Updates on Ryan’s illness and recovery are provided at the bottom of this post. Please check back from time-to-time to see how he’s progressing. Thank you, genuinely, for caring about Ryan and keeping him relevant. It means everything to my family!
The night before I watched Ryan even more closely than normal. I couldn’t put my finger on anything, but something just didn’t seem right with him. That was all I had to go on… my instincts.
His vital signs were all perfectly normal. No fever. No elevated heart rate. Normal blood pressure and oxygen saturation. Urine is clear and producing the appropriate volume. Bowel movements are consistent. No indications of discomfort or pain.
Still… I had a sense. I wish I could explain how but, honestly, I don’t even know how this happens to me. This feeling grew throughout the night and I began preparing for a trip to the hospital, just in case.
So, I put his “Go Bag” (and mine) next to the door. It had been four years since Ryan was hospitalized. That time it was because a kidney stone was blocking his urinary tract. We must always be ready to leave without warning. It’s disheartening to live in this reality.
This time we had a brief warning.
With Go Bags in hand, I went outside to warm up the van and damned near had my feet fly out from under me. The sidewalk had iced over from freezing rain earlier in the day. It looked liked polished glass! I made my way up to the car (using both my hands and feet), then offloaded the Go Bags and started the van. I playfully skated back — simulating a hockey stick in my hands — down to the house.
But, I had a problem. How in the hell would I be able to get him, in his wheelchair, up to the van?
I then remembered that I had stored a couple of buckets of Kitty Litter that I bought years ago for this precise situation! I mentally gave myself a pat on the back for the preparedness as I liberally spread the granules by hand.
Everything was ready to go… if we had to go.
Just after 4AM Ryan started breathing increasingly more rapidly. An hour later his respiration rate was three-fold his baseline (16 breathes per minute). Clearly, something was bothering him.
No different from every morning, I did a detailed visual assessment of his body from head to toe. To me, he seemed a little “pudgy” as though he was retaining fluids, so I weighed him. The measurement was so different from just twelve hours ago that I damned-near convinced myself that it couldn’t be trusted. I weighed him again; the same result. Then I weighed him a third time and got the same.
Overnight he gained 1.5kg… that’s 3.3 pounds!
We were at the hospital’s Emergency Room twenty minutes later. By early afternoon he was admitted and given a room in the ICU.
Here’s what I know so far related to Ryan. [Note: Updates are provided at the bottom of this post]. His lower urinary tract is suspected to be restricted. This time it’s not a kidney stone, but something else. I’m told it could be something that was in the making from early in his injury; when the hospitals were catheterizing him on regular bases. Or, it might be inflammation from an infection. Either way what this functionally means is, although he urinates normally, his kidney’s are always retaining stagnant urine.
Although Ryan presented no symptoms (until just hours beforehand), his blood work showed he had an infection and he was in early kidney failure. He was also becoming septic and both his lungs were just starting to develop into full-blown pneumonia. In other words, I caught it early. This was huge for his recovery prognosis. Unfortunately, it doesn’t change the treatment (but surely prevented more treatments).
First, the infection must be knocked out with powerful IV antibiotics and any inflammation in his urinary tract decreased. Then it gets more complicated if we hope to (possibly) prevent future occurrences. This likely involves procedures like scoping and/or imaging. It also might need surgery to remove any stricture(s) along the length of his urinary tract. Let’s hope not.
I’m guessing we’ll be in the hospital for a while even if everything goes ideally. I’ll keep you posted throughout and might just keep updating this post, so please check back from time-to-time.
One Final Thing:
I am often tormented by a thought, but it spikes when Ryan is ill. This time I can’t suppress it as quickly. Beginning on the drive to the hospital (and since) I can only wonder, what if I ever miss something? What if I catch something a tad bit too late? What if my instincts fail, even just once? What could become of him? Would I blame myself for not being perfect in his care?
Yes. Yes, I would.
For now, I’m barely hanging on. I’m physically (beyond) exhausted. My emotions are teetering on the brink. Mentally, well, I’m staying strong but my brain is in overdrive. I can’t shut it off or slow it down.
There’s no changing this either. I know it. The only action is the same as the past eight-plus years… lean in and plow through.
- Weds., Jan. 10, 9:30 PM: Recent blood work shows that Ryan’s iron level has dropped (i.e., he is anemic),; a result of the infection. An iron supplement will be added to his medications. If it doesn’t recover via supplement then he will need blood transfusions. First dosage should be administered soon.
- Thurs., Jan 11, 1:00 PM: Just received a comprehensive update from the doctors. In short, Ryan’s blood test, urine tests, and imaging/scans (e.g., sonograms, CT Scans, X-rays, etc.) results are all improving; with some even back to normal. Although he’s getting better, it’s still not a certainty this will continue. However, assuming his continued recovery, the next critical step is to find the cause of the urinary tract’s blockage and the remedy/long-term plan.
- Fri., Jan 12, 12:45 PM: Ryan will be here for at least several more days. Definitely through the weekend. Ugh! The cause of the partial blockage in his urinary tract is inflammation from bacterial infections. The best way I can describe what was happening to him is to imagine a slow, partially clogged drain with the tap turned on; it slowly builds because it fills slightly faster than it can drain. For Ryan, the inflammation (i.e., partial clog) was downstream of his kidneys. This caused his urine to stagnate upstream in his kidneys. The good news — if you want to call it that — is that it wasn’t due to strictures, injury, or kidney stones. Therefore, no surgery or invasive procedures are expected as necessary.
The specific infection is the result of (not just one, but) two, gram-negative bacteria; Serratia & Proteus. Eradication requires him to receive IV dosages of a powerful antibiotic for two weeks, minimally. I’ll need to continue these IV infusions when he eventually returns home. Blood work, urine tests, and imaging (e.g., x-rays, sonograms, and CT scans) are showing normal and expected improvement… but it’s going to take some time. Think of his recovery in terms of weeks, not days. Thank goodness this was caught early, literally in the knick-of-time, when he was in early onset kidney (i.e., renal) failure. Had Ryan become acute then we’d be dealing with potentially deadly serious conditions.
This scares the living hell out of me! Perhaps it helps others understand how it only fuels my angst of “…what if I ever miss something? What if I catch something a tad bit too late? What if my instincts fail, even just once? What could become of him? Would I blame myself for not being perfect in his care?”
The next update could be this evening, but no later than tomorrow. Please check back periodically!