Channel Man Stan sure is one tough old bird. Overall he is doing roughly the same as yesterday, but I am encouraged after a long conversation with the Physician's Assistant Greg.

Today the doctors inserted a Swan-Ganz catheter into his heart, which involves the passage of a catheter into the right side of the heart to obtain diagnostic information about the heart and to provide continuous monitoring of heart function in critically ill patients. The results show that the high levels of fluid on his body are stressing his heart, but his kidney function is improving and they will be getting more aggressive with a diuretic tomorrow to help get rid of some of the fluid. Stan is like a big water balloon right now. He has gained approximately 120 lbs, or about 14 gallons of water! This will easily be shed when his condition improves. His liver function is good and he is not running a temperature. They increased the FiO2 level on his ventilator to 65% to improve the blood gas O2 levels. They also slightly increased the respiration rate and his SpO2 is holding at 94%.

The "buzz" of the day was related to learning more about blastomycosis, which has a profile that seems to closely match the pattern of Stan's illness. Stan's respiratory function should be improving by now, but it is largely unchanged and doctors are working feverishly (pun intended) to find out why. I spoke with Annie Crossby who lives in Grimsby, Ontario and is somewhat of an authority on blastomycosis. When she learned all the facts said she felt a tingle and that deep down she believes it might very well be the cause of his condition.

I also spoke with Dr. Mark Shelley, the Head of Infectious Diseases at Highland, and although he wasn't convinced blastomycosis was responsible, he agreed to run tests to try and confirm this. They gathered urine and a bronchial wash sample and sent them to Strong Hospital for analysis and culturing. They also will be running tests for histoplasmosis and leptospirosis, two other possible culprits. The antigen test results (urine) should be back tomorrow and the cultures (bronchial wash) should be ready in 24-72 hours. A positive result for any of these diseases would be more than a welcome bit of information.