Jon was transferred to Specialty Select Hospital late afternoon today. Within an hour of arriving, while still getting settled, Jon's oxygen saturation level dropped to the 60's (above 92 is ideal). Therefore, he is back on a ventilator and as a result can not use the Passy Muir which enabled him to speak. Hopefully this will not last very long. He is stablized just not doing all the breathing himself. This is the lowest his oxygen saturation has gone so far. He does not have the fancy bed yet for the bed sore but hopefully will soon, as Mom said, he does not like to be rolled manually.
Please continue to pray for Jon and the family, for healing and everyone's strength. Thank you for checking in.
The new hospital information is:
Select Specialty Hospital-Columbus
1087 Dennison Ave
Room 240W
Columbus, OH 43201
Friday, February 20, 2009
Thursday, February 19, 2009
Another step backwards?
It's been a relatively calm week. It has been frustrating to see so little progress in healing the bedsore. He has a marvelous air bed which works by activating air coils and turns him all by itself! He finds the turning process rather painful and voices his objection adamantly when it's done manually. With this bed you push a couple of buttons and the bed deflates on one side and pumps up on the other and walah...there you are!
To speed the healing process they have installed a VAC on the bedsore and it pumps out the infection as it forms. So far there has been little collected which they inform me is a good sign. It also protects the bedsore from contamination. I've managed to talk them into discontinuing the stool softener and including some fiber but he's still on the tube feeding. His cultures came back negative for pneumonia which is also a good sign although they thought they would continue with the antibiotic for a few days more.
On the disappointing side-- since his physical therapy has been limited both in time and the amount of activity-- he's rather weak. Too weak, in fact, to go back to Dodd. They want to transfer him to an entirely different facility...another Long Term Acute Care Hospital (LTACH)like the one in Green Springs, only about a mile away. They also use the VAC on bedsores which is a plus since I was quite upset since we had just started him on a process that seemed to me to be a sure cure...and the bedsore is a problem for Dodd also.) We're just waiting for an open bed. We'll let you know when that actually happens. In the meantime check with us if you think you're coming this way.
Thanks for looking in....
To speed the healing process they have installed a VAC on the bedsore and it pumps out the infection as it forms. So far there has been little collected which they inform me is a good sign. It also protects the bedsore from contamination. I've managed to talk them into discontinuing the stool softener and including some fiber but he's still on the tube feeding. His cultures came back negative for pneumonia which is also a good sign although they thought they would continue with the antibiotic for a few days more.
On the disappointing side-- since his physical therapy has been limited both in time and the amount of activity-- he's rather weak. Too weak, in fact, to go back to Dodd. They want to transfer him to an entirely different facility...another Long Term Acute Care Hospital (LTACH)like the one in Green Springs, only about a mile away. They also use the VAC on bedsores which is a plus since I was quite upset since we had just started him on a process that seemed to me to be a sure cure...and the bedsore is a problem for Dodd also.) We're just waiting for an open bed. We'll let you know when that actually happens. In the meantime check with us if you think you're coming this way.
Thanks for looking in....
Friday, February 13, 2009
Darn, Darn, Darn, Drat! In other words #$%&*#$@
Jon settled into Dodd Hall nicely, had one full day of therapy and whammo!
I left him at 4 or so to take Carol to meet her friend, David, who was taking her back to Defiance. Had a quick supper with them and then thought I'd stop back at Dodd Hall to see how he was doing since neither Barb or Bill would be with him. He was subdued and had his passy muir valve off. I looked at his oxygen saturation level and it was a little below 90 which requires some monitoring. We were having a difficult time conversing so I asked if we could have it put back on for just a few minutes. Whether that was a mistake or coincidental to the way his oxygen level had been rising and falling his oxygen went way down, as did his heart rate. He needed several more sets of suctioning to clear his lungs. (He had had several sets of suctioning before I arrived.)
To make a long story short it was back to the E.R. again and more suctioning using a saline solution, more blood samples taken, chest x-ray...the works. He had EKGs at both Dodd and the emergency room.
X rays showed some collapsing of the right lung again and signs of pneumonia. They couldn't tell if it was a chemical pneumonia or the regular kind(?) So he is back in Rhodes Hall. Again we've cleaned out his room at Dodd with the understanding that when he's well and they have room he'll be back.
