An "Intensivist" is the doctor that wanders the ICU taking care of any weirdness that pops up during the day. I had heard it a couple of times and thought they were talking about the character of the doctor who was there (because both of them are pretty intense). So the gentlemen formerly referred to as the "floor docs" will now be known by their actual specialty name, Intensivists.
I reserve the right to be random from time to time.
Saturday, September 6, 2008
So Today I'm Mad
I mean, I'm really mad, and if you're from Texas and remember Eddie Chiles, know I'm going through his whole routine right now (Eddie Chiles was an oil man who was offended by wasteful government spending and bought commercial airtime to talk about it.)
Anyway, over the last several days they have been talking about moving Pete to a regular floor but can't do it because they need to get his heart under control first. I have told them I am not at all in a hurry to do that, the only reason I wanted that to happen is that I think it's very important that Anna get to visit her daddy and vise versa. So, yesterday, his nurse told me that it would be just fine if I brought her up for a short visit and that it would do wonders for both of them. So, this morning, at the 8:00 to 9:00 visiting hour, I took Anna up there. I didn't tell her anything of what we were doing until we were in the parking garage.
We do all the elevator button pushing, get to the floor, use the Purel on our hands and walk thorugh the automatic doors, where I'm accosted by his nurse who says no visitors under 12 are allowed. I told her I made arrangements and was told it would be fine to bring her up there, whereupon she informed me that she is the charge nurse (well la ti dah) and that it needed to be cleared with her first and exactly WHO had I talked to. I told her and she starts telling me about how patients can't be gotten upset and I almost blew right there. How dare someone, who has never met me before and who I've never even SEEN on the floor, suggest I'm going to do anything that would not be good for Pete?
She put us out for a minute because I guess, you know, with all the responsibilities of being a bitchy charge nurse, she forgot there's an 8:00 a.m. visiting hour and she hadn't gotten Pete all arranged in his bed. While we're in the hallway, one of the floor docs walked by, said hi to Anna and, "Are you here to visit Daddy? That will be a good thing!". All of the nurses I've gotten to know over 2 weeks come up and are all excited to be able to meet the Anna of whom they have heard so much.
So they're done, we go in and she says, "Five minutes, you can't tire him out". She got "the look" out of me. So we were there for a few minutes, Anna said, "Daddy boo boo head" a few times, she pulled up her shirt so he could tickle her, but was a little standoffish with him. I think it's a combination of her being angry with him for going away for 2 weeks, being a little off put by Daddy being in bed and I'm sure feeling the stress caused by the nurse. We left, and I was so upset when we left, all of the remaining plans for the morning, including taking a ride on the train to Hermann Park on a morning that is beautiful, 68 degrees and and dry, just went by the wayside and I drove home in tears.
Later, there will be lots of visitors and I can bet there will be trouble. Because after everyone leaves, and I want to sit and needlepoint while Pete sleeps, she's going to try to put me out again. When that happens there may be a clash. And, trust me, I've rehearsed what I will say, including a suggestion that she find a CME course on the subject of sensitivity, patient psychological well being, how to handle families and how to basically not be a complete pain in the ass. Yes, today, I'm cussing and when I go up there later, my eyes will still be puffy.
And maybe she needs to re-read the visiting rules. It’s nobody under 14, not 12.
Anyway, over the last several days they have been talking about moving Pete to a regular floor but can't do it because they need to get his heart under control first. I have told them I am not at all in a hurry to do that, the only reason I wanted that to happen is that I think it's very important that Anna get to visit her daddy and vise versa. So, yesterday, his nurse told me that it would be just fine if I brought her up for a short visit and that it would do wonders for both of them. So, this morning, at the 8:00 to 9:00 visiting hour, I took Anna up there. I didn't tell her anything of what we were doing until we were in the parking garage.
We do all the elevator button pushing, get to the floor, use the Purel on our hands and walk thorugh the automatic doors, where I'm accosted by his nurse who says no visitors under 12 are allowed. I told her I made arrangements and was told it would be fine to bring her up there, whereupon she informed me that she is the charge nurse (well la ti dah) and that it needed to be cleared with her first and exactly WHO had I talked to. I told her and she starts telling me about how patients can't be gotten upset and I almost blew right there. How dare someone, who has never met me before and who I've never even SEEN on the floor, suggest I'm going to do anything that would not be good for Pete?
She put us out for a minute because I guess, you know, with all the responsibilities of being a bitchy charge nurse, she forgot there's an 8:00 a.m. visiting hour and she hadn't gotten Pete all arranged in his bed. While we're in the hallway, one of the floor docs walked by, said hi to Anna and, "Are you here to visit Daddy? That will be a good thing!". All of the nurses I've gotten to know over 2 weeks come up and are all excited to be able to meet the Anna of whom they have heard so much.
