Mallory has remained stable for the remainder of the afternoon and evening. The most importing thing that needed to be done was to get the medicine into Mallory’s lungs, which is now complicated because of the type of lung support she is on (oscillator).  It is very difficult even on a regular ventilator to deliver a large amount of the medicine into the lungs.  Dr. Flores came up with an ingenious way to deliver the medicine and with the assistance of the respiratory group worked to administer the dose (the first one) of medicine into Mallory’s lungs.  Hopefully, this method will be successful in getting at least part of the medicine to her lungs if not all of it.   Now it is time for us to pray that it works as we need it to. Thanks to everyone in ICU team for everything that you have done not only for Mallory but for us as well. And thanks to everyone that have been continually praying for Mallory.

The Smiths

The morning has not been very good today. Mallory had an episode this morning where her blood pressure dropped and her heart rate increased. They had to go back up on the oxygen % from the oscillator they also had to give Mallory meds to increase her blood pressure. We spoke to Dr. Ram by phone (the icy conditions  have him stuck at home) and he told us that so far the KPC in the blood has turned up negative however the KPC is still in the lungs, and it appears to be colonizing. There is another med to treat the KPC in Mallory’s lungs but it cannot be administered using the oscillator and they cannot switch back to the ventilator.  There is a filter that can be used on an oscillator to administer the drug but they do not have one at Emory. They are now trying to find anyone in the area that has such a filter. For now we are praying that Mallory has no more events until they can find a filter.
To quote one of the ICU PA’s “we are getting boxed in more and more every day!”
While we still have hope for a miracle, we are praying that time does not run out.
Please  pray!

The Smiths

So today has not been too eventful (compared to the early morning). They have worked  most of the day getting Mallory stable and lowering the oxygen from the oscillator (down from 100% to 50%). With the addition of the oscillator Mallory’s room stays nice and toasty (ok hot). This is a good indication that Mallory’s gases are much better. The Dr.’s want to limit un-necessary blood work for now, all of her meds have stayed the same.   So far test for KPC in the blood have not grown any cultures (this is very good news),more cultures were drawn today. The KPC is still in Mallory’s lungs so we need prayers that the medicines will rid her lungs of this horrible virus.  That is about it for the update, please keep praying for Mallory to start getting better.

Thank you to the Aiken family for requesting Mass for Mallory at Transfiguration Catholic Church, awesome!!  Thank you Sherri for the Starbucks gift card and also an unnamed person for the additional gift card.  Thank you Inga and Chris for you kind gift and as well.  Angela and Michael provided dinner for us tonight, it was delicious…. thank you both!!  Momma and Robert thank you for house and dog sitting!!  Be sure to sign the guestbook!!!  Rhonda, thank you for staying with us and supporting us last night during the crisis.  We appreciate all the prayers, support and visits from everyone

I am not sure where to even start with this post. Around 10 or so last night Mallory"s dialysis machine clotted off, the technicians worked on it and could not get it to work so they ended up placing a new machine. During the time she was off the machine things got very crazy in her room, not sure if the two are related. So, just after midnight her blood pressure begin to drop and her carbon dioxide began to rise. The ICU team worked on her and was able to somewhat stabilize her. Then shortly after this episode it happened again, they tried many different settings on the vent and were not able to get her in sync with the vent. Also, during this episode she was bleeding pretty bad from her mouth and nose which has since gotten better. So, a decision had to be made, Mallory has now been medically paralyzed and is now on an oscillator instead of a ventilator. An oscillator is a form of ventilation that is used to protect Mallory"s lungs, which are still VERY sick. The ICU team is responsible for saving Mallory"s life last night and for that we are so thankful!! Her white blood count is still very low and she is receiving treatment for this. Also, she received platelets yesterday (4 bags I think) so at the moment her platelets are better, low but better.

Dr.Ram has already been by and is very concerned as is everyone else. We are still waiting to see if the cultures grow anything and new cultures were done this morning.

The plan today is to continue to watch her very closely. Blood gases will be done very often, I believe every 1/2 hour or so. Mallory is in a VERY critical state at the moment and we are all more than worried. Please keep praying!! We know it is in God"s hands and we trust him to hear our prayers!!