In the meantime we are still encouraging visitors but you probably should call Marj, Carol, Barb or Bill to find out exactly where you should go.
I left him at 4 or so to take Carol to meet her friend, David, who was taking her back to Defiance. Had a quick supper with them and then thought I'd stop back at Dodd Hall to see how he was doing since neither Barb or Bill would be with him. He was subdued and had his passy muir valve off. I looked at his oxygen saturation level and it was a little below 90 which requires some monitoring. We were having a difficult time conversing so I asked if we could have it put back on for just a few minutes. Whether that was a mistake or coincidental to the way his oxygen level had been rising and falling his oxygen went way down, as did his heart rate. He needed several more sets of suctioning to clear his lungs. (He had had several sets of suctioning before I arrived.)
To make a long story short it was back to the E.R. again and more suctioning using a saline solution, more blood samples taken, chest x-ray...the works. He had EKGs at both Dodd and the emergency room.
X rays showed some collapsing of the right lung again and signs of pneumonia. They couldn't tell if it was a chemical pneumonia or the regular kind(?) So he is back in Rhodes Hall. Again we've cleaned out his room at Dodd with the understanding that when he's well and they have room he'll be back.
In the meantime we are still encouraging visitors but you probably should call Marj, Carol, Barb or Bill to find out exactly where you should go.
Wednesday, February 11, 2009
Back on track!
All the roadblocks back to Dodd have been hurdled: pneumonia, diarrhea, methadone...all cleared up. Thyroid test came back normal and the only problem at this point was with his echo cardiogram. Normal is 50% or better and he had a score of 45%. The doctor recommends another test in 3 months and make a comparison and then a decision if something is needed.
SO we've just traveled back through the tunnel to Dodd Hall, Room 3147 and therapy!! He is more upbeat and this time looking forward to therapy instead of fighting it...we hope this continues. It's time for some serious work which he's been trying to gear up for.
When Carol and I got to his room yesterday he announced he had been awake for 30 some hours. Whenever anyone came in to the room he updated the count until he was finally at 34 hours straight. When we left last night his eyes were getting droopy. Since he wasn't counting the hours when we arrived this morning we're assuming he did get some sleep. He will probably miss all the young student nurses that took care of him first thing in the morning.
He's happy, talkative and very entertaining to all the staff. He's really working on calling everyone by name and getting his memory back. It takes less prompting for him to remember an event. Meanwhile, there won't be a soul who doesn't know our entire family history by the time he leaves.
SO we've just traveled back through the tunnel to Dodd Hall, Room 3147 and therapy!! He is more upbeat and this time looking forward to therapy instead of fighting it...we hope this continues. It's time for some serious work which he's been trying to gear up for.
When Carol and I got to his room yesterday he announced he had been awake for 30 some hours. Whenever anyone came in to the room he updated the count until he was finally at 34 hours straight. When we left last night his eyes were getting droopy. Since he wasn't counting the hours when we arrived this morning we're assuming he did get some sleep. He will probably miss all the young student nurses that took care of him first thing in the morning.
He's happy, talkative and very entertaining to all the staff. He's really working on calling everyone by name and getting his memory back. It takes less prompting for him to remember an event. Meanwhile, there won't be a soul who doesn't know our entire family history by the time he leaves.
Monday, February 9, 2009
Loopy and loopier
Angelique sure had that last title correct! Evidently Jon has been requesting pain medication too often and really by now I would think that he shouldn't be having much pain at all. However, his new bed, which is doing wonders for the bedsore, does not look like it would be comfortable for sitting. It is like a giant air mattress, but it seems to act almost like it was filled with water, in that there is no support when he's sitting up. At least an air mattress tends to bounce up behind you and remains stiff; this one just seems to envelope him making him look like he's in a U shape, only not that pronounced. They've tried to adjust it so that it doesn't look quite so bad as it did the first few days.
