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.
Subscribe to:
Post Comments (Atom)
3 comments:
As many times our heart is heavy and broken when the things do not move as smoothly as we want it but as I read some healing verses today and my heart is once again assure and enlighten by the word of God that The Power of Prayer and Having Faith and Belief That God Can Actually Heal.
The Power of Prayer
By direct prayer to God the Father - and sometimes that prayer has to be a prevailing type of prayer, which means you keep praying to God until you get the healing to fully manifest onto the affected part of our dad body that needs the healing.
"The effective, fervent prayer of a righteous man avails much." (James 5:16)
Having Faith and Belief That God Can Actually Heal
In today reading, I actually come across following comments. "This is how powerful of a thing it really is if you can get your faith operating at higher levels with the Lord. If your faith is operating at these higher levels with the Lord, then God can manifest bigger and greater miracles either to you or through you to help someone else out." The Bible tells us that faith comes by hearing the Word of God. Hearing the Word of God means you reading the Bible for yourself and believing what you are reading. If you are willing to do this, then the Holy Spirit will start to raise your faith to a higher level. And once your faith has been raised to that higher level - then God may move in to heal someone else you may be praying for.
The following are 2 verses that show what happen to the man and woman with great faith in Bible.
Then Jesus answered and said to her, "O woman, great is your faith! Let it be to you as you desire." And her daughter was healed from that very hour. (Matthew 9:28)
And Jesus answered and said to him, "What do you want Me to do for you?" The blind man said to Him, "Rabboni, that I may receive my sight." Then Jesus said to him, "Go your way; your faith has made you well." And immediately he received his sight....(Mark 10:51)
Today when I am doing my daily bread reading God give this topic to me - OUT OF OPTION?. It is so amazing and relevant that because it is exactly what we need as a family at the moment.
The reading is 2 Kings 5:1-3, 9-15
The sharing in daily bread go like this:
As ancient Syria's mightiest military commander, General Naaman had all the benefits the empire could offer: influnce, afflunce, and power. All, that is, except for health! Naaman was a leper (2 Kings 5:1-3)
In contrast, the servant girl in the general's household had no options or power at all. As a captive from an army raid, she had been forced into a lifetime of slavery (V.2). But she did not permit herself to be overcome by despair and bitterness. Rather, she rose above her no-option estate to serve wholeheartedly the best interests of her master.
This servant girl didn't see her master's leprosy as God's punishment but as an opportunity to point Naaman to God's prophet in Samaria (v.3). Her recommendation led to Naaman's complete healing. He declared, "Now I know that there is no God in all the earth, except in Isreal" (v.15)
Today, many people have abundant options. Others, however, have their choices curtialed by poverty, poor health, or other adverse circumstances. When a crisis comes, even ther limited options evaporate.
Yet one choice always remains. Like Naaman's servant girl, we can still choose to serve God and point others to Him - regardless of our limied circumstances.
Facing an impossibility gives us the opportunity to trust God.
Pray & leave it to God. I believe that He is in conrol.
Post a Comment