed off & 3.9ml/hr Dopamine only
- Heart Rate = 75-78/min ok
- SPO2=100 with Respirator support O2=35%, min f=10/min
- Blood test results all are normal.
- Bateria culture indicated only moderate growth of Stenotrophmonas maltophilia only (It was heavy growth last few results)
7:15 Dr Jong(ICU specialist) - Dad seem to be more alert. Blood test like normal person, all parameters are good. He commented that may be its due to our pray & fasting, so he advisd please continue to do so. He also advised that may be should send David's children back for exam as dad condition is improving. He said Dad IS A FIGHTER.
7:30 Dr Teoh (Intestine Surgeon) - Dad is more alert. Stomach is soft & well.
8:30 Dr Ting - Dad blood parameters shows that he is still quite badly infected. PT & WBC are low hence infection is still there. Need plasma infusion.
8:32 Dr Tang - He said Stenotrophmonas maltophilia has develop resistance to Levofloxacin hence now has to depend on minocycline & Tygaciline.
8:35 Dr Lye - He is back today. He confirmed that bateria is still there. He wonder where is the source of infection, CPV & IV lines from right shoulder & left wrist are -ve but he noticed that dad's right abdominal develop severe pain he press softly. He suspected line from groin for dialysis is infected and need treatment. He asked Dr Teoh to look into detail.
To Summarise, this morning dad is more alert as all parameters are ok but the battle with bateria infection is still need to be severely guarded.
I know, this is a spiritual warfare, but God is the giver of life, to HIM the infection is a small matter.
Prayer support:
1. Dr will identify the source & type of infection
2. Dad will response to the antibiotic given
3. God will cleanse all bateria from dad's body.
-----------------------------------------------------------
200811.11 @ 12:50 news
HR=65,BP=125/52, BPM21, SPO2=100, Dopamine =3.4ml/h.
Today given a new antibiotic Flagyl @10ml/hr (IV), 1 unit of blood & 500mlof plasma.
General whole morning dad is quite awake & can response when we call, by opening his eye & turning his head. He also have facial expression when we talk to him. Dad got temperature this morning hence cooling bed is on.
-------------------------------------------------------
20081111 @ 8.30pm News
Overall today is a fruitful day, we are on the upper hand, satan is fleeing away. Dad is much alert, can acknowlegde what we say with face expression & turn head.
CVP line from groin and left wrist IV line were taken out to prevent infection. Only CVP line on the right shoulder is left for dialysis & IV injection
I know God already restored dad to his original intend.
Yesterday, I had fever & my whole body ache, mouth & throat with inflamation, and I know that its a satanic attack.The evil one want to bolt me down, but haleluja, HE is biger than the one who disturb me. Today I woke with feeling well & even with a higher spirit. I know in my heart today is a brighter day because God is with us. When we reach the end of our way, that is when God's way begin ...
All parameters are good today.
- Breathing Frequency =29 ok
- BP 118-122/48 v good. with Levophed off & 3.9ml/hr Dopamine only
- Heart Rate = 75-78/min ok
- SPO2=100 with Respirator support O2=35%, min f=10/min
- Blood test results all are normal.
- Bateria culture indicated only moderate growth of Stenotrophmonas maltophilia only (It was heavy growth last few results)
7:15 Dr Jong(ICU specialist) - Dad seem to be more alert. Blood test like normal person, all parameters are good. He commented that may be its due to our pray & fasting, so he advisd please continue to do so. He also advised that may be should send David's children back for exam as dad condition is improving. He said Dad IS A FIGHTER.
7:30 Dr Teoh (Intestine Surgeon) - Dad is more alert. Stomach is soft & well.
8:30 Dr Ting - Dad blood parameters shows that he is still quite badly infected. PT & WBC are low hence infection is still there. Need plasma infusion.
8:32 Dr Tang - He said Stenotrophmonas maltophilia has develop resistance to Levofloxacin hence now has to depend on minocycline & Tygaciline.
8:35 Dr Lye - He is back today. He confirmed that bateria is still there. He wonder where is the source of infection, CPV & IV lines from right shoulder & left wrist are -ve but he noticed that dad's right abdominal develop severe pain he press softly. He suspected line from groin for dialysis is infected and need treatment. He asked Dr Teoh to look into detail.
To Summarise, this morning dad is more alert as all parameters are ok but the battle with bateria infection is still need to be severely guarded.
I know, this is a spiritual warfare, but God is the giver of life, to HIM the infection is a small matter.
Prayer support:
1. Dr will identify the source & type of infection
2. Dad will response to the antibiotic given
3. God will cleanse all bateria from dad's body.
-----------------------------------------------------------
200811.11 @ 12:50 news
HR=65,BP=125/52, BPM21, SPO2=100, Dopamine =3.4ml/h.