So they're done, we go in and she says, "Five minutes, you can't tire him out". She got "the look" out of me. So we were there for a few minutes, Anna said, "Daddy boo boo head" a few times, she pulled up her shirt so he could tickle her, but was a little standoffish with him. I think it's a combination of her being angry with him for going away for 2 weeks, being a little off put by Daddy being in bed and I'm sure feeling the stress caused by the nurse. We left, and I was so upset when we left, all of the remaining plans for the morning, including taking a ride on the train to Hermann Park on a morning that is beautiful, 68 degrees and and dry, just went by the wayside and I drove home in tears.
Later, there will be lots of visitors and I can bet there will be trouble. Because after everyone leaves, and I want to sit and needlepoint while Pete sleeps, she's going to try to put me out again. When that happens there may be a clash. And, trust me, I've rehearsed what I will say, including a suggestion that she find a CME course on the subject of sensitivity, patient psychological well being, how to handle families and how to basically not be a complete pain in the ass. Yes, today, I'm cussing and when I go up there later, my eyes will still be puffy.
And maybe she needs to re-read the visiting rules. It’s nobody under 14, not 12.
Thursday, September 4, 2008
Tachy
Nope, that's not a misspelling, it's one of the 75 different alarms that came up on the monitors today, while Pete was having so many arhythmia's that he ended up using up all the paper that prints them for the chart. Tachy is short for Tachicardia, which happens when the heart rate is 175 or more.
The day started just fine. I walked in and saw that the infuser was down to one attachment and that was just for medications (at one point there were 5 separate ones). They were trying to get him off the infusers altogether so that they could move him to a regular room. All that was just fine until the PT folks came into the room and sat him up for maybe 10 minutes. He had done ok with this just yesterday, but today is after all another day. When they went to lay him down his heart started doing all sorts of weird stuff, that I just figured was false readings because of all the activity associated with getting him sitting up and rearranged on the bed. I thought that until I looked over at his nurse who was standing there watching the monitor screen like a hawk. During the hour or so that we watched it, his rates were between 79 and 180, sometimes going from 79 to 135 with nothing in between. There is a different alarm when it reads Tachy, and it's a little more, well, alarming. Dr. Volpi came into the room to check on him just as the floor doc was working pretty hard to get his heart rate stabalized. It was suggested that he stay in the NICU another couple of days since all that got this going was sitting up for 10 minutes. Dr. Volpi concurred and changed his release order.
When I went this evening, his rates were all back to normal and we had another attachment for the infuser to give him some IV heart medication.
I bought a little bitty recorder that will do a 30 second tape of Anna to take to Pete. She sang her abc's on it and said, "I you daddy" at the end. I played it for him when I got there. Poor baby is running a fever and has some sort of sinus infection. After she's over that, I'm going to see about taking her to the hospital and sneaking her into the NICU to visit Pete. I think he needs to see her and she needs to see him. I have told her that Daddy was at work, but then he got sick and he's getting better. I think she's fine with that.
Continued prayers and well wishes are much appreciated. Barring something else happening with his brain circulation, it would appear the stroke has resolved itself. The hard work now will be rehabilitation, and considering sitting up caused all this havoc today, it will be a good bit of hard work, but worth every second. I believe this will be much like going on a diet, you work really hard for a while before you see any results. We need to keep pulling for Pete to keep working. I told the PT's that I'm not one of those obnoxious spouses who think they are "being mean" to him, I know they need to work him hard in order to bring him back to himself. I have no doubt Mr. Hardhead will not let any of us down. After all, his mind is completely unaffected by all of this, he is still Pete. Now that's a good thing.
The day started just fine. I walked in and saw that the infuser was down to one attachment and that was just for medications (at one point there were 5 separate ones). They were trying to get him off the infusers altogether so that they could move him to a regular room. All that was just fine until the PT folks came into the room and sat him up for maybe 10 minutes. He had done ok with this just yesterday, but today is after all another day. When they went to lay him down his heart started doing all sorts of weird stuff, that I just figured was false readings because of all the activity associated with getting him sitting up and rearranged on the bed. I thought that until I looked over at his nurse who was standing there watching the monitor screen like a hawk. During the hour or so that we watched it, his rates were between 79 and 180, sometimes going from 79 to 135 with nothing in between. There is a different alarm when it reads Tachy, and it's a little more, well, alarming. Dr. Volpi came into the room to check on him just as the floor doc was working pretty hard to get his heart rate stabalized. It was suggested that he stay in the NICU another couple of days since all that got this going was sitting up for 10 minutes. Dr. Volpi concurred and changed his release order.
