St. Paul's Hospital Becomes a Temporary Home

Wow.  I have no idea where to begin this blog entry.  So much has happened since the last entry.  I guess we talked about the pre-assessment visit and how well that all went and where Kevin was at with meeting with surgeons etc. Wednesday was a good day here in Vancouver.  Paul and Kevin got some great work done and Kevin had dialysis here at St. Paul's for the first time.  That was a great experience and he really enjoyed the dialysis team and clinic here.  Especially the nurse who needled him - Leo.  He was great and Kevin and him had a great connection right away.

Pre dialysis

Leo needling Kevin

Thumbs up!

The next day, we went to UBC for the volunteer fair in the SUB.  We met the UBC Chapter of the Kidney Awareness Club and Vincent from the BC Chapter of the Kidney Foundation.  Bobby and Vik joined Kevin's Tough Mudder team and they are onboard with supporting Kevin on this journey and in raising awareness.

Vik, Kevin, Jane, Bobby and Vincent at UBC

It was nice to meet them all and we look forward to coordinating our efforts to raise awareness with them!

The next day (Thursday) I went off to work, Paul was at home in Victoria, and Kevin headed back to the hotel.  I got a phone call within a couple of hours that he was not doing well at all and that he was feeling really sick.  I rushed back and took him over to Emergency at St. Paul's.  He almost didn't think he was going to be able to walk there.  He was feverish (39 degrees!), chilled, his muscles were aching and he was not looking good at all.  They sent him straight back to the Acute Care part of the ER and started assessing him. 

It started to seem as though he may have meningitis.  So we were quarantined within the ER and everyone had to wear masks from then on.

He was sent for an x-ray and then he was sent for a CT scan.

And then he had to have a lumbar puncture to rule out the meningitis.

We were then sent up to room 7003 on the CTU (Clinical Teaching Unit) and he was on precautions still.  This meant that everyone around him had to wear masks and he had to wear a mask if he left the room.  This lasted the whole first night.

By morning, the results came back and precautions were removed.  No meningitis!  This was great news.

He was poked and prodded all day Friday to try to figure out what was going on.  He had blood and urine samples taken and then had to head down to dialysis again Friday morning.

Leo was there again to needle him, so they were both pretty happy about that.  Leo commented on how different Kevin was compared to when he saw him 2 days before.  He was just so sick.  Dialysis was not a good time at all.  The results from his bloodwork showed that he had a gram negative rod infection.  This was not an expected finding.  These are usually associated with an infection in the gut - not from his catheter (which is what they suspected).  His arm swelled up a bit but luckily his fistula did not burst, he had to get a swab of his catheter to see if this was the site of a possible infection, and he was feverish and sick the whole time.  I stepped out for 1 hour to check out of the hotel and when I came back I heard that he had not had a good time at all.  He was very sick, had had an episode of Reiger's (extreme, uncontrollable shaking and almost convulsing due to fever) and was not doing well.

Friday ended with lots of doctors and nurses coming and going and plans for many more tests, another CT of his abdomen and some ultrasounds and lots of medication.  Some for pain, some antibiotics, some for hiccups, some for acid reflux, some for sleep, heparin to prevent clotting, some for blood pressure, some calcium for eating and on and on...
The nicest thing was a visit from Leo.  He came up to say good-bye to Kevin because it was his last day at St. Paul's and he was also heading off to the Philipine's to visit his family.  That really meant a lot to him that Leo cared that much to come see him.

Then, they decided to remove his catheter.  They thought that it just wasn't safe for him to have an infection and to keep it in.  So it was removed and a piece of it was sent off to be cultured.

So the catheter also came back with a different infection.  He has 2 separate bacterial infections.  So the antibiotics were increased.

Early Friday morning he developed hiccups.  They have basically been non-stop right up until now.  It is maddening for him.  This then turned into acid reflux and now he has some damage to his esophagus that makes it hard to eat and swallow - even water.

Saturday morning he started peeing blood and then it was black by Saturday morning.  He had right-sided pain that made everyone suspect gall bladder or pancreatitis.  He was sent for his abdominal CT and nothing of any significance was seen - more good news.

Today has been a day of lots of rest and sleep for Kevin.  He has been getting some good rest.

They would like to keep him here until at least Tuesday, so he will do dialysis here once again.  Leo won't be there though. 

Kevin has been so grateful for all of the medical care and attention that he has received here at St. Paul's.  From the ER team on Thursday night, to the nurses in the CTU, to the people in the dialysis clinic and the expert physicians and fellows on his team, everyone has been kind and helpful and supportive.

I should end by saying that Kevin is actually doing much better.  The fever and infection seem to be under control, his pain is not as bad as it was and he is on the mend.  It's just frustrating to be in the hospital this long, to not be able to eat very well and to have so much happening day after day.  The rest will be good though.

-Jane