Mallory has been weaned off the nitric oxide throughout the course of the day and so far so good. It seems like it was an emotional day and a hectic day today. Dr. Ram came out and spoke with us this evening and here are a few changes that have been made: Mallory will start to receive neupogen for her low white blood count and she did receive platelets today, I believe 2 bags. He also started a new antifungal medicine in case she has fungus growing in her lungs. It has also been decided to stop the prednisone, her liver numbers will be monitored VERY closely since now she will not be on any anti-rejection medicines. We are still waiting on results from all the diffierent cultures drawn today. Dr. Ram told us several times today that if she grew the Klebsiella again this would not be good. We are sitting on pins and needles waiting on the outcome of these cultures, we need them to not grow anything!!! Mallory"s lungs are still VERY sick, wetter and junkier sounding today. Dr. Ram said this is the most complex case he has ever had, he is concerned. One of the ICU docs suggested that maybe they call someone else, someone outside the Emory system to get a fresh set of eyes on all of this. We agreed and Mike told them he would gladly let them use his phone. So, as you can see we are getting desperate! Mallory is fighting but her little body can only take so much. I am not telling you all of this to upset anyone but I want everyone to know how serious this still is. Please pray and pray hard for her lungs and for the Klebsiella to be responding to the treatment.
Thanks to Mallory and Joe"s friend Todd for providing us with dinner from Olive Garden tonight, I had been craving it so it really hit the spot.

The Smiths

Today has been a stable day again for Mallory, YAY!!! They were able to replace the central port and the dialysis port today and Mallory remained stable.Dr Ram did come by later in the day and was happy with Mallory"s day, again stable. He did tell us that the cultures done on Tuesday was still positive for the Klesibella in her blood, however with that said she had only been on the medicine for one day when these were drawn. Tomorrow morning she will have cultures again for this bug, they usually take 24-48 hours to grow.Dr. Ram is still very worried about this bug.  We need to specifically pray for the new medicine (Gentamiacin) to work and for her lungs to get better!!!! God is awesome and he will answer our prayers!!!

Thanks for all the visits today! Thank you Kim for the giftcard to Chickfila, I am sure we will enjoy using it! Thank you to Mallorys friend Sarah Harvill for visiting and for the fruit basket! Also, thanks to Meghan, Callie and Lindley for the delicious soup and salad you provided for us tonight and the wonderful cake from Gabriels (Paula Deens cousin) in Marietta. Thank you Gabriel for the cake and the very touching note!!

We will update again in the morning!

Continued:

This is not an update but more of a declaration for the people who take care of Mallory. A very wise gentlemen (smarter than he knows) was speaking with us this evening. He had actually just had gotten off work and had come down to check on Mallory and took the time to talk with us. He said something that stuck with us all, he made the statement that he had been blessed to have people in his life that had given him the opportunities to learn. He so eloquently stated that everyone has the ability to learn anything but not everyone has the support need to achieve their potential. When he said those words we know we all felt the same thing (we will let you figure that one out on your own). With that said we would like take this opportunity to thank everyone who has taken care of Mallory and the people who have taken care of us! Thank you to all the Mom’s and Dad’s, brothers and sisters, husbands and wives, uncles and aunts, cousins  and friends who have supported you in your dreams in the health care field. It is a coordinated effort of everyone to take care of just one patient! I takes a special person who says to themselves, you know I want to work 8/12/16/24/32/48 hours a day (ok small stretch there). Ah, working weekends and holidays are ok with me; I want to work night shift! (as fun as night shift can be we know how tuff it is and ALL the Smith’s have worked night shift!). Please let me work this weekend and next weekend too! It’s just a birthday, anniversary, holiday, vacation, football or baseball game. What we are trying to say is Thank you Dr.’s, NP’s, Nurses, PA’s, techs, staff FOR EVERYTHING THAT YOU DO FOR US EVERY SINGLE DAY!!!!!!

