Stable and more awake

Abigail remained stable for most of Sunday and we had a busy day at Evelina with lots of visitors, including Becky and Josh who got to see their sister again for the first time since the trauma of last Wednesday. Joshua, in particular, has been deeply affected by what's happened, but he's asking lots of questions so that's good. Abby even started to wake up quite a bit in the afternoon and opened her eyes several times as doctors weaned her off her sedative drugs. She had a quiet and restful night on Sunday too.

Today (Monday) there has once again been mixed news. Blood tests in the last day or two have revealed there to be a secondary source of infection somewhere and doctors were pretty sure that the central femoral IV line into her groin was the culprit so this has been removed. Despite lines being essential for access with meds and fluids, they can start to be a source of infection after a few days. They also have a tendency to stop working after four or five days and both of Abby's other lines 'tissued' today so were removed. Another line into her chest was eventually put in after a lot of trouble, so the antibiotics can keep flowing in.

A chest drain used to remove fluid from the chest cavity which had 'leaked' out of her poorly lungs was also removed today after draining a lot of fluid. That should give more space inside for her lungs to expand.

The better news is that Abigail is now off all sedation (morphine) and very much more awake. Doctors are taking this steadily because they don't want Abby to panic and fight the ventilator, but she seems to be relatively happy and without pain. Although the pressures and oxygen levels on her ventilator are still quite high, Abby is now initiating all breathing on her own and at her own rate. The ventilator is simply helping her with each of those breaths when she takes it. This is certainly a small step forwards.

Abigail is also off all saline drips and is being fed her normal daily milk feed, albeit slowly over 20 hours. She has also had two other drugs stopped: one used to thin her blood (because of a fear of a leg clot) and another to help her heart. She's only receiving three very strong antibiotics for her chest via IV. These are all tiny steps forward but the magnitude and severity of her chest infection cannot be underestimated.

We had a good chat to one of the consultants today and we tried to nail a few issues down. The recent concerns over her deteriorating kidney function seem to have been reversed with the help of drugs. The consultant said this could easily turn for the worse again, but for the moment her kidneys were improving and the assessment was that they had simply taken a "big hit" with the infection. Should they get worse again, though, that would prove very bad news indeed, indicating that the kidneys were indeed shutting down.

Today's chest x-ray showed that the infection is no better than the last few days. When we asked whether (given its severity) doctors would have expected her infection to have improved by now, they said no. But the key now is for her immediate clinical signs improve as the infection begins to clear. The consultant said there would be problems if Abby was not significantly better and preferably off the ventilator by the weekend. If Abby is still being ventilated to the current high level at the weekend it will be because a) Abby proves difficult or impossible to wean from the ventilator, or b) because the chest infection simply hasn't cleared at all. If this happens, Abby is likely to succumb to the next infection to bombard her fragile immune system.

In terms of her immediate prognosis, we asked whether Abby could be described as "critical". The consultant said no, because critical means that the patient could die at any moment. She said that whilst things could still go downhill very quickly for Abby, she was not in any immediate danger right now and was pretty stable. The consultant added that the medical team had expected Abby might die on Thursday soon after she was admitted because of the severity of her infection, but that she'd done very well to pull through that time.

And that is really our constant benchmark: if Abby continues to fight - which she clearly is at the moment - then we and the superb medical team will continue to offer her the very best opportunity to recover.