Bleed

Maggie had another major bleed from ulcers in the same area of her stomach, I think around 10 pm. It was very similar to the one from the other day in terms of how massive the blood loss was, the intervention, and how frightening and critical it was. Maggie can't keep doing this--partly because the bleeding and the fix are too traumatic to her lungs. Also, because each time it happens, it is life threatening. We had about 20 people working on her from 10 through 12, then the GI team (2 docs) and 5 or so nurses took care of her until close to 2 AM. At that point, her bleeding was stabilized and they were suctioning blood clots, then cauterizing the same ulcers as before.

The GI doc gave us feedback afterwards. After the first bleed in Cinci on Friday, she was hopeful that Maggie wouldn't have another bleed. Obviously she did. That, plus the fact that the ulcer was tougher to get to stop bleeding this time makes her less confident that this procedure will take care of the problem.

So in a few hours when the day shift comes on, they are going to be consulting with the surgical team and also interventional radiologists to try to concoct a plan to act proactively to prevent another bleed. The possibilities include removing the portion of the stomach that is causing problems (surgery) or having the vessels that feed blood to that portion of her stomach embolized (radiology). Both would have benefits and risks. The surgery, especially would be dangerous and it is unclear whether Maggie is healthy enough to tolerate it. It is possible that something could happen today (today is Monday, I think).

The ICU doc told us that those options are not really standard protocol (there is no standard protocol); they may or may not be an option, but there are many brilliant minds here that might be able to put together a plan. Cincinnati is rated the 3rd best children's hospital in the country and we're having to take advantage of all of the expertise from ICU, oncology, gastroenterology, and now surgery or interventional radiology.

Maggie is going to be dealing with lots of the trauma of having gone through this twice. The key to getting her lungs healthy is getting rid of her excess fluid but the procedure, though life saving, put a boatload of fluids back into her. Her settings on the vent, as I type, are much higher than they were this afternoon.

There's not much else to say. This journey keeps on taking serious, exhausting, and absolutely ridiculous turns. Maggie continues to live--she could have died quite a few times already. One of the docs said tonight that it isn't her time yet. We pray that this institution finds solutions for her and that God would take care of all of her problems and allow us to keep on being her parents.