Mallory has been stable all day today (great news!). For now the Dr.’s are going to leave everything the same. Dr. Ram came by this afternoon to check on Mallory and seemed pleased with her progress.  All indications show that Mallory is responding to the treatment for KPC. Tomorrow will be the last treatment for PCP which is now officially gone!  Heck it’s hard for us to keep up with the bugs that Mallory has so we wanted to give a update:
PCP – GONE!
HSV-  GONE!
CMV – going down but still there
KPC (lungs) Still active (treatment working)
KPC (blood) Still active (treatment working)
Mallory is still critically ill and it will be a while before she returns to her normal life but these small steps will seem like giant leaps in the near future. I know we posted earlier in the week that we had been told that if Mallory got a fifth bug it could be more than she could handle, well this tells us that NOTHING COMPARES TO THE POWER OF PRAYER!
As our Dr.’s , Nurses, PA’s, NP’s , friends and family have continued to remind us daily; keep praying and our faith in GOD will guide us through our time of despair.  Thanks to everyone who visited today, we enjoy spending time with each of you even if only for a few minutes!  Thank you Ellie for the wonderful basket of goodies and also Tim and Debbie for the fruit basket!  Also thank you Sarah for your sweet gifts, the cross is in my purse and the angel will be given to Mallory soon!!  Thank you Michelle for having dinner delivered to us tonight, the wings were great!!  And, thank you to our wonderful Northstar family for your generosity and most importantly your support!!! 

Well today has not been to eventful (Yea!). They have made some changes back and forth with Mallory’s ventilator. During the ICU rounds the Dr.’s did tell us that the “bug” in Mallory’s blood is in fact the KPC virus (not what we wanted to hear but…), she is already on a antibiotic for the KPC in her lungs so we are praying (specifically) very hard that her body responds to the drugs. They have switch meds for the CMV virus because Mallory’s white blood count has gotten very low (everyone now wears mask when they are in Mallory’s room), they have also given her a shot of Neupogen  (normally a painful one) to help her body produce more white blood cells. Mallory did test negative for the HSV today but the treatment for HSV is the same for CMV so no med are changed for that. Tomorrow will be the last day of bactrim for the PCP pneumonia so this will eliminates about 2 liters (of total fluids) that Mallory receives every day. We do not know if she still tests positive for PCP but we will ask tomorrow. So for now we are in a holding pattern and praying for more good news tomorrow.  We can announce that Mallory officially has won the silent game. We have not heard a word from her in the past 28 days!

Thanks again for all the prayers!

The Smiths

Dr. Ram just came in and gave us a report. He is pleased that Mallory had a good night, he didn"t get paged last night so that is a good thing. Today at 2:30 she will have a bronchoscopy and an endoscopy (only if she can tolerate these) to check on the bleeding she is having and just to get a better look at things. Dr. Ram said he will do the procedure and that he is basiclly monitoring her on an hourly basis given her critical state. Mallory received 2 units of blood today. Dr. Ram did also mention the new bug that is growing and still feels we are looking at klebsiella in her blood, which is not good at all. Please keep praying for Mallory.

Just thought I would give everyone a breakdown of what is going on in Mallory"s room everyday.

Mallory has a central point in her chest, an arterial line in her wrist and a port in her jugular vein (for dialysis). She has a ventilator hooked to her trach, a nitrous oxide machine, a dialysis machine and a machine used to keep her warm. She has 3 chest tubes, and ng tube, cuffs and boots on her legs, bp cuff, monitor on her forehead that monitors her sedation level, heart monitors and a pulse ox on her ear.

As far as medicines on a routine basis she has 7 antibiotics, 2 sedations, 1 paralytic, tpn, protonix, actigall, 2 pain meds, insulin, 2 bp meds, 1 med to boost production of red blood cells, prednisone, eye drops, miralax and ointment for her mouth sores. All of these meds are IV meds and she is also getting other meds as needed. She is also getting platelets and other blood products as needed.

Just wanted to thank everyone for visiting today, we are blessed with my wonderful family and friends.  Thanks to Lindsey Hamilton for the goodies and generous gift, we love you Lindsey.  Also, thanks to all my coworkers (Caric, Valerie, Rose, Tracey, Tricia, Angela and Melissa) for visiting today and for bringing us lunch  from OK Cafe, it was delicious! 

Thank you also to Michael and Amy from Jubilee Church for providing us with a delicious dinner tonight. Thank you to my relatives Chris, Tammy, Todd and Aunt Lucy for the gas gift card!!  Thanks to Mr. Ledbetter from our church for hanging out with us.  Thanks also to Rhonda and Kristen for taking time away from work and your family to spend time with us. We are so thankful for all of you!! 

