Sandra Kim

Saturday update - fever down.

Just talked to Willem.  Sandra's fever is down, likely due to the antibiotics and other meds they put her on.  Otherwise no change. 

Back to basics

We started to take the blog in a different course to add stories about Sandra and non-medical posts, but upon greater reflection we're going to keep to the day-to-day updates.  I deleted the last couple of posts that were not related. Unintentionally some comments were lost as well.  --Arie

Friday box of chocolates

The biggest news tonight is that Sandra has a fever again and they are treating it with new antibiotics.  They also took a lung tissue sample today to be analyzed.  On a brighter note Sandra is still active and as Willem was talking with the doctor she heard his voice and started moving around so he had to cut the meeting short to be with her. 

Since it's been almost 4 weeks on the breathing tube they plan to do a tracheotomy and bring the tube through her throat on Monday.  This is a precaution to prevent scaring on the throat and voice cords, but it will also allow them to lower the sedatives and she may be able to mouth words and communicate more. 

Due to the fever we're still limiting visits to Sandra's room - the family and staff at Harborview would like to minimize the possibility for agitation, etc.  Check with Willem first if you have any questions.

In summary it's another week and another box of chocolates.  Sandra will likely smack me for quoting Forrest Gump once she has the strength :).

*****update*****

Willem informed me that they will evaluate on Monday prior to deciding on the tracheotomy so it's not a done deal.  If they feel she is close to no longer needing the tube they may opt to wait it out. 

Also "box of chocolates" comes from a quote in the book and movie Forrest Gump "My momma always said, Life was like a box of chocolates. You never know what you're gonna get."   Every day we get both encouraging news and concerns, so this  a roller coaster ride for many of us.  Thus the quote.

--Arie

Thursday - something to look forward to

Willem talked with Sandra's new resident doctor today, Stephanie.   The big goal now is to get Sandra of the breathing tube in a few days as that can be a cause of infection.  They went over the MRI, CAT scans and echograms.  There is some tissue damage in the lungs, but it's hard to know if there will be long lasting effects.  The source of the bacterial infections outside the lungs is something of a puzzle, but they have theories. 

The necrotizing pneumonia in the lungs is serious and something they are very focused on, but it may not have been the direct cause of the bacterial embolisms in other parts of the body.  They changed some of the antibiotics today, hopefully that helps further.  Today there  were infectious disease experts checking in.  (As we've mentioned a few times before, these folks at Harborview don't mess around.)

Though the doctors won't put a time-line on it, we'd like to see Sandra off the tube in 4-5 days.  That is the next big milestone.  For now it's still baby steps.    --Arie

Wednesday report

Nurse April said that her vitals were still good today.  No fever again.  Her heart rate came down a little bit which is a good thing because it was beating on the fast side.  She was pretty active and awake according to Mom.  Nurse April said that they put a glove on her right hand because it looked like she might pull out some of her cords.  Activity is another a good sign.  

 

They will be doing a transcranial doppler tomorrow.  It's a test that measure the blood flow in the vessels in the brain.  

 

Thought some of you might want to know that when Dr Sterling gave his last update yesterday, he mentioned that Sandra has necrotizing pneumonia.  

-- Esther

Tuesday- swtich from burn team to pulmonary team

Sandra is still improving, but remains in critical care.  Today she was passed off from Dr. Sterling and the burn team to a pulmonary team.  I didn't catch new doctor's name, but I heard him working with the nurses in Sandra's room while Willem met with Dr. Sterling.  Per usual here at Harborview, he is sharp, works well with the nurses and was asking a ton of critical questions.  He mentioned some improvement in the lungs and the need to balance keeping her comfortable, but somewhat alert.  This afternoon she was heavily sedated, perhaps as we heard that she had been fighting the breathing tube a bit.

Dr. Sterling was reluctant to be pulled off the case, but Sandra's pulmonary issues are now much more critical than her burns which are healing.  He teared up during the meeting with Willem - incredible dedication here.  Sandra will stay on the 9th floor as she still needs treatment for her skin.

To recap, we still have concerns about bacterial emboli in the brain and lungs, but Sandra's improvements including lack of fever, decreasing white blood cell counts and increased responsiveness all bode well. 

--Arie

Monday- steady

Sandra continues to gradually improve.  Willem just met with the doctor and there are no major updates today.  Sandra had a CT scan last night that didn't discover anything new.  We'll continue to ask that visitations be limited.

I'd like to take a moment to thank everyone for their support to Sandra and Willem's families.  It's been wonderful and overwhelming.  This goes from comments on the site to the food brigade, cards, offers of help, emails, etc.   Thank you!  --Arie

Good Pic

Added a pic to the site. --Arie

 From Will: 

"Attached is the latest photo I have of Sandra and I think it is kind of nice.  thought it might be good for the site.  It was the day we all three got our hair cuts (at Russel's condo - check out the amazing post-it-note art thing he did of Eunhae!) and I think it was only a few weeks before all this happened and that nice haircut was shaved off."

Fever down

From our Mom who was spending the day with Willem:

"Some more good news.  The doctor called while we were there and told him that her fever had been down for 24 hours.  That is great news because the worst fear has been that she would get more infection."

 

--Arie

Good Sat visit

Saturday was a good day.  First I heard that in the morning that the nurse told Sandra that her parents were in the doorway to her room and she turned her head toward them and opened her eyes trying to see them, which was thrilling.  I saw her late in the afternoon after she had wound care and was therefore more heavily sedated than usual.  Still, she tried to open her eyes to see me also and shut them quickly and scunched up her face and nodded her head yes when we asked if the the lights were too bright.  She tried again after turning down the lights but had trouble seeing clearly, which we thought was due at least partially to the goop that they have all over her eyelids and which I could see on her eyeballs as well.  But she's trying! 

Later I had what amounted to my first conversation with her in 2 1/2 weeks.  I asked her if she knew why she was in the hospital and she shook her head no.  I reminded her of the alergic reaction to the medication and asked if she remembered being at Virginia Mason.  She nodded yes.  I reminded her of being in the ER at Harborview and the conversation with the doctors about surgery, she nodded yes.  I explained that she got pneumonia and got very sick and has therefore been sedated for 2 weeks instead of 2 days.  I asked if she understood now why she was in the hospital and she nodded yes.  She also squeezed my hand periodically during my visit and I would answer by squeezing hers or vice-versa and this was very nice also. 

It's exciting to see her more awake but she is still very weak and we are a little concerned about her getting over stimulated and/or tired out by too many visitors especially over the weekend so we're asking to limit visits right now to family and a few closest friends for the next few days at least.  Feel free to call me if you're unsure.  -Willem