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!!