Tired

If you would ask Andrea how her day went today she would likely say not too good.  That is mostly because she needs mobilization and nutrition more right now than anything else, so the doctors say, at the same time not pushing her more than she can do.  She had a poor night last night awake a lot, too much commotion and lights on and off etc, on top of that she was so tired out from the day before without a nap.  Then when she is put on speaker valve as a step toward weaning her off ventilation it requires more effort on her part too.  This afternoon she managed to sleep for 1.5 hours with the speaker valve which was a first for her, her oxysats stayed good, CO2 levels were low also, and after she woke up she felt a little better.  Remember though that she is having someone either checking her various pumps, changing dressings, washing her up, doing physiotherapy or something most of the time, so she is tired from all the activity.  X-rays this morning show a little extra fluid around her lungs, which is no wonder since she has hardly moved since a week ago.  The steps forward are small but are going in the right direction at least.  Being willing to work through her pain and weakness will be a challenge.  Faye is with her again tonight.  Remember us in your prayers please.

 

Until next time, Maynard 

Small Progress

Today seemed to be a day of small progress, Andrea had more pain today than yesterday, and generally wasn't as cheerful as usual, although tonight she seemed a little better.  Thankfully her stomach is moving the waste through, the vomitting seems to be over, she does not complain of nausea either.  But she is so weak and frail that her recovery will at best be very long.  the plan is to try dialysis at night only and see if her kidnes will start up again, this will allow more active physiotherapy and to try to get her mobile again.  Today she was on the speaker valve for 5 hours again which is a lot less support for breathing than being ventilated, but she quickly tires out so today was done in two sessions.  Tomorrow they want to get her sitting on the edge of her bed which will be the first time since surgery on Friday.  Her pain is mostly her stomach incision, which the surgeon today said was healing up nicely.  As you can see it is an emotional rollercoaster we are on, pray for strength for Andrea and her parents to endure.

 

Thanks and Goodnight, Maynard 

Good Day

Andrea had a fairly good day today.  She was awake most of the day and alert and not in too much pain, except for dressing change repositioning her etc.  She is up to 45 mls per hour tube feeds, most of her blood pressure support meds are off, they are not giving blood transfusions at all now, she has been restarted on heparin to reduce her chances of clotting her heart mate pump.  She was finally feeling good enough that we had our christmas gift exchange around her bed, Jeff and Twila were with us and she was very thrilled.  Today Dr Sobey the intensivist who is also a gastro surgeon and has been following her very closely, said he hoped she would be moved out of the CVICU and onto the ward this week.  They are hoping to get her weaned off her ventilator ASAP and be able to remove her trache.  It may be somewhat unrealistic to think she could be moved out of the CVICU this week, don't want to have our hopes set too high.  It is very late so I will close.

 

Thanks, Maynard

Big Improvements!

Good Evening to All

 

Well 2010 is history and may 2011 be better please!  It is maybe too much  to hope for , but maybe, just maybe Andrea has turned a corner this afternoon and is on the mend at least in a small way.  This morning her pain was very bad but by midafternoon she was started on a PCA pump, a self administered system where she holds a switch in her hand and it is set to give a preset amount of painkiller when she presses the button. It is also set so that she cannot overdose because it will not activate more than a preset time interval.  At first she was trying too often to give herself pain medication so they increased the dosage a little, and she was still asking for more than the machine would allow, that is how they determine how much pain killer she actually needs.  Then she slept awhile and after she awoke she went for nearly two hours without activating the pain killer, in fact we had to remind her that she could do it as needed, but she actually went long stretches without  using her switch and said she did not have pain either.  In the evening the effects of her sedation medication had worn off and she was fully awake and comfortable.  Her bilirubin was down to 294 this morning and 274 this afternoon which is a very good sign.  The cardiac surgeon was in this afternoon with the Gastro surgeon and both were pleased with her progress. The cardiac surgeon said he thought that in 4 or 5 days she would be sitting up in a chair.  Faye is staying the night with her, and as she improves she hopes to come here to RMH for the nights.  Andrea also had her tube feeds increased to 40 mls/hour tonight.  She sure is a lot of work for the nurses, maintaining her med pumps, washing her up and keeping the bed linens changed, all the paperwork done too, most of them just thrive on the challenge though and some even request to look after her instead of 70 year old men, they seldom have a teenager as a patient.  Well it's time for bed.

 

Happy New Year's to all, Maynard

Andrea's surgery-Went Great

Andrea went in for her stomach surgery at 10 AM this morning and was back in her room at around 2.  Everything went well, they had a full crew on hand in case anything went wrong and nothing did.  Her friendly little pump had no hiccups, her blood didn't clot or thin out, unnecessarily either.  Her colon was not perforated and they had no contamination either they told us, so now maybe she can soon be on the mend.  They will sedate her for the night so that she can rest comfortably.  She was awake briefly when she returned from the operating room, but she will mostly sleep tonight we expect.  The plan is to resume tube feeds at a low rate tonight.  Otherwise I don't know what to report, so a happy New Year's Eve to all.

 

Thanks, Maynard