Patient: Brian Diagnosis: Kidney/liver Distress; Compromised Vasc. Circ. Leg

Brian remains unconscious. He was operated on mid-day for vascular circulation in his right leg, which was corrected. He is not expected to regain consciousness for another day. The doctor's concerns at this point are liver and kidney function, as well as tissue damage in his right leg. It is expected to be 3-5 days before the doctors are able assess the full extent of the damages.

Brian is recovering from vascular surgery on his right leg that was performed earlier this afternoon. He now has a faint pulse in his right foot. He has begun to regain consciousness, but has been sedated for his protection. We expect the respirator to be removed on Saturday and his vitals are now stable (90/50).

Brian regained consciousness, but has been sedated because his breathing is still being supported by a respirator and due to the pain his right leg. His blood pressure is 107/52. His pulse is 119. He has regained a pulse in his right foot, but he still has significant swelling in his legs. Because of the breakdown in the leg muscle tissue, he continues to give off toxins that are going to his kidneys. He is currently being treated with blood transfusions and high doses of fluids. He continues to have high levels of blood and fluid loss from his legs. His liver levels are slowly declining, which is a positive sign. His kidney levels are still high and of concern. Hopefully, he will be taken off of the respirator early next week and we hope to know the extent of the kidney, liver, and leg tissue damage by the later part of next week. Brian is currently resting and being visited by his immediate family.

Brian is awake. He is still on the respirator, because he cannot take in enough oxygen on his own. There is concern of pneumonia from being on the respirator for so long. He is being given medication to minimize any pain he may be feeling. There is also a possibility that he may have to undergo dialysis, but the doctors will be reducing the amount of fluids they are giving him before they take any steps in that direction.

Brian is awake but very tired. His vital signs are better but he has a fever of 100 degrees. He is being given a pain killer for the legs. The lab numbers for his kidney and liver are high and are not trending down yet. He has been given medication to improve the urine out put which is a concern. The oxygen level on his respiratory has been lowered to in hopes to wean him off the machine.

Brian was awake yesterday laughing and joking. His vitals have improved. Hopefully, he'll be taken off the respirator Today or Tuesday. The doctors are still concerned about the damage to his kidneys, liver and legs, but will not know the extent of the damage until later in the week.

Brian is experiencing significant pain in his legs. The doctors are trying to reduce the amount of pain medicine and sedatives in order to wean him off the respirator. His blood pressure and heart rates are elevated and are a concern as well. The ICU staff has asked visits to be limited to the immediate family for only short periods so he can get the rest he requires.

Brian’s condition improved overnight. He is awake and semi alert. He is putting out more urine indicating an improving kidney function. The lab works on his Kidney and liver are still high but trending downward. He has a good distal pulse in his left leg and able to move it. His right distal pulse is getting stronger but he has not moved the leg. The hospital hopes to remove the breathing tub from his throat and take him off the respirator today.

Unfortunately the Doctors were not able to wean Brian off the respirator today. The dressings on his legs were changed today which required administering a sedative for the leg pain. This caused his respiration to slow down preventing the removal of the airway. His Kidney and liver numbers are trending down which is a good sign. His blood pressure is high at 170/80 and pulse is better at 112. The ICU will attempt to remove the respirator on Wednesday.

Brian’s condition continues to improve. His kidney and liver numbers are high but trending downward. He has no fever, but is being given an antibiotic as a precaution. His pulse and blood pressure are high, but he is awake and feeling anxious from the breathing tube. The doctors will attempt again today to remove the respirator and breathing tube. The vascular specialist examined Brian’s legs yesterday. Although he said Brian’s case was the most serious he was currently handling his progress is very good. His circulation continues to improve in both legs. He will require plastic surgery on the left leg sometime down the road.

Brian was taken off the respirator and is now breathing on his own. His is giving off urine without the help of medication. Unfortunately, Brian’s liver and kidney numbers are still very high but slowly trending down. He is being sedated for the pain from both legs.

Brian was moved off the ICU late Thursday afternoon. He is in extreme pain from the incisions in both legs and has pain coming from his lower stomach. The doctors have upped the pain management to morphine and will be doing a CAT scan of his stomach today. He is awake but semi alert.

Brian had a difficult day with the pain in his legs and stomach. A CAT scan of his stomach was negative with no signs of blockage. His pain medication was upped to morphine every 4 hours. The vascular surgeons’ have scheduled surgery on his legs Monday to remove scare tissue. He is uncomfortable but his blood pressure and pulse are getting closer to normal levels. Brian’s liver and kidney lab numbers continue to trend down.

Brian’s condition continues to improve. His vitals are higher than normal but in an acceptable range. His liver and kidney numbers are declining but still too high. He had physical therapy on his legs today for the first time. It was very painful but the beginning of a long recovery for the legs. He is in a great deal of pain from the legs which results in him not being able to sleep and acting restless. Brian is being given morphine every four hours for pain control.

Brian was visited by the vascular surgeon and neurologist this afternoon. They tested the reflexes in his right and left legs. He still does not have any feeling in his right leg below the knee. The doctors will continue to test his legs, but believe that it may be a few weeks before he regains feeling in the lower half of his right leg. They will have a better idea following the surgery that will be performed on his right left on Monday.

Brian's white blood cell count is high indicating that he has an infection. The doctors are currently trying to determine where the infection is. He is very uncomfortable today, but his kidney and liver levels continue to decline.

Brian experience severe chest pains today. The doctors ruled out a cardio problem and are treating the problem as a blot clout in the lungs. He is now in an isolated room due to his infection. So far, the surgery for his legs is scheduled for Monday.

Brian had surgery on both legs late this afternoon. The vascular surgeons found more dead tissue in his right leg than expected. The continued break down in his leg tissue resulted in more toxins flowing to his weak kidney. Brian will require additional leg surgery to remove bad tissue the timing for it is unknown. The left leg is in better shape and the doctors disconnect the suction machine from the leg. The hospital will be giving him a unit of blood tonight. The prognosis for the legs will depend on how the tissue and nerves heal. He is continuing to be treated with a blood thinner for the lung clot. This treatment increases his overall body fluids delaying the heeling in the legs. The lab studies for the liver and kidney are continuing to trend down but we are still not sure how much damage has been done to the organs. His heart rate, blood pressure and oxygen levels are improving. He is being given morphine for the leg pain. He is having difficulty sleeping and is very tired. Brian is feeling anxious and is experiencing altered mental status.

The feature to email messages to Brian has been enabled for the site should anyone wish to leave a message.

Brian continues to be in considerable pain and is being medicated with morphine. This has caused him to have an altered mental status. He was able to sleep today. The doctors are discussing putting a screen in his right leg to prevent blood clots in his lungs. This is an alternative to treating him with fluids which have overstressed his kidneys in prior treatments. The attending physician is consulting with an infectious desease specialist to determine the best medication for treating Brian's intestinal infection. The vascular surgeon will consult with a plastic surgeon for treating Brian's legs. Brian was giving a unit of blood last night to compensate the blood loss in his legs from last night's surgery. The attending physician does not feel that Brian will beed dialysis and that any issue issues with his kidneys will be treated by adjusting his diet. The liver lab studies are improving and the attending physician feels that the liver will be ok.