At any rate, methadone is supposed to be a good replacement for any opiate based drug. They had given him a dose Wednesday evening (and then another one early Thursday morning.) Jon and I had not had a good relationship Wednesday. He was back on just a trach without the passy muir speaking valve and had to rely on using short bursts of air to get words out which gives him a brusque commanding sound since he also "gets to the kernel" of the message he is conveying. He also gets your attention with the same kind of "kissing" sound that fellows use to get dogs' attention. Couple that with his need to direct you through every component of a task and you have an idea of how exasperated I was that day. Anyway, Barb spelled me that evening and left me a note in the morning that said Mike, the night nurse, had been reviewing the "please" and "thank you" necessity as well as helping him work through the process of putting his his arms down to his side. (For some reason he seems to think they lock up half way down--Mike told him to turn his wrist inward and then they go down easily on his own.) So when I went in Thursday morning and Jon gave a big grin and greeted me with "Mom, come... here! I...want... to... hug... you!" I was absolutely ready to worship Mike. I was so overwhelmed I had to go out to the hall for a few moments to compose myself. When I went back into the room and that request was repeated as if it had not been made before I was suspicious. It seems he had been in that happy state for a couple of hours. As the day wore on happy went downhill to fighting with demons. I hardly left his side the rest of the day and evening trying to get him calmed and reassured his world was not coming to an end.
The next day the speech therapist said he could have his passy muir valve put back onto his trach. He was so used to speaking so forcefully that for the first 10 minutes or so he yelled instead of talking. Silly me, I finally suggested that perhaps he should sing his answers instead. The singing never stopped! Most of the time I didn't recognize the songs and quite often he was just singing monotonous phrases--over and over and over. Occasionally it was interrupted by sudden fearful looks at the clock. I did however, get a chance to read quite a bit of my book "Three Cups of Tea" that my book study group is reviewing. (It's quite a good book about an American mountain climber who decided to build schools for girls in Pakistan and Afghanistan.)
As Angelique put it this week-end the best that could be said was that Jon was loopy. Barb reported to me this morning that he was still talking well into the night but that it was much calmer. I came home Saturday afternoon and will be going back down tomorrow (Tuesday) and taking Carol with me so Jon is in the hands of Barb and his dad. Before I could get home Saturday Barb called with a question about Jon's blood pressure. It seems that it had been extremely high at one point in the day and then dropped to just about half both numbers. I haven't been keeping the kind of records I did for her last January and they haven't been volunteering that info so I didn't really know what normal for him has been--needless to say we are starting to take copious notes--Bill's notes the last few days have been far better than mine. He's now on high blood pressure medication. I'm not sure I like the fact that he has different nurses every day. The continuity in care just isn't there.
I've started to ramble so I'll just say--Thanks for tuning in....
P.S. He passed another swallowing test so he is allowed to eat but he either acts likes he's falling asleep in the middle of a bite or is asleep and we haven't felt comfortable with pushing food. I think he was doing better Saturday when I left so hopefully he's doing better in that regard.
At any rate, methadone is supposed to be a good replacement for any opiate based drug. They had given him a dose Wednesday evening (and then another one early Thursday morning.) Jon and I had not had a good relationship Wednesday. He was back on just a trach without the passy muir speaking valve and had to rely on using short bursts of air to get words out which gives him a brusque commanding sound since he also "gets to the kernel" of the message he is conveying. He also gets your attention with the same kind of "kissing" sound that fellows use to get dogs' attention. Couple that with his need to direct you through every component of a task and you have an idea of how exasperated I was that day. Anyway, Barb spelled me that evening and left me a note in the morning that said Mike, the night nurse, had been reviewing the "please" and "thank you" necessity as well as helping him work through the process of putting his his arms down to his side. (For some reason he seems to think they lock up half way down--Mike told him to turn his wrist inward and then they go down easily on his own.) So when I went in Thursday morning and Jon gave a big grin and greeted me with "Mom, come... here! I...want... to... hug... you!" I was absolutely ready to worship Mike. I was so overwhelmed I had to go out to the hall for a few moments to compose myself. When I went back into the room and that request was repeated as if it had not been made before I was suspicious. It seems he had been in that happy state for a couple of hours. As the day wore on happy went downhill to fighting with demons. I hardly left his side the rest of the day and evening trying to get him calmed and reassured his world was not coming to an end.