Today has not been the best of days and it has not been the worst by far! The Dr.’s tried wean the Nitrous Oxide over the course of several hours today, when they got to almost zero Mallory’s BP started to bottom out. They changed the level’s back and kept it there for now. Someone is always in the room with Mallory talking with her while she is constantly being pampered by the wonderful ICU nurses. Dr. Ram came out this afternoon and spoke with us and discussed this “NEW” fifth (5^th) bug. They are not sure exactly what it is but any new infection/virus right now is not what we needed to hear. The KPC and PCP virus’s had previously only been detected in Mallory’s lungs, Dr. Ram suspect that the KPC virus could possibly be in her blood. We are awaiting confirmation on what this “new” bug is but we remain confident that Mallory will beat the latest challenges that have been placed before her. We again are asking for your prayers for our beautiful princess Mallory.

The Smiths

Last night was uneventful. Last night they did start back 2 more antibiotics that Mallory had previously been on. A test was done on her heart this morning and it looked good. Dr. Ram and the liver team did rounds already and here is what we know. Mallory is very complex and her lungs are still very bad and not looking any better, as a matter of fact her xray today is a little worse. The plan right now is to wean her off the nitrite oxide, it is not really helping as much as Dr. Ram had hoped. We were told they have not had a patient as sick as Mallory in a long time. Some of her treatment is unconventional but they are trying everything they can come up with. Right now the plan is to keep her sedated, paralyzed and see if her lungs can heal. Dr. Ram had planned to do a bronchoscopy today but has changed his mind because he does not feel she can handle it. Please continue to pray and we will update later. The Smiths

Today has been emotional (to say the least). We will try to tell you everything that happened. So Dr. Flores did put in another chest tube and she had a bronchial scope procedure. The bronchial procedure did not yield many results. After the procedure the Dr.’s did tell us that they felt it could be another infection or a re-occurrence of the KPC virus. Regardless they are going to start the treatment again, this time they will use the medicine that she was not able to tolerate. The Dr.’s reminded us that this virus is very very hard to get rid of. We soon realized this was going to be the easiest part of the day. At about 3 pm Mallory’s vitals started to plummet! Her blood pressure dropped to a critical level, it was only a few moments before Mallory’s room was full of Dr.’s and Nurses. Dr. Galloway instructed the respiratory team to “Bag” Mallory, this is to push the largest volume of air into her lungs. Mallory’s BP continued to fall this brought more people into her room. The Dr.’s were hovering around her bed then one of the Dr.’s  said they had to wake Mallory up and asked if one of us could come and talk with Mallory. We both instantly put on our gloves and gowns and were by Mallory’s side. She was waking up and we could tell she was in tremendous pain.  We both talked to her and she was able to squeeze our hands, she glared at us with intense look of pain! As a parent this was heart wrenching, we continued to encourage her letting Mallory know we where there. After about 20 to 30 minutes they were able to stabilize her vitals. The ICU Dr.’s  were in constant contact with Dr. Ram about Mallory’s condition. One thing Dr. Ram had them do was add nitrous oxide to her ventilator.  It was not long before Dr. Ram was in the ICU, he came in Mallory ‘s room and after a few minutes he told the team he wanted to paralyze her immediately. They started to process and before we knew it her room was again filled with Dr.’s as Mallory’s BP dropped again. By now the area outside Mallory’s room (and waiting room) was filled with our friends, family and our pastor. We were all watching Dr. Ram do his magic with the ventilator settings. We were all watching until they were able to finally get her stable.  Needless to say we all have been emotional wrecks. So for now the plan is to wait (we are getting good at that) and let her lungs heal. There is probably more that we have forgotten to post but this has truly been one of the most emotionally challenging days ever! We are still begging for prayers to heal our Mallory’s critically ill lungs! We would like to thanks all our friends for being by our side and to our church friends as well, Thank you to Danielle and Brock for bringing dinner and to Maw Maw and Robert for lunch. Also thanks to Dana for the delicious cake and potato soup.  

