Difficult night

Wow, this was the most difficult night we've had to this point, the one blessing is I don't think Aly will remember any of it, but I don't want to go through that again!

As of about 7 am this morning, Aly was placed in a medically induced coma.  Over the course of last evening and through the morning hours, she developed water/liquid in her lungs.  Her doctor believes it to be a reaction to a blood transfusion they gave her around 6pm yesterday.  She called it a TRALI, which is an acronym for Transfusion Related Acute Lung Injury.  She said this happens in about 1 out of 4000 patients!  It happens when the blood donor's blood has antibodies in it.  Antibodies are created by your body when you are fighting an infection.  It typically wouldn't hurt a "normal" patient, but cancer patients have their own antibodies and I guess what happens is those antibodies fight each other and this somehow affects the blood vessels in the lining of the lungs.  They are weakened which allows the liquid into the lungs.  They are not 100% sure this was the cause, but because her breathing problem started so closely after the transfusion they are leaning towards it.  They are also testing for viruses that cause pneumonia and doing other tests to rule out other possible causes.

Shortly after the transfusion was completed, Aly started complaining that she was having trouble breathing.  By 10pm it was bad enough to have a chest x-ray done.  At that time, her lungs did not show any liquid, but they started hearing signs of wheezing and what they call "crackling" through their stethoscope.  By 11pm she was really struggling so they made the decision to move her to Intensive Care where they could monitor her more closely and give her humidified oxygen to help the breathing.  At 1am after finally settling in and getting her hooked up to everything it got worse.  She could only take short, shallow breaths.  She was sobbing, groaning and was exhausted.  She could not get comfortable and every time they tried to put the oxygen tube around her nose she had an anxiety attack and couldn't calm down.  I can't tell you how scared I was.  After the Intensive Care Dr. and Aly's cancer Dr. conferred, they gave her some pain medication that kicked in around 3am.  I laid down and closed my eyes for not more than an hour and Aly was awake again.  It broke my heart to see her struggling like that!  Since the first pain med didn't last long they gave her a dose of morphine which only helped again for about an hour.  At 5am she was awake and this time was coughing so hard she was vomitting.  They told us she coughed so hard that one of the feeding tubes they had placed had come up into her esophagus so that had to be removed.  At 6am they made the decision to put her on a ventilator so that she could get the oxygen she needed and she could rest.
I was at the hospital with Aly all evening and night.  I was calling/texting Kevin at various points and I called him at 6am to ask him to come down.  The ventilator was in by the time he got there.  At this point, until they make a finally determination or until her lungs start to clear they will keep her sedated/sleeping.

Please keep praying that the doctors find the answers they need to help Aly.  She continues to be what seems like the one in a million patient that is affected by everything they do.  It is completely awful to see her struggle so!  They keep telling us how easy these rounds of chemo could/should be...hmmm....