The next day the speech therapist said he could have his passy muir valve put back onto his trach. He was so used to speaking so forcefully that for the first 10 minutes or so he yelled instead of talking. Silly me, I finally suggested that perhaps he should sing his answers instead. The singing never stopped! Most of the time I didn't recognize the songs and quite often he was just singing monotonous phrases--over and over and over. Occasionally it was interrupted by sudden fearful looks at the clock. I did however, get a chance to read quite a bit of my book "Three Cups of Tea" that my book study group is reviewing. (It's quite a good book about an American mountain climber who decided to build schools for girls in Pakistan and Afghanistan.)
As Angelique put it this week-end the best that could be said was that Jon was loopy. Barb reported to me this morning that he was still talking well into the night but that it was much calmer. I came home Saturday afternoon and will be going back down tomorrow (Tuesday) and taking Carol with me so Jon is in the hands of Barb and his dad. Before I could get home Saturday Barb called with a question about Jon's blood pressure. It seems that it had been extremely high at one point in the day and then dropped to just about half both numbers. I haven't been keeping the kind of records I did for her last January and they haven't been volunteering that info so I didn't really know what normal for him has been--needless to say we are starting to take copious notes--Bill's notes the last few days have been far better than mine. He's now on high blood pressure medication. I'm not sure I like the fact that he has different nurses every day. The continuity in care just isn't there.
I've started to ramble so I'll just say--Thanks for tuning in....
P.S. He passed another swallowing test so he is allowed to eat but he either acts likes he's falling asleep in the middle of a bite or is asleep and we haven't felt comfortable with pushing food. I think he was doing better Saturday when I left so hopefully he's doing better in that regard.
Sunday, February 8, 2009
Methadon't
Joey and I made the trek to see Uncle J this weekend. At first, I thought we had walked into the wrong room. Uncle J is completely clean-shaven! No goatee, no mustache...I don't think I have ever seen him without at least a mustache! He also has a new short do and didn't have his glasses on, so it was all a lot to take in. He had been given some methadone a few days before, which he didn't react very well to, and he was acting quite loopy the entire visit. I am hoping the next time we get to see him, the "methadone effect" is gone and he is back in Dodd hall for rehab. I'm sure there will be a posting coming from Barb or Grandma soon with more info, I just wanted to post a little bit. Thanks!
Wednesday, February 4, 2009
When Will I learn?
Nothing is ever set in stone! Either the anesthesiologist was in the wrong room or was misinformed. There is no surgery scheduled for today. There is a CAT scan and I can say that with some certainty because he just left the room and was headed to radiology! When the doctors are through looking at the scans and checking out the possibilities they will let us know what is going on.
Jon had his feeding tube disconnected this noon and had his first meal since the choking incident. He ate 4 or 5 smaaaallll bites of hamburger, a few bites of what they called cornbread dressing but tasted a lot like Carol's corn souffle, almost all of 2 slices of peaches, a fourth of a slice of apple pie and all of his carton of milk. The nurse said that wasn't too bad for the first meal.
A physical therapist was in today (and yesterday) to work some on Jon's hands and arms. His shoulders are very tight. Therapy would be a lot easier if we could just get him to relax his muscles--less painful, also. We've been slipping on the daily exercises of his hand. I did get to finish a manicure of sorts on one hand and will try to do the other one when he is shifted to a different side.
Student nurses have come yesterday and today. They have either participated in or watched some of his morning care. The male nurse last night teased Jon about having a harem when Jon wanted Barb and I to rub each eye in unison...asked him if he had any requirements: blond, brunette, age, etc. And then he found out about the student nurses and really razzed him.
That's all for now. I'll try my best to keep you accurately posted and in a timely fashion. If that's possible!
Jon had his feeding tube disconnected this noon and had his first meal since the choking incident. He ate 4 or 5 smaaaallll bites of hamburger, a few bites of what they called cornbread dressing but tasted a lot like Carol's corn souffle, almost all of 2 slices of peaches, a fourth of a slice of apple pie and all of his carton of milk. The nurse said that wasn't too bad for the first meal.
A physical therapist was in today (and yesterday) to work some on Jon's hands and arms. His shoulders are very tight. Therapy would be a lot easier if we could just get him to relax his muscles--less painful, also. We've been slipping on the daily exercises of his hand. I did get to finish a manicure of sorts on one hand and will try to do the other one when he is shifted to a different side.