Mallory had a somewhat stable night last night, she received platelets and a unit of blood. The oxygen levels were better than on Friday night (but still not where they need to be). The liver team made their rounds this morning and said the X-ray of her right lung looked a little worse this morning so they were going to consult with the thoracic Dr. and see if they need another chest tube. They will also be starting back on of her antibiotics just to be safe. The Dr. Flores (thoracic/cardiac surgeon) came by and said he did not think Mallory need a new (or another ) chest tube. The lung seems to be inflated but he did see a haze in the X-ray that he thought could be excess fluid from the blood products she received last night so they have increased the dialysis to remove the excess fluid. For now the thoracic group will also be keeping an eye on her. Thanks for checking in.

The Smiths

Mallory has remained stable all afternoon,  the X-ray from earlier this afternoon looked good. Dr. Flores spoke with us about the “suspect” chest tube. He explained (very thoroughly) that he would advise leaving the current chest tube “as is”. Taking it out to reposition would basically yield the same results tube us currently performing. There could possibly be some improvement but removing the tube and repositioning would be painful for Mallory and it’s very difficult remove and place a tube in the same area. It is re-assuring that the Dr.’s have Mallory’s best interest in mind when it comes to treatments what she has been put through and they truly concerned about managing her pain. Mallory will be receiving some blood products along with her standard meds. We did talk with Dr. Galloway this evening (the ICU Dr. for the next week) and were very impressed with his level of concern for Mallory’s care.  Well that’s about all for the Saturday January 1, 2011! We would like to all our friends, family, Pastors, Dr.’s, Nurses, NP’s, PA’s, Technician and everyone else in the medical community that have supported us during these trying times and we wish nothing be the best for everyone in 2011.

The Smiths

Well we have yet to have rounds so far today, Mallory had her CT scan of chest and abdomen to look for any signs of bleeding. The results did not show any bleeding however the CT scan did show that one of her chest tube may not have been in the right spot (the x-ray had been done but the CT scan is a better image). No bleeding was detected but the CT scan did show that the upper (right side) chest tube was not where is should be and was possibly leaking air.  We were blessed (again) to have a Heart/Thoracic Surgeon (who just happens to be the husband of Mallory’s nurse) who was available to look at Mallory.
Dr. Flores felt that the chest tube in question should be removed (which he did). After the first chest was removed Mallory’s oxygen % went up almost immediately after the tube was removed. Dr. Flores also reviewed the second right chest tube to see if it is effectively placed. Dr. Flores did remind us that it is easier to look at the effectiveness of a chest tube after they have been placed. Placing a chest tube is a very delicate and precise procedure that surgeons have to feel where the tube goes (between the ribs). We are now awaiting a X-ray to review the second tube and the removal of the first.
Malloy’s blood pressure was a little low (lower then Celina would like) so Mom had a GREAT idea, Alabama was playing Michigan State so we turned the TV on in Mallory’s room and placed the pillow speaker beside Mallory. Well Alabama was driving down the field and guess what? You guessed it, Mallory’s blood pressure UP!!! Celina was amazed (to say the least) and in true Mallory fashion her blood pressure kept going up so they had to turn the volume off and yup you guessed it her blood pressure leveled off (a true Bama Fan!).
We will keep you up to date with the latest detail. For now we are still praying for Mallory’s lungs to heal properly.
Thanks for checking in, the Smith’s

It has been a busy day in Mallory"s room today. She had many vent changes throughout the day and we are hopeful that she will like the current setting and have an uneventful night. She does still have the PCP however it appears that the KPC is gone, both of these are the pneumonias that she was diagnosed with a few weeks ago. She now has CMV and HSV (both viruses) she is already receiving treatment for both. Dr. Ram is off service in the ICU and Dr. Galloway will take over tomorrow, however Dr. Ram will be lurking in the background and be called in if needed. He is off for the weekend but will round on Mallory next week with the liver team so we will still be talking with him. I wanted to say Thank you to Mike Linch, Marlon Longacre, Robert Ledbetter and Bryan Barton from Northstar Church for visiting us, we appreciate you all!! Thanks to my sweet momma for making dinner for us tonight, it was delicious!
 