When I went this evening, his rates were all back to normal and we had another attachment for the infuser to give him some IV heart medication.
I bought a little bitty recorder that will do a 30 second tape of Anna to take to Pete. She sang her abc's on it and said, "I you daddy" at the end. I played it for him when I got there. Poor baby is running a fever and has some sort of sinus infection. After she's over that, I'm going to see about taking her to the hospital and sneaking her into the NICU to visit Pete. I think he needs to see her and she needs to see him. I have told her that Daddy was at work, but then he got sick and he's getting better. I think she's fine with that.
Continued prayers and well wishes are much appreciated. Barring something else happening with his brain circulation, it would appear the stroke has resolved itself. The hard work now will be rehabilitation, and considering sitting up caused all this havoc today, it will be a good bit of hard work, but worth every second. I believe this will be much like going on a diet, you work really hard for a while before you see any results. We need to keep pulling for Pete to keep working. I told the PT's that I'm not one of those obnoxious spouses who think they are "being mean" to him, I know they need to work him hard in order to bring him back to himself. I have no doubt Mr. Hardhead will not let any of us down. After all, his mind is completely unaffected by all of this, he is still Pete. Now that's a good thing.
Wednesday, September 3, 2008
It's a Marathon Not a Sprint
I've heard this a time or two. Lest I wear myself out, I decided to spend the day at the hospital today and not go back this evening. I just called the hospital and Pete is sleeping anyway so it's a good deal.
We had all our therapists there today, speech, occupational and physical. The speech and physical therapists have each been branded "a pain in the ass". I suppose so, they are making him work, although the speech therapist did give him a bit to drink today. There was talk of moving him to a "real room", but they thought better of it because of worries about him not being able to swallow. Until that, he is not recovered enough to do so. Patience Kristy!
I am overwhelmed by the well wishes. Keep em coming, Pete and I feel your prayers with us.
We had all our therapists there today, speech, occupational and physical. The speech and physical therapists have each been branded "a pain in the ass". I suppose so, they are making him work, although the speech therapist did give him a bit to drink today. There was talk of moving him to a "real room", but they thought better of it because of worries about him not being able to swallow. Until that, he is not recovered enough to do so. Patience Kristy!
I am overwhelmed by the well wishes. Keep em coming, Pete and I feel your prayers with us.
Tuesday, September 2, 2008
Three steps forward, One step back
You gotta expect that things just can't go great everyday, particularly when you're dealing with stroke, but hopes and expectations aren't always in line with each other.
Nothing bad, in the grand scheme of things, but it is a setback. I got into the NICU this morning and he had the oxygen mask on again and this time not for a breathing treatment. The nurse told me that he had some irregular heartbeats last night and that they have increased his oxygen to help him with that. His "stable" situation is no longer stable. The doctor told me it was an atrial fibrillation and that his heart rate was up in the 160's, but that they were fortunately able to get it under control with some medications really fast. Evidently, some patients take a good deal longer to recover from the thing than he did. So, we're probably about 2 days delayed in getting into a regular hospital room, which is disappointing, but considering all the progress of the last several days, I should really not let it affect me at all.
The medications are making him a little subdued, which doesn't make me too happy, but I'm sure it isn't making HIM so happy either.
I talked to a child psychologist this morning about Anna. She assured me that as long as I'm acting like Pete not being there is not a big thing, she'll mirror that, but that I might say that daddy got sick at work and he's staying in the hospital while he gets all better.
There might be more later, you just never know, right?
Nothing bad, in the grand scheme of things, but it is a setback. I got into the NICU this morning and he had the oxygen mask on again and this time not for a breathing treatment. The nurse told me that he had some irregular heartbeats last night and that they have increased his oxygen to help him with that. His "stable" situation is no longer stable. The doctor told me it was an atrial fibrillation and that his heart rate was up in the 160's, but that they were fortunately able to get it under control with some medications really fast. Evidently, some patients take a good deal longer to recover from the thing than he did. So, we're probably about 2 days delayed in getting into a regular hospital room, which is disappointing, but considering all the progress of the last several days, I should really not let it affect me at all.
The medications are making him a little subdued, which doesn't make me too happy, but I'm sure it isn't making HIM so happy either.
I talked to a child psychologist this morning about Anna. She assured me that as long as I'm acting like Pete not being there is not a big thing, she'll mirror that, but that I might say that daddy got sick at work and he's staying in the hospital while he gets all better.