Today given a new antibiotic Flagyl @10ml/hr (IV), 1 unit of blood & 500mlof plasma.
General whole morning dad is quite awake & can response when we call, by opening his eye & turning his head. He also have facial expression when we talk to him. Dad got temperature this morning hence cooling bed is on.
-------------------------------------------------------
20081111 @ 8.30pm News
Overall today is a fruitful day, we are on the upper hand, satan is fleeing away. Dad is much alert, can acknowlegde what we say with face expression & turn head.
CVP line from groin and left wrist IV line were taken out to prevent infection. Only CVP line on the right shoulder is left for dialysis & IV injection
I know God already restored dad to his original intend.
Monday, November 10, 2008
A brighter day
20081110
Last nite dad has a good sleep. All parameters this morning are good. BP 115/50. SPO2=100% (with 35% O2).
Rosalind arrive about 9pm last nite & Hong SC came on Saturday.
Dr Leong See Odd (Kidney specialist) said - today all parameters remain the same.
Dr Teoh Tiong Ann (Surgeon) - dad seem to be better today. Response to pain when he press hard the tommy.
Dr Winston Jong (ICU specialist) said - dad is stable today.
Dr Tang Kok Foo (Neurologist & physician) - Temp coming down, seem to be good sign, dad is still alert & response to pain when he press hard. He said Sodium level is high, so called Dr Leong
to remove some during dialysis today.
Dr Cheong Tuck Hong (Lung specialist) - Lung seem to be better, no additional infection from lung X-ray & blood test. He said the present antibiotics are sufficient. He said we might get dad out off ICU but the bateria may come back again if dad immunity is low.
Dr Ting (Blood Specialist) said today blood count still low HB (8.4 as compare to 7.1 yesterday and also plasma level also low, so today need 1 pint of blood & 500ml of plasma transfusion.
To summarise, today all parameters are ok & treatment will be 4 hrs of dialysis to remove toxic, creatine & sodium. Will be given 1 pint of blood & 500ml of plasma.
Due to BP is stable, hence Levophed is stopped but Dopamine remain as 4.9ml/hr.
Overall my feeling is God is answering our plead & dad is getting better each day. We just have to cast out the demon of sickness.
Last nite dad has a good sleep. All parameters this morning are good. BP 115/50. SPO2=100% (with 35% O2).
Rosalind arrive about 9pm last nite & Hong SC came on Saturday.
Dr Leong See Odd (Kidney specialist) said - today all parameters remain the same.
Dr Teoh Tiong Ann (Surgeon) - dad seem to be better today. Response to pain when he press hard the tommy.
Dr Winston Jong (ICU specialist) said - dad is stable today.
Dr Tang Kok Foo (Neurologist & physician) - Temp coming down, seem to be good sign, dad is still alert & response to pain when he press hard. He said Sodium level is high, so called Dr Leong
to remove some during dialysis today.
Dr Cheong Tuck Hong (Lung specialist) - Lung seem to be better, no additional infection from lung X-ray & blood test. He said the present antibiotics are sufficient. He said we might get dad out off ICU but the bateria may come back again if dad immunity is low.
Dr Ting (Blood Specialist) said today blood count still low HB (8.4 as compare to 7.1 yesterday and also plasma level also low, so today need 1 pint of blood & 500ml of plasma transfusion.
To summarise, today all parameters are ok & treatment will be 4 hrs of dialysis to remove toxic, creatine & sodium. Will be given 1 pint of blood & 500ml of plasma.
Due to BP is stable, hence Levophed is stopped but Dopamine remain as 4.9ml/hr.
Overall my feeling is God is answering our plead & dad is getting better each day. We just have to cast out the demon of sickness.
Sunday, November 09, 2008
Miracles
Dad has been in comma since last Wednesday 05.11.2008. He has no pain or feeling even when we pinch him on the finger tips. Situation get worse on last Friday afternoon. Dr Lam (principal Dr)was called & came in to ICU at 5:30pm. He saw the breathing pattern & BP, he pulled me & Freda aside & told us to prepare for the worse as dad may go within 24 hrs. We devastated after hearing the news. I called all the family member to prepare for the worse.
I could sense there is clouds of deadly spirit roaming in ICU that day. The devil has claimed 2 lives that day in ICU. Thru a indonesian friends whose father also an ICU patient, arranged Pastor Timothy Tee together with 2 church elders A/Prof Lim Lean Huat & his wife Doreen Lim(lawyer) from Light House Healing Ministry. They came about 8pm and laid hand over dad. After few minutes of praying, I could felt the power of healing flowed in the room . Initially I noticed dad is moving mouth slightly & we were overwh
elm. My sister Ai Ming was so overwhelming that he shouted "Praise the Lord" so laud that attracted the ward nurse sister to come in to find out whats going on. Then next thing we saw dad open up his eye. We were all so amazed with the healing power.
