Angie & Jim

Morning Reportby Jim

We had a visit from a few of Angie’s doctors.  We caught them up on the events from last night (Dr. Perry’s cath).  The pulmonary doctor didn’t seem convinced about the blood pressure theory.  We had Angie sit up and measured her blood pressure and it was about the same as when she was laying flat with higher saturation levels.  So, I wouldn’t say we’re back to square one, but we still don’t have all of the answers.

Dr. Lui came by just as I was typing the above paragraph.  He came and chatted with us for a bit and did some tests with Angie.  He wouldn’t tell us his opinion based on the results of his tests just yet, but he seemed optimistic about the diagnosis of just low blood pressure and loss of fluids causing the problem.  He was all for changing her diet (to unrestricted! Wahoo!) and lowering the diuretic drugs (the ones to make her lose fluid).  He still wants to do a test for hepatopulmonary syndrome, but for right now, Angie just needs to regain some strength.  He said that there is a balance between trying to keep her oxygen levels high and retaining fluid (which caused her lung to fill with fluid last week).  The more she takes in and retains, the higher her oxygen levels will be (because of pressures in the venous system of her body), but if they go to the other extreme, her pressures drop and her oxygen drops too.  They’ve swung the pendulum from one extreme to the other, and it is just a matter of finding the balance again.  One thing he mentioned that makes a lot of sense is that two weeks ago Angie came down and saw him for an appointment and she was just fine.  Shunts and AVMs form slowly over time.  He thinks it strange that they would suddenly be a problem.  That was certainly encouraging.

Dr. Dong (the dietician) also just stopped by to talk to us about Angie’s diet.  They’ve got dietary supplements ordered too to help her start gaining weight.  Her appetite has been poor, but a big part of that is because she’s already had everything she can from the very low sodium diet and none of it was that great.  So, we may be here a little while longer while she regains her strength, but at least we’ve ruled out some of the most scary possibilities.