Student nurses have come yesterday and today. They have either participated in or watched some of his morning care. The male nurse last night teased Jon about having a harem when Jon wanted Barb and I to rub each eye in unison...asked him if he had any requirements: blond, brunette, age, etc. And then he found out about the student nurses and really razzed him.
That's all for now. I'll try my best to keep you accurately posted and in a timely fashion. If that's possible!
Tuesday, February 3, 2009
Some Minor Surgery Scheduled
We'll take a step back for a moment. The process of going from ICU back to Dodd yesterday had an interruption. Jon had more problems with his lungs and needed more suctioning. This section of Rhodes Hall specializes in lung disorders so he was moved for a second time to Rhodes Hall, Room 824.
The neurosurgeons had stopped by yesterday to check on Jon and I asked about the problem which was developing with the thoracic vertebrae. They seemed to be shifting according to the MRIs...drifting might even be a better word. Since the only pictures they had were from the original and what they had the last few days they weren't sure when the movement started or if it had stopped. If it had stopped it would be considered frozen and there would be no remediation and I got the impression it would interfere with his ability to maintain an upright position, especially in a wheelchair. If it was still moving then surgery could be done to keep the spinal column in alignment.
I had spent the night with Jon since he was in considerable pain and doesn't seem to be able to use any of the call buttons here either (One plus for St Francis!) so I went home for a nap this morning and of course an anesthesiologist came to inform Jon's father that he was scheduled for surgery tomorrow. The nurse tonight informs me that this particular surgery is not the major one that was discussed yesterday but is a minimally invasive procedure which will cut into some of the muscle which is pulling on the spinal cord. They will take another CAT scan tonight so they know exactly where everything is at the moment. This will also allow more movement of the shoulder and make physical therapy more productive and possibly lessen the pain.
One other complication in communication involves the removal of Jon's old trach which had straight edges and the replacement which has a cuff which can inflate to seal around the trach opening and allows more of the oxygen to get to the lungs. They need one with a cuff when using a respirator. It also prevent unwanted objects, such as carrots, from going down into the lungs. That is great but the big BUT is that for the most part it prevents normal speech and we are back to guessing what he is trying to say, spelling important words etc. unless he is so perturbed he practically yells and the voice box reverberates!!!
And finally, since the halo has been removed the new strain put on neck muscles, especially during things like repositioning, has created new pain... sometimes quite intense.
Some plusses...the new room is quite large, has a new style flat TV, a nurse -patient ratio of 1:3 (with great nurses) and this computer which we can use to update the posts.
The neurosurgeons had stopped by yesterday to check on Jon and I asked about the problem which was developing with the thoracic vertebrae. They seemed to be shifting according to the MRIs...drifting might even be a better word. Since the only pictures they had were from the original and what they had the last few days they weren't sure when the movement started or if it had stopped. If it had stopped it would be considered frozen and there would be no remediation and I got the impression it would interfere with his ability to maintain an upright position, especially in a wheelchair. If it was still moving then surgery could be done to keep the spinal column in alignment.
I had spent the night with Jon since he was in considerable pain and doesn't seem to be able to use any of the call buttons here either (One plus for St Francis!) so I went home for a nap this morning and of course an anesthesiologist came to inform Jon's father that he was scheduled for surgery tomorrow. The nurse tonight informs me that this particular surgery is not the major one that was discussed yesterday but is a minimally invasive procedure which will cut into some of the muscle which is pulling on the spinal cord. They will take another CAT scan tonight so they know exactly where everything is at the moment. This will also allow more movement of the shoulder and make physical therapy more productive and possibly lessen the pain.
One other complication in communication involves the removal of Jon's old trach which had straight edges and the replacement which has a cuff which can inflate to seal around the trach opening and allows more of the oxygen to get to the lungs. They need one with a cuff when using a respirator. It also prevent unwanted objects, such as carrots, from going down into the lungs. That is great but the big BUT is that for the most part it prevents normal speech and we are back to guessing what he is trying to say, spelling important words etc. unless he is so perturbed he practically yells and the voice box reverberates!!!
