Re-Intubation...

I could use a Valium about now...

Another rough night starting about 3am. Mom was in an obvious discomfort and looked as if she was in a lot of pain. At 4:15am she had a fever of 100.6. At 5:35am, it was 101.9 with an elevated heart rate and blood pressure. She was administered extra Fentanyl, Cardizen and Tylenol and eventually settled down, albeit hours later.

Mom's day nurse from yesterday was back and I was, and am still, so thankful. He paid such close attention to her, checked on her constantly, pro-actively monitored and treated her for pain and just in general was amazing.

I left for a short time just before his shift ended at 7pm. When I got back from dinner at about 8pm, her night nurse was just coming in to change her. When he rolled her to her side, her intubation tube came out. All hell broke loose about then and I am not going to lie, I was scared. The respiratory therapist came in and "bagged" mom while she ordered an emergency intubation kit and called for the doctor. He had already left for the evening and she simply said "Get him back here. Now." A scene right out of ER errupted right in front of me as the room was filled with people. Joseph (her day nurse) came in too - already changed and with his jacket on ready to walk out the door, he quickly got right into the mix and started helping.

We waited in the hall while they worked on mom. Joseph came out with an update telling us that the tube had come out and they would have to re-intubate her. He assured us that she would be okay. An hour later, Dr. Patel (the day hospitalist) and the night doctor, came out and let us know that the re-intubation had been completed and that it appeared to have gone ok. Mom's vital stats stayed steady throughout the procedure. They've taken an xray to check that placement is correct and should be able to tell if she aspirated as well. Not sure when those results will come back but we were told it would be sometime tonight.

She was heavily sedated for the procedure with Versed, Fentanyl and Succinylcholine and appears to be resting okay. We're definitely keeping an eye on her.

As always, your thoughts and prayers are appreciated.

xox,
Tommy

Temp 104.7

Mom was uncomfortable yesterday evening when her night shift nurse came in (about 7pm). Mario was staying with her as my dad went home for the evening and he had been trying to get her some pain medication for a while. He was told by the day nurse that they would alternately be administering Versed and Fentanyl every half hour. At 8:10, she got her first doses. About 8:30 two nurses came in to set up a Fentanyl drip so that they wouldn't risk missing a manual administration of the prescribed dosage.

At 9:00pm the drip was just finishing being set up, when Mario asked the nurse if she knew what mom's temperature was because she felt hot. She didn't know so she started to take a reading and before the thermometer was done, she confirmed that she did have a temperature and then left the room to get a doctor. Her temperature was 104.5.

Five minutes later Dr. Patel, the hospitalist, came in and checked her stomach. He said it was not acute. He was concerned of a distended abdomen. He told Mario that if there was a perforation it might cause her stomach to harden and swell. If this happens, Dr. Patel says that they probably will not be able to treat it as she is not likely to be a surgical candidate.

At 9:15pm her temp was 104.7. They iced mom up pretty good - ice bags under her neck, arms and legs and treated her with Tylenol, Ibuprofen and Vancomycin. At 11:20pm her temperature was 99.6. The nurse said she had never seen a temp go down so quickly.

Blood labs were drawn and showed that her white count was up. Dr. Patel said that it was good that they had already ordered and administered antibiotic to treat.

At about 4:40am, mom's blood pressure started getting low and her temp was at 96 so they turned off the Fentanyl drip. There's a fear that in such a sedated state, mom's brain might not be allowing her to "take care of herself". After that it seemed to be okay as she rested well through the rest of the night and most of the morning before needing another dose. (At 5pm this evening, the drip was put back on and they will be monitoring it closely. )

At 7:30am, her heart rate went crazy. It got up to 155 and they acted fast to get that under control by administering Lopressor and Cardizen. At 10:50am it stabilized and has been okay since then. Likewise with her blood pressure.

It's been a whirlwind of medications today and I will have to look them up to get it straight in my head. They kept a really good eye on her and I think she rested well. It's hard to know since she is unable to communicate with us at all. It's very hard to see her like this, but I am faithful and hopeful that the tracheostomy will happen next week and put her on a road to recovery. Please pray for this.

xox,
Tommy

Intubation... (is that how you spell it?)

The EEG trip took just over an hour and there were no issues going and coming back from Saint Anthonys. We still haven't got the results, and are hoping that what we have learned is true - No news, is good news.

Yesterday she was started on another anti-seizure medication called Dilantin in addition to the one that they started her on on Wednesday (Keppra). I'm not sure what has done what, but she doesn't appear to be tensing up with her brows furrowed nearly as much. Dad said she rested through the day and got by okay with Percocet. She does wince and get fidgety, but it's not as constant as it was before. Her face was more relaxed (her lips were not pursed together like they had been) and she seemed to get some rest through the night.

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Just talked to Dr. Vocal (Pulmologist). He is recomending that we intubate my mom to reduce the risk of her getting another case of pneumonia. In her current state, she non-responsive and the fear is that she will aspirate on the mucus that she does manage to cough up. This will put her on a ventilator and in a medicated coma. We are hoping that this will help to speed up the scheduling of her tracheostomy, which we have been waiting for.

