For those of us interested in the medical details of Terry's condition, Tammy asked me to post this. It's from an email Tammy sent to the USC Center for Pancreatic and Biliary Diseases in LA on Saturday. She hasn't heard back from them yet, so if anyone has some pull there, feel free to rattle their cage! Or, if you know of another group that might be more responsive, please leave their name in the comments for this post:
Dear USC Pancreas Disease folks,
I am in La Paz, Bolivia, while my significant other/¨husband¨ (Terry Bingham) is in the ICU unit at Clinica del Sur fighting for his life. I found your email address on the Internet and was hoping that you might be willing to do a long distance consult with us.
As you can imagine, this is a very tough situation all around. I would like to give you some background:
Terry woke around 4am Monday with a stomach ache. At 8am he took his vitamins and within minutes was in severe abdominal pain. I have never seen him in such pain, he was doubled over and no position provided relief. He was near tears - and he is a VERY tough guy. Within 2 hours we were admitted at the best private hospital in La Paz, Clinica del Sur. He was quickly diagnosed with acute pancreatitis.
They put him on IV fluids, Demoral and on oxygen due to the high altitude here (11,000 feet)and his difficulty breathing due to the pain and distension. The rest of Monday and through Wednesday around noon his condition just seemed to deteriorate. Monday afternoon he developed a fever (38.9 centigrade) and they put him on antibiotics which did take away the fever.
They did an ECRP scope procedure Tuesday around noon and found nothing much. His blood pressure dropped precariously low at this point and they took him to ICU after the procedure. Tuesday night he was taken to surgery because of the severe distension. They first did a laprascopic (sp?) surgery but then had to proceed to full blown surgery and they found nothing wrong other than a very distressed pancreas, a lot of fluids, including puss, and I would assume blood but am a little unclear here.
They told us that he had a sepsis infection that was very bad. He is on three antibiotics still at this point: Ciprofloxacino, Meropenem, and Metronidazolin (Spanish spelling, of course). He is on Norepinefrina, I can´t remember what that is for but you´ll know. Maybe for the pain?
He is on the ventilator of course and is fully sedated, although they seem to be ready to allow him to wake up. It is my understanding that they have been gradually dialing back the ventilator assistance.
We have a bit of a language issue as you can imagine. We have the US embassy involved and they are helping in many ways including translation. They took blood cultures during surgery which results came back just yesterday as totally negative for any infection. However, after surgery they told us that he had a sepsis infection, a very bad one.
He had a small fever on Wednesday but has not had one since. All of his lab reports are coming back with very small signs of improvement. His kidney function is still not normal, but it too is slowly improving. They have now started giving him plasma and platelets.
His arms and legs are quite swollen with water retention and he still has some distension of course.
So far we are dealing with an unknown cause. The doctors say there was no parasite involved. We have been in Latin America off and on (mostly on) for the past few years, cruising on our sailboat from Seattle to Ecuador. Terry´s main doctor´s name is Dr. Ibanez. He seems to be highly respected and we are very impressed with him. While he does seem to be in good hands we are feeling a bit helpless here. We get a little misinformation or there is miscommunication at times, which leads us to feel a bit insecure about whether everything that should be done is being done.
Terry is overall in very good health, although we suspect now that he has been having some mild symptoms for at least a month that maybe attributed to this. Occasional loss of appetite/mild nausea, occasional mild diarrhea, last week some mild heartburn a few times which is not normal for him, and maybe some general malaise.
We have been traveling via bus through Peru so these were all easily explained away as due to travel in a 3rd world country. The possibility of medical evacuation has been discussed off and on. We have the impression that while on the ventilator that is not much of an option. To complicate things, evacuation from La Paz requires an air taxi from here to a lower altitude where a medical evacuation plane would be waiting. Not the best circumstances!
We are writing to you in hopes that you might be able to assist us. I´m sure this is a bit unusual, but as you can imagine we are a bit desperate. Terry´s children have flown down from the USA to help us through this. We are in very good hands with the embassy folks, in fact they have taken charge of making sure there is a source of plasma and platelets for Terry - he is type A positive which is not common here in Bolivia.
I am hopeful that we will hear back from you and thank you so much for taking the time to read this long email! We will look forward to hearing what you have to say!
Sincerely,
Tammy Woodmansee
from Seattle, WA, and a US Citizen
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