And finally, since the halo has been removed the new strain put on neck muscles, especially during things like repositioning, has created new pain... sometimes quite intense.
Some plusses...the new room is quite large, has a new style flat TV, a nurse -patient ratio of 1:3 (with great nurses) and this computer which we can use to update the posts.
Update
Jon is still in the main hospital. He is going to be having an MRI because they think they may have to do back surgery. Will keep you updated as we know more...Thanks for checking in!
Monday, February 2, 2009
Out of Medical I.C.U.!!
Jon was given a swallow test earlier today and he passed!!! He has been breathing on his own and maintaining his oxygen saturation above 95% long enough that he is able to be moved out of I.C.U. However, they would like to keep a closer eye on him still so instead of going back to Dodd Hall, he has been moved to a regular room at Ohio State University Hospital Room S1120B.
(written by sister Barb, yes I can be brief!)
(written by sister Barb, yes I can be brief!)
Just when I thought all was OK
(written by sister Barb, sorry - this is actually the short version!!!)
Jon seemed to be resting peacefully but unbeknownst to me his oxygen saturation levels (sats) were dropping. I went to the nurses station at 11:15 to let them know that he was overdue to be turned and they were in the middle of a shift change. The new nurse would see Jon first. I came back and told Jon the nurse would be down to turn him soon. He cut me off “Hush. I’m testing." I don’t know what that meant but he was doing something with his breathing. She came at 11:45. Before turning him, she took his vitals. When she saw that his oxygen saturation was at 83% she immediately called the doctor.
The next hour and twenty five minutes was spent trying to get his saturation up to at least 92%. The respiratory therapist came down and did his standard treatment; that did not help. Then he “bagged” him. It is a mouthpiece with a bag that the therapist deflates. After the first time, Jon said “Can Steve do that again?” It seemed to help him, but not his saturation levels (sats). The nurse suctioned him after each bagging. The first time, the secretions were a thick white; the second they were yellow and a piece of carrot came with it as he had choked on some raw carrots at dinner time. The doctor ordered a chest x-ray to see if he had aspiration pneumonia (pneumonia caused by food getting into the lungs). The nurse drew blood and the respiratory therapist wanted to do an AGB draw (Arterial Blood Gas) which measures how much oxygen is actually in the blood itself to make sure the machine was working properly. The respiratory therapist (RT) would draw blood directly from the artery and therefore had to do it at the base of his wrist or through the groin. Jon was not happy at either option. The RT told Jon “I’m very good at this." After the first failed attempt Jon said “You’re right, you’re not very good at this.” The RT said “No, I said I am usually very good at this.” Jon replied “Well, you’re not now.” The RT apologized and said that if he couldn’t get it the second time, he would let the doctor do it. He asked the nurse for a Doppler to help find the artery. The second time brought some blood but not enough. When Jon replied again that the RT was not good at this, the RT replied “No, your artery isn’t good.” He told Jon he had to try a third time at which Jon was really rather upset. The third time was a charm. The RT said “I’ve got blood.” Jon said “Is it enough?” He said “yes.” Jon said “Are you happy?” (not sarcastically).
At 1:10 a.m. Saturday morning, the doctor came in-- the nurse was communicating with him on the phone for the first hour. He ordered an ambulance to take Jon to the main hospital for closer monitoring. The AGB results showed his oxygen levels really were at 84%. The paramedics put him on 100% oxygen through a closed mask and his sats went up to 99% in a matter of minutes. However, the hospital does not like to keep a patient on 100% oxygen for very long, it is only for “emergencies.”
Spent 5 hours in ER, then moved to 10th floor Doan Hall for “closer monitoring.” Barb was with him until 6 a.m. Then Dad was with him from 6 a.m. until 6 p.m. After suctioning numerous times in less than 20 minutes, he was moved to the Medical Intensive Care Unit for even “closer monitoring.” (Like a 2:1 ratio.) He was put back on a respirator.
His cousin Dick and Linda came up for the 1:00-2:00 p.m. visitation. Linda asked him if he would like a face massage. His eyes lit up “Yes.” So she did. He really liked it. Later when I asked Jon about the visit he said “Dick made me laugh.” When I asked what Dick said, Jon said he was just “goofy.”