This is not considered an emergency procedure - as in placing her on life support with no other options. She has been breathing on her own (although with a nasal cannula to offer supplemental oxygen) - and we were asked by the doctor if we wanted to go through with this recommendation. We feel like pneumonia is a huge risk and has been one of the main things to bring her down, again and again and because of that, we wanted to do the elective tracheostomy in the first place.

Once more, I don't know if this even makes sense... I'm trying to wrap my head around it and am praying that we are making the best decisions for my mom.

Please pray that we are...

xox,
Tommy

Restless night...

After the Ativan wore off last night, mom started getting fidgety again.  The Percocet helped for a short time, but did not last the whole four hours between does.  She was given Dilaudid as well, but I don't see that having a great effect on her either.  Her night was quite restless, spent tossing and turning and moaning in what looked like pain to me. 

I left at 6:15 this morning as she was just about to get another dose of Percocet.  I talked to my dad at just after 8am and he said that it had seemed to calm her down and allow her to rest.  They were getting her prepped to transport to Saint Anthony's so that they could perform an EEG on her.

EEG (electroencephalogram)

An electroencephalogram (EEG) is a painless procedure that uses small, flat metal discs (electrodes) attached to your scalp to detect electrical activity in your brain. Your brain cells communicate via electrical impulses and are active all the time, even when you're asleep. This activity shows up as wavy lines on an EEG recording.

An EEG is one of the main diagnostic tests for epilepsy. An EEG may also play a role in diagnosing other brain disorders.

 

To read more about EEG's, click here.

Seizure...

Here I am again, not knowing where to even begin. My face hurts from crying... yet I know that things could be far worse and I have faith and hope that they will get better.

Mom had such a great day yesterday and I was so happy that it was a "snow day" at school which allowed me to spend time with her - seeing her do so well. It's hard to believe how quickly things can turn around.

Early this morning I talked to dad and he said she walked all the way around the ICU ward (more than twice as far as yesterday) without stopping for a break.

Today was a good friend of our families funeral. Manuel, who my dad worked with at RTD, passed away last week from Stage IV liver cancer. Mario made arrangements to come and stay with my mom so my dad would be able to attend the services.

I called Mario at 11:45 this morning to see how she was doing and he said good. She was sitting in her chair, dozing in and out while listening to the radio.

About 11:30, the nurse had come in and said that they might move her back up to the 3rd floor (non-ICU unit).

They had just taken her vitals at 11:40 and everything was good;
Temp 97.6, BP 132/60, Oxygen 97 & Heart Rate 79.

After our phone call, Mario said he noticed her dozing and told her "Mom. Wake up! You're missing the story!" and she looked at him and laughed, then dozed off again.

At 11:50 she suddenly woke up groaning and lifted both arms at the same time in a locked position in front of her. When he called to her and tried to get her attention, she lulled her head to the left but didn't focus or respond to him. He called for help.

The doctor came in with more staff and took her down for a CT scan. They had told Mario it could be another stroke, the same stroke, a hemorrhage, an infection or a seizure.

When I got to the hospital, she was lying in a non-responsive state with her lips pursed shut (very strange because we usually can't get her to close her mouth when we want her to breathe through her nose). The respiratory team was suctioning mucus through her nose.

The results of her CT showed no acute bleeding - although we were told this might not be seen for 6-7 hours. The neurologist came in and when he examined her, she finally responded. She raised her arms and moved her feet when he asked and she even seemed to open her eyes. He believes that she had a seizure which is apparently a common result of bleeding in the brain from a stroke. They have started her on a seizure medication called Kepra.

The best she came out if it was when she saw Mateo and Sophia and reached over to hug them. It was a brief glimpse of mom. Soon after, she seemed to be in pain and received her pain meds. It looked like they offered her some comfort in a less tense sleep.

About 6pm she started getting fidgety and making more groaning sounds. Her breathing sounded horrible. Her nurse said it was similar to her fit this morning. Respiratory did another nasal drain and she got more pain killers along with some Ativan. She is resting in a comfortable - or at least less tense although completely "out of it" kind of way. I can only hope and pray that this is what she needs. It's hard to imagine how much this day has taken out of her.

My apologies if this doesn't make a lot of sense. I'm writing this out on my phone with bloodshot eyes and a pounding headache.

Please pray for her.

xox,
Tommy

Spa Day...

It was a good day for mom. She walked almost twice as far this morning as she has this whole month - about 225 feet down the ICU hallway. She was doing well enough to be able to take a shower too. Although it wore her out, she was very relaxed when she got back into bed.

Her oxygen levels are doing better as well, and she is back on 4 liters. She is continuing to take Lasix to remove the extra fluids from her body and the reduction in swelling is really apparent. They have also ordered a new medication for the purpose of keeping her heart rate and blood pressure in check. All of this should reduce the risk of complications with the tracheostomy.

It was great to see her alert and even laughing today.

Hopeful for a good night's sleep and continued improvement of her condition.

xox,
Tommy