Back to the USS Northwestern

This is Giudi, with a report based on notes from Kate Green.

Valjean was admitted to Northwestern Memorial again on June 18, with severe breathing difficulty. The next morning they transferred her to the ICU and put her on a BiPAP machine, which pumps oxygen through a tightly fitting face mask, similar to the C-PAP that’s used for sleep apnea. With that support, she was able to undergo a CT scan.

That scan, upon which we pinned so many diagnostic hopes, was inconclusive. It did show that there was not much fluid in the pleura (hence nothing to drain to make her more comfortable). But there is a large "white-out" area in the right lung, which could be due to 1) bacterial pneumonia, 2) radiation-induced pneumonia, 3) an "aggressive clone" of cancer cells (the oncologist thinks this is unlikely), or 4) a combination of the above. In any case, she has only a small portion of lung working. She’s receiving antibiotics to treat #1, steroids for #2. Bronchoscopy (to retrieve samples of fluid and tissue) might clarify the diagnosis, but she couldn’t cannot tolerate such an invasive procedure without more breathing support: intubation and a ventilator.

After frank discussions with docs and friends, Valjean has agreed to intubation, if her breathing worsens, in order to give the meds a chance to work and, we hope, resolve the acute situation. If the treatment is successful in turning around whatever is going on in her lungs and she becomes able to breathe on her own, the ventilator will be removed; if not, we will honor Valjean's wishes for removal of the tube. The docs have been respectful, informative, compassionate. Friends with medical power-of-attorney are standing by.

Sounds pretty grim....but Valjean is still Valjean. When the pulmonologist arrived and asked how she was, she replied (muffled by the 02 mask), "not my perky best." After the consult with the oncologist and pulmonologist re: the CT scan, "Don't they know what the white stuff is? What are we paying these people for?"

When we left tonight (6/19) they had raised the pressure on the BiPAP and Valjean was breathing a bit easier. She was alert, hungry (only sips of water or juice are allowed), apparently stable, and watching Law and Order.

Valjean sends her love.