We have diagnoses and a whole new set of challenges

Here is what we have to date:

• Diagnosis #1. Pneumocystis carinii pneumonia (PCP) is a fungal infection of the lungs.PCP is a pneumonia caused by the fungal organism Pneumocystis carinii (now renamed Pneumocystis jiroveci). This organism is common in the environment and does not cause illness in healthy people. However, Pneumocystis carinii can cause a lung infection in people with a weakened immune system due to any of the following conditions:Cancer ,Chronic use of corticosteroids or other medications that affect the immune system HIV/AIDS ,Solid organ a,d/or bone marrow transplant PCP in those with AIDS usually develops slowly and is less severe. People with PCP who do not have AIDS usually get sick faster and are more acutely ill.Symptoms : Cough -- often mild and dry , Fever , Rapid breathing , Shortness of breath -- especially with activity (exertion) Exams and Tests -Sputum induction (to detect Pneumocystis carinii) was how they found it in Jack.Treatment -The main treatment for PCP is with drugs that kill the bacteria (antimicrobial therapy). Antibiotics can be given by mouth (orally) or through a vein (intravenous) depending on the severity of the illness.People with low oxygen levels and moderate to severe PCP often take corticosteroids as well. This is usually a 21 day protocol so I will need to get a better idea of how he is reacting in the next couple of days from the doctor - that may have an affect of whether we are out on the street, if I need to extend the apartment????Outlook (Prognosis) Pneumocystis carinii pneumonia can be life-threatening, and respiratory failure can lead to death. People with this condition need early and effective treatment.
  
• Diagnosis 2-Respiratory syncytial virus (RSV)Respiratory syncytial virus (RSV) is a very common virus. This virus causes mild, cold-like symptoms in adults and older healthy children. It can cause serious respiratory infections in young babies, especially those in certain high-risk groups. (JACK)Causes --RSV is the most common respiratory pathogen in infants and young children. In healthy adults and older children, RSV is usually a mild respiratory illness. Although studies have shown that people produce antibodies against the virus, infections continue to occur in people of all ages.Each year up to 125,000 infants are hospitalized due to severe RSV disease, and about 1-2% of these infants die. Infants born prematurely, those with chronic lung disease, those who are immunocompromised, and those with certain forms of heart disease are at increased risk for severe RSV disease. Symptoms -Breathing difficulty or labored breathing , cough ,Cyanosis (bluish discoloration of skin caused by lack of oxygen) ,Fever .Nasal flaring ,Shortness of breath ,Stuffy nose ,Wheezing Note: Symptoms vary and differ with age. Infants under age 1 are most severely affected and often have the most trouble breathing. Older children usually have only mild, cold-like symptoms. Symptoms usually appear 4-6 days after exposure.Exams and Tests -Rapid tests for this virus can be performed at many hospitals on fluid obtained from the nose.Treatment -Antibiotics do not help in the treatment of RSV. Mild infections go away without treatment. Infants and children with a severe RSV infection may be admitted to the hospital so they can receive oxygen, humidified air, and fluids by IV.A breathing machine (ventilator) may be needed.Outlook (Prognosis) In older children and adults, the disease will usually be quite mild.Some evidence suggests that children who have had RSV bronchiolitis have an increased risk for asthma.
  There is medication for this that is given under a breathing tent - the doctors have called the pharmacy to see if they have any (but since it is usually a kids disease they would need to see if they have enough that would make a sensible dose for Jack). Also this is not the kind of equipment that they use in Boston Medical so there has been discussion of moving him to another hospital for this protocol.
  This can also be transferred so everyone is gowning and masking before going into Jack's room and they wanted to ensure that I was not pregnant since it could cause complications.
  
• 3rd issue - I have been running a fever, sore throat, headache, etc. Not sure what that is about - just run down or what. I did just get a call from one of the doctors that was making rounds and seems Jack was coherent enough to share since the doctor called to find out what is going on with me. If I am still sick in the morning - I guess I will hit the clinic or ER and get a few tests of my own. We are a party kind of couple!
  
• I hope that the antibiotic for the PCP has a dramatic effect in the way Jack feels - my major concern as if the above wasn't enough is his attitude. He has gone too long without feeling well and seems distant from the process. He is usually on top of asking what is going on and what is next, etc but he seems to have lost a little interest. I will have to ask the doctors for an attitude adjustment pill.