Update August 14th

Deborah, Laura, Jenna, and Mandi met with doctors and other key staff members yesterday. Steven Johnson, head of the surgical team, was especially interested in what the family had to say. They spoke of not being notified in a timely manner when a significant change occurs in Jimm's condition; not having that change explained in detail afterwards; inaction, rudeness, sloppiness and possible carelessness on the part of some nursing personnel; lack of responsiveness on the part of certain medical teams; and lack of efficient communication between the various medical teams*. Deborah displayed pictures she had taken to drive certain points home. It is hoped that this will cause Jimm's treatment to improve.

Since taking a turn for the worse Tuesday night, Jimm has suffered a severe backslide in his status. He picked up an infection(no one has really been counting, but it seems to be perhaps the fifth hospital-acquired bacterial infection), spiked a temp and began to become septic. He is now on an antibiotic cocktail of four or so drugs. He had a respiratory issue that was finally explained as very shallow breathing that resulted in insufficient oxygen intake.. he was put on a respirator again. His BP declined so that he once again needed meds, often called simply pressors, and fluids. His kidney performance worsened, therefore more dialysis would be needed. He was in need of no-nonsense pain meds and was given morphine. He developed a facial twitch which doctors don't seem worried about and which has decreased with the lowering of the morphine dosage(connection?).

During these days, in which he was set back further than he has been for a long while, there were other occurrences such as drain jostling during a flip, and clogging of at least one drain resulting in a buildup of internal fluid.
As a result of the morphine dosage he has been unconscious and unresponsive.. to look at it optimistically, he is resting, and should be able to gather strength and start to heal again.
The next moves will be to continue lowering of morphine.. continue fighting the infection(the ID team has done cultures and knows what it is- we don't).. weaning off the respirator and BP meds.. pressing on with dialyzing(now more fluids are again present that beg removal too).. and hoping he is as responsive as he has been able to be in the past.

Kudos to the family for standing up for Jimm. Now it's time for everybody, including the Jimmer, to give it their best.


*numerous teams are involved in Jimm's complex care such as: surgical, pulmonary, plastics, nursing, infectious disease(ID), and numerous others.. and as you can imagine coordination of treatments among all these parties, some of which don't see particular patients that often, is not always easy- but critically important.

aw -day77