Progress
- Today Bob began to respond to simple commands (wiggle your toes, squeeze my hand) and he also would open his eyes whenever someone approached him and spoke loudly to him. His awakening is slow following yesterday's surgery, but he's gradually coming around. He can't stay awake or alert for very long yet.
- He is now spontaneously breathing 9 breaths per minute on his own, while the ventilator is assisting with the rest. He is back down to 35% oxygen, and hopefully tomorrow they'll be able to dial back the vent even more. Everyone wants him off the ventilator as soon as possible, but they aren't pushing him too quickly and want to do things right the first time around to avoid any backtracking.
- They did remove the Arterial IV line from his left wrist, and one of the veinous IV lines from the back of his hand. They'll continue to keep the Central Line in his jugular for all of his IV medications and TPN (IV nutrition) as well as the other two IV's he still has.
Concerns
- Today Bob began to respond to simple commands (wiggle your toes, squeeze my hand) and he also would open his eyes whenever someone approached him and spoke loudly to him. His awakening is slow following yesterday's surgery, but he's gradually coming around. He can't stay awake or alert for very long yet.
- He is now spontaneously breathing 9 breaths per minute on his own, while the ventilator is assisting with the rest. He is back down to 35% oxygen, and hopefully tomorrow they'll be able to dial back the vent even more. Everyone wants him off the ventilator as soon as possible, but they aren't pushing him too quickly and want to do things right the first time around to avoid any backtracking.
- They did remove the Arterial IV line from his left wrist, and one of the veinous IV lines from the back of his hand. They'll continue to keep the Central Line in his jugular for all of his IV medications and TPN (IV nutrition) as well as the other two IV's he still has.
Concerns
- Although his heart rate was very good most of the morning (around 100bpm) he again became tachycardic this afternoon and remained so this evening (115-120bpm).
- His blood sugar was 217 at noon, and 292 at 6pm. It is not being adequately controlled by his body, and they pulled blood for labs today to see if his TPN (IV nutrition) needs to be adjusted.
- His third-spacing fluid retention was returning, especially in his feet, legs and abdomen, as well as more fluid collecting in both the base and the upper portion of his right lung. They started him on aggressive levels of Lasix today, and thankfully his urine output tripled by this evening. They don't want that belly getting tight. And they don't want to hear "rattling" in his right lung like they did today.
- Tonight they added another antibiotic to his cocktail, this latest one is Mycamine. So they took away the Vancomycin, but he's back on 3 antibiotics again (Maxipeme, Mycamine and Flagyl). He's been feverish on and off all day (101-102F), so they're concerned about infection creeping up.
- Pain control was very difficult today. Although they removed his sedation (Versed & Clozapine) they are still giving him the maximum Fentanyl IV drip (250mg) and are now also giving him IV Dilaudid once an hour.
If any of you know me very well, I have never been a rollercoaster rider, especially the ones that go upside down and do loop-de-loops. This rollercoaster ride is worse than anything I've ever ridden at Cedar Point or Six Flags. I'll be glad to leave this theme park and never come back!
- His blood sugar was 217 at noon, and 292 at 6pm. It is not being adequately controlled by his body, and they pulled blood for labs today to see if his TPN (IV nutrition) needs to be adjusted.
- His third-spacing fluid retention was returning, especially in his feet, legs and abdomen, as well as more fluid collecting in both the base and the upper portion of his right lung. They started him on aggressive levels of Lasix today, and thankfully his urine output tripled by this evening. They don't want that belly getting tight. And they don't want to hear "rattling" in his right lung like they did today.
- Tonight they added another antibiotic to his cocktail, this latest one is Mycamine. So they took away the Vancomycin, but he's back on 3 antibiotics again (Maxipeme, Mycamine and Flagyl). He's been feverish on and off all day (101-102F), so they're concerned about infection creeping up.
- Pain control was very difficult today. Although they removed his sedation (Versed & Clozapine) they are still giving him the maximum Fentanyl IV drip (250mg) and are now also giving him IV Dilaudid once an hour.
If any of you know me very well, I have never been a rollercoaster rider, especially the ones that go upside down and do loop-de-loops. This rollercoaster ride is worse than anything I've ever ridden at Cedar Point or Six Flags. I'll be glad to leave this theme park and never come back!
This is a bag of Bob's TPN. I think it looks like Gatorade,
but apparently some people say it makes them think of something else...
😝
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