By Sunday morning, his sats had been consistently over 95% on the respirator.
By Sunday afternoon he was breathing on his own, but still hooked up to the respirator. His sats were still consistently over 95%.
At the 5:00 p.m. visitation Sunday the respirator was off, he still had moist air over his trach for extra pressure support but things were looking very good. He needs to have a swallowing test to determine when he can eat again and when he can have a talking trach again.
He will hopefully be back at Dodd Hall by the time you read all of this!!
Jon seemed to be resting peacefully but unbeknownst to me his oxygen saturation levels (sats) were dropping. I went to the nurses station at 11:15 to let them know that he was overdue to be turned and they were in the middle of a shift change. The new nurse would see Jon first. I came back and told Jon the nurse would be down to turn him soon. He cut me off “Hush. I’m testing." I don’t know what that meant but he was doing something with his breathing. She came at 11:45. Before turning him, she took his vitals. When she saw that his oxygen saturation was at 83% she immediately called the doctor.
The next hour and twenty five minutes was spent trying to get his saturation up to at least 92%. The respiratory therapist came down and did his standard treatment; that did not help. Then he “bagged” him. It is a mouthpiece with a bag that the therapist deflates. After the first time, Jon said “Can Steve do that again?” It seemed to help him, but not his saturation levels (sats). The nurse suctioned him after each bagging. The first time, the secretions were a thick white; the second they were yellow and a piece of carrot came with it as he had choked on some raw carrots at dinner time. The doctor ordered a chest x-ray to see if he had aspiration pneumonia (pneumonia caused by food getting into the lungs). The nurse drew blood and the respiratory therapist wanted to do an AGB draw (Arterial Blood Gas) which measures how much oxygen is actually in the blood itself to make sure the machine was working properly. The respiratory therapist (RT) would draw blood directly from the artery and therefore had to do it at the base of his wrist or through the groin. Jon was not happy at either option. The RT told Jon “I’m very good at this." After the first failed attempt Jon said “You’re right, you’re not very good at this.” The RT said “No, I said I am usually very good at this.” Jon replied “Well, you’re not now.” The RT apologized and said that if he couldn’t get it the second time, he would let the doctor do it. He asked the nurse for a Doppler to help find the artery. The second time brought some blood but not enough. When Jon replied again that the RT was not good at this, the RT replied “No, your artery isn’t good.” He told Jon he had to try a third time at which Jon was really rather upset. The third time was a charm. The RT said “I’ve got blood.” Jon said “Is it enough?” He said “yes.” Jon said “Are you happy?” (not sarcastically).
At 1:10 a.m. Saturday morning, the doctor came in-- the nurse was communicating with him on the phone for the first hour. He ordered an ambulance to take Jon to the main hospital for closer monitoring. The AGB results showed his oxygen levels really were at 84%. The paramedics put him on 100% oxygen through a closed mask and his sats went up to 99% in a matter of minutes. However, the hospital does not like to keep a patient on 100% oxygen for very long, it is only for “emergencies.”
Spent 5 hours in ER, then moved to 10th floor Doan Hall for “closer monitoring.” Barb was with him until 6 a.m. Then Dad was with him from 6 a.m. until 6 p.m. After suctioning numerous times in less than 20 minutes, he was moved to the Medical Intensive Care Unit for even “closer monitoring.” (Like a 2:1 ratio.) He was put back on a respirator.
His cousin Dick and Linda came up for the 1:00-2:00 p.m. visitation. Linda asked him if he would like a face massage. His eyes lit up “Yes.” So she did. He really liked it. Later when I asked Jon about the visit he said “Dick made me laugh.” When I asked what Dick said, Jon said he was just “goofy.”
By Sunday morning, his sats had been consistently over 95% on the respirator.
By Sunday afternoon he was breathing on his own, but still hooked up to the respirator. His sats were still consistently over 95%.
At the 5:00 p.m. visitation Sunday the respirator was off, he still had moist air over his trach for extra pressure support but things were looking very good. He needs to have a swallowing test to determine when he can eat again and when he can have a talking trach again.
He will hopefully be back at Dodd Hall by the time you read all of this!!
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