Before they left, they called me & Freda and annointed us with the power of healing, saying that they can't be here all the time, so in their absent, we have to step in to continue the healing ministry for dad. Though may be its new to us, but as long as we have faith in Jesus & proclaim his name & blow creative power into dad's body, God will heal him. Pastor told us that as long as 2 or 3 gather together & agree with what we pray then God will answer our prayer, but God also respect the will of our father whether he prefer to be with the Lord now or later, the decision is belong to dad.
Through out that night, dad breathing pattern (25 BPM) & BP (120/50) were normal.
Next morning (Saturday), I went to visit dad at 6.30am & God gave me Palsm 71 to read to dad. At the end of reading, dad manage to say amen. I was so overwhelming & tears filled in the eye. Its a very touching moment. Through out the sharing time (about 15 minutes), I can see that dad is engaging with me can aknowledge what I said. Dad held my hand & rest on his heart. I noticed he gained little bit more strength with his right hand.
Mum came in about 6:45am. She called dad's name & dad turn his eye to mum. Mum was so thrill, because she hasn't see dad open his eye to look at her like that.
About 7am, my brother Ah Dee came in & called dad. Dad was very emotional, breathing became heavy & more frequent. He open his both eyes and stared at Ah Dee. Ah Dee talked to him & he acknowledge & I saw tear came down from his eye. The conversation was distrupted because nurse want to change dressing for dad.
Dr Lam came about 11am for his usual round. After examing dad, he was amazed with dad's condition & with a big smile on his face & told us that don't ask him why.
Whole day, dad was alert, open his eye once a while and moving his right hand.
Pastor Tee & the Team came again at 4pm (Saturday) & laid hand on dad again. When Patsor Tee pray & laid on him, dad was alert & engaging. He send off Dr Tee & the team by turning his eye & head.
God is good all the time. All the time God is good. Praise The Lord.
I could sense there is clouds of deadly spirit roaming in ICU that day. The devil has claimed 2 lives that day in ICU. Thru a indonesian friends whose father also an ICU patient, arranged Pastor Timothy Tee together with 2 church elders A/Prof Lim Lean Huat & his wife Doreen Lim(lawyer) from Light House Healing Ministry. They came about 8pm and laid hand over dad. After few minutes of praying, I could felt the power of healing flowed in the room . Initially I noticed dad is moving mouth slightly & we were overwh
elm. My sister Ai Ming was so overwhelming that he shouted "Praise the Lord" so laud that attracted the ward nurse sister to come in to find out whats going on. Then next thing we saw dad open up his eye. We were all so amazed with the healing power.
Before they left, they called me & Freda and annointed us with the power of healing, saying that they can't be here all the time, so in their absent, we have to step in to continue the healing ministry for dad. Though may be its new to us, but as long as we have faith in Jesus & proclaim his name & blow creative power into dad's body, God will heal him. Pastor told us that as long as 2 or 3 gather together & agree with what we pray then God will answer our prayer, but God also respect the will of our father whether he prefer to be with the Lord now or later, the decision is belong to dad.
Through out that night, dad breathing pattern (25 BPM) & BP (120/50) were normal.
Next morning (Saturday), I went to visit dad at 6.30am & God gave me Palsm 71 to read to dad. At the end of reading, dad manage to say amen. I was so overwhelming & tears filled in the eye. Its a very touching moment. Through out the sharing time (about 15 minutes), I can see that dad is engaging with me can aknowledge what I said. Dad held my hand & rest on his heart. I noticed he gained little bit more strength with his right hand.
Mum came in about 6:45am. She called dad's name & dad turn his eye to mum. Mum was so thrill, because she hasn't see dad open his eye to look at her like that.
About 7am, my brother Ah Dee came in & called dad. Dad was very emotional, breathing became heavy & more frequent. He open his both eyes and stared at Ah Dee. Ah Dee talked to him & he acknowledge & I saw tear came down from his eye. The conversation was distrupted because nurse want to change dressing for dad.
Dr Lam came about 11am for his usual round. After examing dad, he was amazed with dad's condition & with a big smile on his face & told us that don't ask him why.
Whole day, dad was alert, open his eye once a while and moving his right hand.
Pastor Tee & the Team came again at 4pm (Saturday) & laid hand on dad again. When Patsor Tee pray & laid on him, dad was alert & engaging. He send off Dr Tee & the team by turning his eye & head.
God is good all the time. All the time God is good. Praise The Lord.
20081109 Mt E stay
Today dad woke up feeling quite alert. BP 110/50 ok. Under the cardiac support of IV 15ug/kg/min dapamine (400mg/50ml) & IV levophed 4mg/50mls @0.5ml/hr (give small maintaining dose after 7am)
General all Drs says he is more alert than last few days. Now dad is given Levofloxacin 250mg /48hrs, minocycline, Vancomycin 1g single dose & yesterday start Tygacil. All these are antibiotic to fight against the bateria identified as stenotrophomonas maltophilia esp in the lung.