Here is the link to Kennys website, please also continue to pray for him:
http://www.caringbridge.org/visit/kennykretz

On another note, we always have some excitement to share. Well...Mallory"s friends Mary and Callie from bible study came for a visit today. Mary went in to see Mallory and was getting ready to come out of the room and well....she passed out in the room. My mom and our wonderful nurse Celina were trying to catch her when I looked in the window and saw it happening ran and got Mike so he could help safely get her to the floor! Not sure exactly what caused this but Mary is okay now!! Dr. Ram came around the corner to inform us there are a few empty beds in the ICU! Never a dull moment, we have so much to tell Mallory when she wakes up!! Below is link to the picture of Mary and David...our two friends that gave us quite a scare...

I"ll Do ANYTHING for a Team Mal Shirt!!
David & Mary Survive!

Earlier this morning the paralytic was stopped.  The sedation was also turned down in hopes of waking Mallory up today.  We did get her to open her eyes however she did become agitated and her SATS dropped.  Dr. Ram made some vent changes and has decided that she is not ready and therefore she has been sedated again.  Her lungs are just very sick so we will have to be patient a little longer.  The liver team came by and her liver numbers are slowly getting better, Bilirubin is 2.4 today.  For the moment the feeds have been stopped again because she was not tolerating them well.  Please keep the prayers going for our sweet girl!!!  Also, please pray for a young man here in the ICU, Kenny Kretz, he is very sick and can use some extra prayers from Team Mal.  I will post a link to his website later today.  Also, just to let everyone know our good friend, David MR. VIP, is feeling better and seems to be doing good, which we are thankful for!  We will update as we know more.  Mike and Lisa (Pops and Nana)

Mallory had a good day, PRAISE GOD!!!  Dr. Ram told us this evening that if she has a good night then the plan tomorrow will be to start weaning the sedation and the paralytic!!!  Oh how we pray this will happen.  She seems to be tolerating the feeds again...this is a battle for her!  Her oxygen on the vent has been turned down to 40%.  Please pray for her lungs to heal and for her to be able to wake up without her vitals going too high.  Thanks to the Spence family for sending Rachel and Ashlyn down today with some yummy soup for us!  Also, thanks to Heather and Brandon Branham for providing a delicous meal for tonight. Sherman...thank you for visiting as well!  Our friends and family are doing a great job at feeding us!!  Praying also for a good night!!! 

The Smiths

Well we were not first on rounds today (YEA).  We had a good report today, Mallory’s oxygen level have stabilized to the point that they are now lowering the amount supplied by the ventilator. They will not lower them too much today (still want her lungs to recover) but they still want to reduce her dependency on the ventilator. If the carbon dioxide levels go up (or she becomes more acidic) they will do another bronch procedure just to rule out any obstructions.  The fluids samples from Monday night came back negative for CMV. The Dr.’s will continue to monitor the CMV treatment to insure it is effective. All in all it was the best report we have had in the past weeks. Thanks for the prayers (that we all can see are working)  and support.

The Smiths

Mallory had a stable night, the Dr.’s have yet to round will update after today’s rounds.

The procedure is complete. Dr. Ram said that Mallory"s lungs are very inflammed and oozing a little. He did a wash on her lungs and did remove a few clots as well. He will continue to monitor her lungs very closely. We asked Dr. Ram did he feel optimistic that Mallory would be okay, it was a hard question but it needed to be asked. He said that if she were a 60 year old person then no. However, she is young and her other organs are doing well so she has that going for her. He also said that if he didn"t feel like she would get better he would not being doing all that he is to get her better. He said that if we got to the point that he felt he had done all they could do for her, he would be the first to say so, which is NOT going to happen. So, with that said we need everyone to keep those prayers going and ask God to heal her lungs, this will be the first step in healing her. The Smiths

1 am Update:

Dr. Ram has finished the bronchial scope and found there was some inflammation in both lung along with some fluids, they did a wash (and suction) of the area’s and has sent the fluid out for testing. Dr. Ram also said the “wash” was therapeutic for Mallory’s lungs. For the next 48 hours they will keep Mallory paralyzed and the ventilator is on a protective mode to allow her lungs heal. We were also informed yesterday the Mallory did test positive for CMV (forgot to post), they have started her on meds for that.
Some might think “How much more can she take?” I can easily answer that; Mallory is one of strongest young ladies anyone will ever meet. She is up to the challenge because her faith in GOD is mightier than any can imagine!

