Tuesday, March 08, 2011

Ups and Downs and Ups Again

The view from his window that he can't see, it's behind his head.

I tried to start off my morning in a positive attitude.  Even put on a dress he bought me a couple years ago, and I had yet to wear it.

Today, I went from high to low.  They had him all set to go to surgery and the surgeon came up and cancelled saying he wasn't ready for a trach today.   He talked to the respiratory therapist and I guess they are going to try again in two days. His blood gasses were too low and his oxygen requirement too high. They brought the nitrous oxide back in.

In the meantime, he's become quite alert and his cognitive thinking increases each day.  Last night, I was trying to think of something to talk about.  Then I remember how sedated he was when the Christmas pudding arrived.  So, I told him it had finally came in.  He rolled his eyes.  Then I said, that was a very slow boat from England.  He nodded yes, and rolled his eyes again.

The nurse told him about the trach in a manner, I would have rather she hadn't.  It was, "I'm readjusting this because you are having a trach put in."  His anxiety went through the roof.  I was trying to calm him down, and of course, everyone from all the teams wants to talk to me out in the hall.  He was de-satting when the surgeon came up.  It was all too much and I just wanted to scream.  I still want to scream, but everyone would come running in the complex.

When they did rounds, there was mention of a small pneumothorax on his left lung.  I was pretty sure I knew what it was but didn't want to sound stupid.  So I Googled it and it was what I thought I remembered, so I will have to remember to ask tomorrow.

Dialysis didn't start off so well last night, but they were able after 5 hours to get a good run.  They are holding dialysis today to see how he does.

The more with it he becomes, the less patience he's having with being in bed and the whole process.  It's exhausting trying to help him find a comfortable position.  After 4 hours this morning, I was just worn right out. He wanted to see the pictures of the animals, but when I showed them to him, he became agitated.

Here's a cute bunny for you.

So, I ended there this afternoon and was uploading pictures, proof reading when my cell phone rang.  It was my neighbor J. He and Miss Di were up at the hospital.  The Dr. was just starting the trach procedure and the nurse said she tried calling the house but there wasn't an answer.  They said they would get a hold of me.  So they raced back and we all went back up to wait.  Miss Di had class so they had to leave before they could see him.  She said something told her to go up today.

The nurse said the surgeon appeared just as she received the new lab results from the added nitrous oxide.  He was calm and his oxygen requirement was lower.  The surgeon said, Let's go, and they did.  Right then and there.

He looks so much better without all that tubing in his mouth.  Is in much brighter spirits too, it seems.  He can actually give a small smile without trying to curl the corners of his mouth around the tubing.  We'll see how he feels tomorrow after the lidocaine wears off  on the incision.  They say a trach is more comfortable.  I just don't know,  tubes in my mouth or my throat cut.  I'll take their word for it.

Some of the nurses who had him in the beginning stopped in to see him and tell him how great he looks.  Of course, I doubt he remembers them, but he smiled and nodded.  His day nurse said she was going to get someone to help turn him.  She came back with the nurse he had on that awful Saturday.  That nurse's eyes lit up when she saw him so alert with his glasses on.  She said, I was asked to help turn a patient but I wasn't told who.

Tonight he has my favorite night nurse.  I gave her a hug when I saw her.  His day nurse and I started talking about how some nurses work better with some families than others.  I told her how I did a happy dance at a 8am when I called up and he had this one nurse three days in row last week.  She agreed that nurse was just great.  His nurse today was new, and she was great as well.  Anyway, I said, there is no way do I ever happy dance at 8am until now.  D nodded emphatically.   He now sees me after two cups of coffee, I'm still not approachable between the alarm going off and that first cup. I'll have to practice my before coffee cheerful before he comes home.

To answer a suggestion.  He isn't able to write yet.  He can lift his head and shoulders up a few inches by pushing on his elbows. Just today he can lift his hands up about an inch for a few seconds.  He's finally just getting a good grip today.  It yesterday, I was thinking I've had newborns hold my fingers with a tighter grip. He's unable to lift his legs but can rock them back and forth.  When we were positioning him today, I said, something's still not right, those legs are rocking.  The PCT (CNA back home) said, yep, that's how I know something's wrong.

Thank you Rudee for the compliments on my spinning and knitting.  I wish you and Amy could come down to visit, I would love to teach you both.  If I were a millionaire, I would open a dude ranch fiber retreat.

I've already looked into teaching knitting, spinning and crochet.  All the fiber stores have their people. Micheal's crafts is big joke.  I applied to them when we first arrived.  I believe January 2010 post explains what a joke that place is.  I'll find something somewhere, I hope.

Well, the night nurse and I are going to play with the phones now and try to figure out what is going on that I'm not receiving calls from the hospital.

ETA:  I was trying to remember what Miss Di and I were joking about while we were waiting.  I was telling her how Infectious Control is still asking if he's been to India in the last month.  I said, I wish we could afford a trip to India. Not that we would go there.  More likely the south of France, the UK and the Netherlands.

She say's, "Are you kidding me.  Tell them you can barely afford a trip to the grocery store."

We burst out laughing.  Good friends can make you laugh in times of stress.


by Teresa said...

Better news every day! I'm sorry you had a down time, but the positive is building all the time! Yay!!

What kind of job are you hoping to get?

Tell D I said hi when you go in next.

Love from Oregon.. Teresa

nursenikkiknits said...

Sounds like you are adjusting to the new routine of this nightmare. I hope the trach is more comfortable for D. I'm sure all the tapes & tubes on his face must have felt awful. I'm sending my very best wishes of hope and luck for your job search.

CraftyCripple said...

I'm glad your neighbours were able to tell you about the Trach. It would have been such a shock to arrive for a normal visit and see that it had been done without your knowledge.

Thanks for the cute pictures of bunny and kitties. Your animals make me smile.

Tami Klockau said...

YAY, great news that he's more alert and comfortable! It must be great to have him responding to you in some way after so long of nothing. So glad you had friends visit and a good laugh. You need it!

Your animals are adorable.

Carol said...

hopefully things continue to improve! and down the road when he can lift his hands more, try cutting a hole in a nerf ball or othe large, soft object and putting the marker in there. he won't have to squeeze so much to get a grip on a pen and if it helps keep him calm...... high test still being sent over. I;m going to have to get stock ina tanker compny for it or something... :)

Melanie said...

I managed to catch up after being away for a bit. I'm sorry to hear about what's going on. Just thought I would send along good thoughts and feelings.

Rudee said...

You know, he's doing remarkably well given the viral infection he was assaulted by. Recovery for mechanical vent patients is wearing on everyone, but just know that soon, this will be a thing of the past.

Hopefully now, with the trach in place, he'll do better at weaning.