Dad last nite experience low BP (90-95/40) hence Dr Lam gave levophed to constrict the peripheral blood flow, inorder to increase the BP
Dr Leong say, dad renal function conddition no change from day one he involved.
Dr Ting (blood specialist) said dad haemogolin 7.1 very low as compare to 2 days ago Hb10.1, hence need 1 bag of blood transfusion.
Dr Teoh say dad instestine recovery is good & this morning got a good BO.
Dr Jong said we just have to wait & see his response to antibiotic against bateria. Right & left lung shown in the yesterday X ray has very slight improvement.
Dr Lam said dad is more alert today, good sign however the we are in more & more difficult to wean him off if dad lay on the bed longer.
Dr Tang say, dad is more alert compare to last few days, a surprise. But war again bateria is not improving. Dad got temperature. However the liver infection is improved & recovered. He describe dad position is like holding him tight next to the cliff preventing him to slide down the hill. If it happen, it will be steep fall. He commented that dad is keep on losing blood cell after blood transfusion, meaning that dad system is not producing new blood cell, which is no good. He said we have posibly used up all the ammunition of medical science & now depend on dad's own body.
My feeling: We have the best team & done our best according to modern medical science. Now, we need God intervention to do t rest.
This afternoon, dad is more chesty, BP under the support of cardiac drugs dopamine & small dose of levophec, BP is dropping to between 87-105/45. BPM about 30-35.
Dad is alert and I called him, he will reponse to me. Its griefing to see dad lying on the sick bed & yet can't alert yet can't express his feeling.
Dad is still taking liquid food Nepro - Full Strength 900ml /day thru tube from nose.
At about 4:30pm, We notice that SPO2 & BP getting lower. Nurse has to increase the dosage for dopamine (800mg/100ml, 13ug/kg/min) to 6.3ml/hr & levophed (4mg/50ml, 0.05ug/kg/min)to 2.4ml/hr inorder to maintain the systolic BP above 90. Dr Jong came & break the news that Dad only got 1% chance to make it. We denounce what Dr had said & cast out demon of doubt & claim victory over dad wholesome body. We all believe God has heard & answer our plead.
General all Drs says he is more alert than last few days. Now dad is given Levofloxacin 250mg /48hrs, minocycline, Vancomycin 1g single dose & yesterday start Tygacil. All these are antibiotic to fight against the bateria identified as stenotrophomonas maltophilia esp in the lung.
Dad last nite experience low BP (90-95/40) hence Dr Lam gave levophed to constrict the peripheral blood flow, inorder to increase the BP
Dr Leong say, dad renal function conddition no change from day one he involved.
Dr Ting (blood specialist) said dad haemogolin 7.1 very low as compare to 2 days ago Hb10.1, hence need 1 bag of blood transfusion.
Dr Teoh say dad instestine recovery is good & this morning got a good BO.
Dr Jong said we just have to wait & see his response to antibiotic against bateria. Right & left lung shown in the yesterday X ray has very slight improvement.
Dr Lam said dad is more alert today, good sign however the we are in more & more difficult to wean him off if dad lay on the bed longer.
Dr Tang say, dad is more alert compare to last few days, a surprise. But war again bateria is not improving. Dad got temperature. However the liver infection is improved & recovered. He describe dad position is like holding him tight next to the cliff preventing him to slide down the hill. If it happen, it will be steep fall. He commented that dad is keep on losing blood cell after blood transfusion, meaning that dad system is not producing new blood cell, which is no good. He said we have posibly used up all the ammunition of medical science & now depend on dad's own body.
My feeling: We have the best team & done our best according to modern medical science. Now, we need God intervention to do t rest.
This afternoon, dad is more chesty, BP under the support of cardiac drugs dopamine & small dose of levophec, BP is dropping to between 87-105/45. BPM about 30-35.
Dad is alert and I called him, he will reponse to me. Its griefing to see dad lying on the sick bed & yet can't alert yet can't express his feeling.
Dad is still taking liquid food Nepro - Full Strength 900ml /day thru tube from nose.
At about 4:30pm, We notice that SPO2 & BP getting lower. Nurse has to increase the dosage for dopamine (800mg/100ml, 13ug/kg/min) to 6.3ml/hr & levophed (4mg/50ml, 0.05ug/kg/min)to 2.4ml/hr inorder to maintain the systolic BP above 90. Dr Jong came & break the news that Dad only got 1% chance to make it. We denounce what Dr had said & cast out demon of doubt & claim victory over dad wholesome body. We all believe God has heard & answer our plead.
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