Today I managed to get over again during the day to visit with my sister-in-law. A number of her machines have been removed as she continues to progress forward. Today when I saw her she looked absolutely exhausted. Not only that, it was also apparent that she felt miserable and was in no mood for company. Through simple signs she managed to tell me she had a headache, was completely exhausted and her that her stomach was causing her discomfort. I spoke with the nurse assigned to her and she told me that my sister-in-law had a good day from the perspective of making strides forward. There was not much they could do for the headache since my sister-in-law had tugged out her nose line which was how they administered her Tylenol. The stomach pain could be addressed by removing some of the gas that had accumulated and the nurse went about doing that.
Although she was pretty tired we visited for about 45 minutes. In the last few days she has made some pretty incredible strides forward, however, she is still in Intensive Care. Her breathing is laboured, although she is breathing on her own now – through the tracheostomy. She has a lot of congestion in her lungs and is being suctioned every few minutes, as well as taking medication to break it up. It is exhausting work trying to cough up all that phlegm as well as breathing on her own after three weeks on a machine. So she’s tired and frustrated. A couple of times she pointed to herself and mouthed “stupid”. Somehow she figures that this was all her fault. I suspect that the road ahead of her is a tough one and she will be tired and frustrated throughout, but each day she is getting stronger. It will be a momentous event when she finally is transferred out of the ICU.
Yesterday I had the opportunity to go in and visit with my sister-in-law through the midday. Usually I am in during the evening shift and there is not a lot of technical work being done. When I was in yesterday I was able to observe one of the breathing exercises that they are conducting to prepare her for the removal of her tracheostomy. It’s quite simple really, they remove the trach hose and loosely fit an oxygen mask over the trach opening to ensure oxygen flow. She is then forced to breathe on her own while being monitored by the technician and the machines. Although she did quite well and wasn’t in any obvious distress with respect to her breathing, I left the hospital feeling very uncomfortable with what I saw.
Going into the breathing exercise her resting blood pressure was around 160-170/100. Her eyes were quite dark and she presented as being in some sort of discomfort. During the actual exercise her blood pressure rose significantly, to a point where I didn’t think it was possible without all sorts of alarms going off. I’m talking 250/120. Can you imagine what her head must have felt like – it must have been like jackhammers pounding in there. I finally had to speak to the nurse, no one seemed overly concerned at this potentially lethal blood pressure. In discussion with the nurse, she advised that my sister-in-law had a headache earlier on and that she would administer some more Tylenol to help with that. She also stated that it was time for some blood pressure medication and she would get that into her too. The nurse also stated that these breathing exercises do tend to put my sister-in-law’s blood pressure up. If they are aware of this can’t they do anything prior to commencing the exercises to ensure that she doesn’t face any additional unnecessary risk?
It was all very clinical and detached. Too detached I’m afraid – it bothered me all night. My sister-in-law cannot lobby for herself, she’s voiceless at this point in time. I wonder what the protocols are for this type of situation? Her son has the same worry as I do in this regard and was going to speak with the doctor this morning. It seems to be pushing the boundaries a bit unnecessarily allowing her blood pressure to go so high. We don’t need any more complications, she has been through too much already.
Today started off well with a positive update on my sister-in-law. Yesterday they had stopped the blood pressure medication and my sister-in-law appears to be holding her own in that area. Her temperature was normal and the antibiotics appear to be working. The nurse stated that the night had been good, and that things were on track. The doctor, during his rounds this morning, stated he is pleased with what he is seeing by way of response. He did advise however, that they had discovered a second bacteria in her lungs and are awaiting its identification; hopefully the present cocktail of antibiotics will be effective to address this new bacteria.
For the immediate future the intent is to get her breathing on her own, consequently the medical staff advised that they will remove the support provided by the respirator in the next few days. They do not want to keep her on it for more than 14 days and she is nearing that mark. If she is unable to breathe on her own, then they will perform a tracheostomy. Although this sounds dire, the hope is that she will improve sufficiently in the next couple of days and pleasantly surprise all of us by regaining her capacity in this area and this procedure will not be required.
Certainly during my visit yesterday I noticed visibly encouraging signs. I don’t know if she was registering that I was there but there was a physical response using finger movements to certain statements made. She is still sedated, but the level of sedation has been reduced – I can’t help but think that she is making her way back to us.
Unfortunately things have not gone as planned for my sister in law. She came through her surgery well but had some swelling and discomfort while recuperating in the hospital. Still in all they discharged her on Thursday and she went home where her two sons were staying to provide her support and assistance while she mends.
On Friday I went over and did check in and decided that perhaps us women should stick together and brought her home to my place. Her sons were okay with it and she agreed so we packed her up and brought her home. That night her discomfort increased although the pain didn’t. Her legs were still quite swollen as was her belly. She had no appetite and no desire to drink or even move. We tried to keep her moving but it winded her, absolutely took her breath away.
On Friday, she had a restless night and the painkillers caused her hallucinations. It was difficult to get her up on Saturday morning. Her breathing was very labored. Apparently she has used puffers in the past and asked me to go pick them up from her house. The prescriptions were quite old but she used them anyway and seemed to get some relief. Still she seemed over the course of a couple of hours to get worse not better. Around dinner time we made the decision to take her to the hospital. She went by ambulance which was the right choice – she was seen immediately and needed to be. She had developed a complication that required immediate surgery.
Gas from her intestine had leaked into her abdomen and was pushing up her diaphragm. No wonder she was feeling short of breath! It was quite remarkable that she wasn’t in pain – she was struggling to breathe yet was not really experiencing pain. The doctors at the hospital moved quite quickly to get her diagnosed – she was in and back for a CT scan in record time. So it’s 1 o’clock in the morning and here I sit, along with her son, waiting to get the all clear from the surgeon.
Cancer is the darnedest thing. It’s like that tumor was still trying to wreak havoc on her even after it was gone – one last kick at trying to make her life miserable. The surgeon said it would be a couple of hours in the OR. It’s likely we will get the update by 2 a.m.