Information overload

During our last visiting hours last night Chris and I were both in the room standing on either side of the bed. Chris was more than likely “singing” and I was trying to stop my ears from ringing. As I was getting ready to leave for a few minutes I looked down and notice a blood pool forming on dad’s gown, shocked I looked further and saw that the area in which his arterial line was placed was the culprit. I showed Chris and she immediately went to get the nurse. The nurse came in and immediately applied pressure to the femoral artery and we saw that he lost some blood. Luckily the blood also formed on the gown, rather than just pooling near the groin region. The drill sergeant nurse warned us a few days ago, that it’s common for people to lose a lot of blood without anyone knowing about it because it pools in the groin and isn’t evident without anyone looking for it  (it can also drain up to 6 liters per minute).

An arterial line is typically used for critically ill patients who need levels in their blood to be monitored frequently. The art line keeps a consistent measure of blood pressure on the fancy computer monitor so you can get a very accurate reading. It also helps to reduce the amount of needle pokes he gets because it has an access to draw blood from.  So now that you have the theory and purpose behind the line, they decided to pull it out because it was already half way out. It was then time to make sure we form a clot to stop the bleeding. They have a nifty device called a fem (for femoral) stop which looks like a tea cup with excessively large handles. It has a pump like a blood pressure cuff which you pump up to apply more pressure with the bottom of the tea cup. It was important to make sure the fem stop wasn’t too tight, so they brought in a Doppler machine which looked like something out of an ancient submarine or a boat. They used a microphone like thing to check for his pedal (foot) pulse to make sure it wasn’t diminished. Eventually it was stopped and we were able to stop sweating (again I’m being overdramatic with the sweating). 

We left after the visiting hours to our normal hangout, yea you guessed it, the waiting room. We were talking to our house guest and even new one arrived for awhile. She was timid at first, but she eventually relaxed. She stole the remote for awhile, but gave it back after she turned up the TV excessively loud. My ears were still ringing from Chris singing but they eventually stopped. Everyone else laid down for the night and started to sleep. The new house guest (complete with a stylish breathe right strip) told me she was concerned she may snore, so she was leery about falling asleep. I assured her it was fine, and we’ve heard far worse through our two weeks. Boy was I wrong, this lady made it sound like I was sleeping on a dairy farm. It was pretty bad up to that point, but it got better. The house secretary (Patsy) made some sort of Indian call in his sleep that had me covering my head so I didn’t get scalped. Sometime later I heard a sound that was a mix between a Michael Jackson owww and a wolf call (it was actually fairly impressive).

Chris decided to go and check to see if dad was still restless and he was. She came back and told me that she’s going to stay in there for the night and try to calm him down. I was willing to stay up as well but the Benadryl I had taken earlier (because of an allergic reaction to shellfish, which is a whole other story) was getting the best of me. I woke up in the morning and went to go check on both of them. They both looked tired, and Chris said she was able to get some sleep last night. The morning report from Denise (our favorite) and Chris was that his kidneys are still improving so they have orders to take out the dialysis catheter (Great news). They also said he was on pressure support, which basically means he’s breathing on his own, but the vent is helping slightly.

He is still pretty restless and visibly in pain which never gets any easier to watch. I’ve been able to determine that when he moves around a ton it’s usually one of two things, one of them being he needs suctioned, and the other that his butt or back hurts because he needs turned. I have noticed a little area of irritation on his butt that looks a little like a pressure sore starting. We’ve been trying to keep him turning, but it’s been hard to turn him fully because of all the important lines and tubes placed strategically.  He was becoming very anxious and moving around more and more about 3 and half hours into being on pressure support, so they decided to put him back on assistive breathing and increase his sedation to give him a little rest.

They’re working on weaning the argatroban today (the drug that helps thin the blood). They can test it by doing a pro-thrombin time test (PTT) which I think is a test that determines how long it takes the blood to clot. The dobutamine is also trying to be weaned slowly today. It’s a drug for the heart which helps to contractibility of the ventricles so that they can work more efficiently. Hopefully these are able to be weaned nicely and we don’t have any problems or complications with it. Dad has been restless throughout the day, and he throws his body weight around when he wants off of his butt. He came off the vent again today for awhile and tolerated it well, but he was put back on so he can rest. They keep taking him on and off so that his respiratory muscles will get a little exercise.

Dad is getting used to the fetanyl (sedation/pain relief drug) so we have to increase the drip to get him to relax a little. He has a high temperature (102) tonight which could be a sign of an infection. They’re doing a sputum (mucus), urine and blood specimen sample to try to find the cause. The nurses started the antibiotics to fight the infection or potential infection. Let’s just hope there isn’t one. The GI doctor decided to start him on some tube feeding again to see if his bowels will tolerate it.

He has been so restless it looks as if we’ll take shifts again for awhile trying to calm him down. I wish there was a Starbucks closer, or they could just infuse us with caffeine that should help a little. The roller coaster is still continuing and I may vomit at the end. I’m ready for this ride to be offer. This is reminding me like the first week where it was so hard to calm him down, and keep him from being so anxious. I think it’s so much easier now with the trach (without a tube in his mouth).