So here we are...still in the hospital for what I thought was going to be a fairly quick, routine admission. I thought Will needed continual fluids with carnitine every 8 hours for a few days, then he would be back at baseline, and all will be well. That isn't quite the way it worked out.
This admission has been anything but routine. Not only is Dr. T unavailable, but the team of physicians that were treating Will were essentially unaware of the challenge that he can provide. (Just ask his nurses... "May I take your temperature?" "No, it is mine and you can't have it!") For some crazy reason they really do like him, and they have treated him for long enough that they have a healthy respect for his medical condition and how fast his status can change...especially around 4 every morning. The residents were skeptical, but their learning curve was fast and steep.
So despite all of the early challenges, things were finally settling in. We had consults consulting and running tests, and fluids galore entering his veins. His numbers were looking better...until 4 am...when he tanked...every night.
Well, interestingly, he didn't tank last night...but that was because of a test that was being run that basically gave a jolt to his system to see how his adrenal gland would respond. The short answer is...it didn't. His initial labwork showed that his cortisol level was extremely low, and after the jolt they administered, it should have skyrocketed, but instead, it barely rose to the low side of normal.
Dr. K, standing in for Dr T this week, was standing beside the endocrinologist when he stated that news, and she looked at me and said, "Not at all what I expected." Well, apparently that makes three of us. But upon reading about it, it makes absolute sense. Will has been receiving more and more infusions but he is responding for shorter periods of time. Something had changed, but I didn't know what. I mistakenly thought that he had just fallen too far off baseline and needed time on continual fluids to give his body a break and return to "normal". Not happening.
There is no cure here. Man, but that sounds famililar. And the question that everyone is asking is...what happened. Mito happened. The strain of the mito not working sufficiently has affected yet another system. Progression happened. We know that mito is progressive. We know that things can change on a dime with it. But when a doctor walks in and tells you that you have essentially lost yet more ground to this heinous diesease, then it hits like a punch in the stomach.
It took a while for the news to really set in today. I heard it, but I didn't really process it. Then when things got calmer, I started reading and talking to the nurses. Then it hit me. Wow. This does really change things. This takes his fluid management to new levels. When he gets sick, we won't be able to keep him home. He will need to be in the hospital so his levels can be supported appropriately. That means more hospital time...more family strain...more grief...and honestly, more work. Tossing this lovely little variable into a fragile system really is incomprehensible to me at the moment.
What does this mean for today? It means I am going to go to sleep soon so when his alarms start beeping at 430 I won't be cross eyed. It means we will be here until the steroid we are now giving him reaches a level that helps stabilize his blood pressure. That means we may go home tomorrow (Wednesday), and we may not. It means we get to add a specialist and a medication to his current (what I thought was full!) arsenal of specialists and medications. It means that caring for Will just got a little more...challenging...and not in a good way.
God is still on His throne, and the sun is still shining way above the clouds. But, here, at the moment, it is gloomy and dark and stormy.