08:02 – Barbara’s sister called at midnight to say that she was on her way over to their parents’ house to meet the 911 responders. Their mom had called 911 because their dad was breathing strangely and their mom couldn’t wake him up. At around 12:45, Frances called back to say that Dutch was awake and responsive, but they were transporting him to the emergency room. Barbara quickly dressed and left to meet them at the hospital. She got back home about 6:45 and said they’d just admitted him, finally. He’s in no immediate danger, but for someone aged 90 this whole sequence of events over the last two or three weeks isn’t good. Barbara got almost no sleep overnight. She’s sleeping now, finally, with Colin curled up next to her on the bed.
For the last ten days or so, Dutch has been on outpatient IV vancomycin to treat a drug-resistant S. aureus infection, with Barbara and her sister administering the drug daily and taking Dutch in daily to be tested for serum vancomycin levels. Our main concern at this point is that his levels have remained elevated, which indicates that the vancomycin isn’t being eliminated, which in turn suggests that Dutch may be in renal failure. At the same time, they’re concerned about Dutch’s persistent edema and congestive heart failure. He’s now simultaneously water-logged and dehydrated. The dehydration causes confusion and unresponsiveness, but hydrating him would increase the edema. Conversely, they can’t treat him with lasix or another diuretic to reduce the edema because that would dehydrate him even further. Everyone, especially Dutch himself, is exhausted and under extreme stress.