The Smiths

Mid Night Update:

Sunday evening our pastor (Mike Linch) made mention to how quick things change, well they have change again.  We’ve been up and down with different things since Sunday. This evening they had to raise the oxygen % backup on the ventilator subsequent blood gases show Mallory’s oxygen levels had risen (but not enough) and her carbon dioxide levels had also risen (should be going down). A X-Ray was done to rule out another pneumothorax (this was negative). Mallory’s blood also started becoming more acidic (again) so Dr. Ram was called and they started several different things, the oxygen level did not go up where they need them to.
So now what?  I just spoke with Dr. Ram (who has come back in) and he has have increased Mallory’s sedation and they are going to paralyze her again to perform another bronchial scope (this can be very painful for Mallory so they want to insure she is completely out). Dr. Ram wants to insure there is no bleeding or blockages in the lungs.  We will post results as soon as we are informed.
Please keep praying!

The Smiths

Well today was not too eventful (thankfully). Mallory seems to be tolerating the feeds and has been doing well on the ventilator. They continued to lower the oxygen requirements during the day, they had lowered it down to 50% but her blood gases were a little low so they bumped it back up (which is fine because of the strides that have been made over this time last week). They will be giving Mallory another unit of plasma tonight but there are no other medicine changes for now. In another step forward they have been slowly decreasing one of the drugs used to keep her sedated.  Mallory did get her hair washed today by her wonderful nurse Hanna (thanks for taking great care of our Mallory) so she has to feel better now. Marlon and his wife (and cute son) came to visit Mallory today, Marlon did all the talking and Mallory did all of the listening. This evening we were treated to a great meal from Mallory and Joe’s friend Todd Fickes (thank you Todd, the food was great).  We are very appreciative for all the Dr.’s and nurses that have been taking GREAT care of Mallory, from the bottom of our hearts we thank you all for choosing to be nurses and Dr.’s.

The Smith’s

 [This is for you Mr. Ledbetter!]  >=

Mallory had a rough night but is resting better now. We were first on rounds again today, Dr. Ram said that he was not surprised that she had another pneumothorax (this is not an uncommon with PCP). Her Kidney and Liver functions are still ok (taking into account the procedures and medicines she is on). Mallory’s pupils are still reactive and they will be keeping a close eye on them. They have placed the feeding tube back in and are starting the feeds again, this mode of nutrition is preferred v/s TPM (IV feeds). So the plan for today is to watch her neurological signs closely, get the needed nutrition going, watch for any new sign’s of additional pneumothorax and weaning of the ventilator. This all may seem like steps backwards but they are actually big steps forward. Mallory’s oxygen % has remained high while the oxygen% supplied from the ventilator is being decreased (she is still initiating all her breath’s).  Thanks again for all the prayers and notes!!

The Smith’s

I wanted to let everyone know that our wonderful friend David is home and feeling better tonight.  He stayed at Emory last night for observation and a few tests.  He did not have a heart attack, they believe this was stress related.  We are so thankful he is home and is going to be okay!  We love you Rhonda and David!!  (aka mom and dad to Mike)!!  The Smiths

PS There are a few updates below on Mallory

Two updates below.

Today has been a better day with a few small improvements. Mallory is still getting sedation and some IV pain meds as needed. The dialysis is going well and the goal as of rounds this morning was to remove a little over 2 liters in 24 hours. Her eyes are still responding to light, GREAT. She has not woken up today because of the sedation, but that"s okay her lungs need to continue to get better so we can hear that sweet little voice. As of right now, 10:30 p.m., the ventilator has been set to a mode where Mallory is initiating the breathing and the machine is just supporting her, the vent was changed to this mode at around 7:30 p.m. and so far so good. They did increase the oxygen they are providing to her but only after they bathed her and she became aggitated. So all in all Mallory seems to have improved...slightly, but we will take it!! Thanks to all the visitors today!! Thank you so much to Kathy Chupp and her daughter Caroline for providing dinner for us tonight, it was delicious!!! Please keep the prayers going for sweet Mallory! The Smiths (aka Nana and Pops)