There might be more later, you just never know, right?
Monday, September 1, 2008
Like I said, things change fast :)
I got to the hospital today around 11:00 and met Dr. Volpi thre. He tells me that he would like to see Pete in a regular room tomorrow. You read that right.
He's got good intercranial pressure and he had almost no drainage when they clamped off the shunt; his oxygen saturations, with very little support, are in the high 90's to 100% and he's almost done with the pain medications. A week ago tonight I was wondering what I was going to do without him, and now I'm just feeling like I'll be sleeping against His Furriness before I know it.
The only thing he's going to have to work on is speech and swallowing. Until he can swallow, he's not leaving the ICU, so let's pull for something like that tomorrow when the speech therapist goes in. I asked him tonight if he's feeling stiff from just laying there and he said yeah, so I rattled the PT cage too. The gauntlet for a good while now will involve exhausting rehab and therapy.
That's it for now, and I think that's plenty.
He's got good intercranial pressure and he had almost no drainage when they clamped off the shunt; his oxygen saturations, with very little support, are in the high 90's to 100% and he's almost done with the pain medications. A week ago tonight I was wondering what I was going to do without him, and now I'm just feeling like I'll be sleeping against His Furriness before I know it.
The only thing he's going to have to work on is speech and swallowing. Until he can swallow, he's not leaving the ICU, so let's pull for something like that tomorrow when the speech therapist goes in. I asked him tonight if he's feeling stiff from just laying there and he said yeah, so I rattled the PT cage too. The gauntlet for a good while now will involve exhausting rehab and therapy.
That's it for now, and I think that's plenty.
Sunday
I really, seriously expected that I would be getting a phone call from the nurse telling me that they put Pete back on the vent overnight on Saturday night. When I got up and there was no such call, I was very pleasantly surprised.
Calling his mom on the way to the hospital was a good experience, since I had good news to share. When I got to the hospital, he was not only no longer intubated, but the oxygen mask was gone and he was getting a supply through a nasal canula. The incision from the craniotomy was starting to droop, which means his brain is shrinking and the cervical spine fluid is getting progressively clearer.
He was snoozing, so I sat down to read my book during the early visiting hour. It was a very relaxing thing to do, almost like a normal morning, except we'd be in the same bed.
The nurse told me he's communicating very well, something happened to his oxygen canulas and he rattled the side of the bed until she came over to fix it. I assured her he said thank you in his head. I went to mass in the chapel (no excuse to miss when all I have to do is get into an elevator!) and when I came back, he was sitting up in a chair. Well, not exactly a chair, but a bed that will make itself into a chair. It's important to get gravity doing its job to help keep clots from developing in his legs. He sat up for a good while, and was ready to get back into bed.
I picked up Anna from Kerry and she had made a little sign for Pete with Anna's handprints. It was very cute and I hung it up on the IV bag holder that is on a track around the bed so he can look at it wherever the move him.
By the late visiting hours, he was able to talk with a little voice behind it. Again, the NICU was quiet, like it always is from 8 to 10. I asked him a couple of questions that had him shaking his head no and then I asked if he wanted me to take all my clothes off and he nodded and smiled.
Calling his mom on the way to the hospital was a good experience, since I had good news to share. When I got to the hospital, he was not only no longer intubated, but the oxygen mask was gone and he was getting a supply through a nasal canula. The incision from the craniotomy was starting to droop, which means his brain is shrinking and the cervical spine fluid is getting progressively clearer.
He was snoozing, so I sat down to read my book during the early visiting hour. It was a very relaxing thing to do, almost like a normal morning, except we'd be in the same bed.
The nurse told me he's communicating very well, something happened to his oxygen canulas and he rattled the side of the bed until she came over to fix it. I assured her he said thank you in his head. I went to mass in the chapel (no excuse to miss when all I have to do is get into an elevator!) and when I came back, he was sitting up in a chair. Well, not exactly a chair, but a bed that will make itself into a chair. It's important to get gravity doing its job to help keep clots from developing in his legs. He sat up for a good while, and was ready to get back into bed.
I picked up Anna from Kerry and she had made a little sign for Pete with Anna's handprints. It was very cute and I hung it up on the IV bag holder that is on a track around the bed so he can look at it wherever the move him.
By the late visiting hours, he was able to talk with a little voice behind it. Again, the NICU was quiet, like it always is from 8 to 10. I asked him a couple of questions that had him shaking his head no and then I asked if he wanted me to take all my clothes off and he nodded and smiled.
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