Today started as usual, dressing change and then the stretch chair for about an hour. The Occupational therapists came in and moved Brenda from the stretch chair back to her bed. They worked with her on sitting up and then standing up. Brenda did a lot of the work herself. She made three attempts to stand ALL the way up, but was only able to go about 60% of the way up. This is the first time she attempted this. After this session she was placed back in the stretch chair for about 4 hours. This is very good position for her lungs. The Rehab therapist came in and replaced the facial pressure tape. The therapist was impressed with her lower lip flexibility. She will not get the pressure mask until she is off the Ventilator. The mask is not made to accomadate a ventilator. The Pulmonary doctor and therapist said today she would start breathing on the Ventilator first, then to CPAP and then finally try to breath without the Ventilator. Breathing on her own only lasted a short time because of the size of the Trach and the type of Trach. Breathing through this Trach is like breathing through a straw. The Renal doctor reported her numbers are steady, urine and processing toxins. The Dialysis Cather Tube was removed late yesterday. Later in the afternoon, while she was in the stretch chair, the Speech therapist worked with her swallowing and putting in her dentures. Today she was only able to put in the upper dentures. The therapist was impressed with her tongue movement and made sure we continue work with her using the mouth exercises. Tomorrow they are going to insert the feeding tube into her stomach. She still remains in the Surgical/Medical ICU in critical condition.[...]

Brenda watched the Super Bowl and her team won! She must have been so excited that she could not sleep. First thing this morning they placed her in the Stretch Chair for about 1 hour. Then the Burn team did the dressing change. The Renal Doctor reported that her urine output was acceptable and that her kidneys were processing Toxins at an acceptable level, better than yesterday. No Hemodialysis was required today. He said that the plan is to remove the Catheter tube used for dialysis today. The Respiratory doctor reported she is doing fine and she doing CPAP, breathing on her own, today, but during the evening the Ventilator is doing the work. The Physical therapist had her sitting at the side of the bed, by herself, for 40 minutes. They exercised her at this time. She was in the stretch chair for 2 hours this afternoon and may spend time in it tonight.[...]

Brenda experienced a restless night which had her poll out several lines. So the dressing change was done after the repairs. I think she woke up confused and fustrated. This morning they changed the Ventilator settings to CPath, that is breathing on her own. The PEEP was changed from Seven (7) to Five (5). Her urine output is about 100 cm per hour and she has improved her processing of toxin's. The Renal Doctor said there was no need for Hemodialysis today. The Dressing team changed her dressing and report that she is healing nicely, about 96%. She went into the stretch chair this afternoon for about three hours.[...]

Happy Groundhog day! And to celebrate, Brenda had her best day yet!. What a day!  At 6:30 Brenda was sitting in the stretch chair until 9:45 a.m. She is going to sit in the stretch chair twice a day for 3 hours at a time. She is scheduled to this again in the late afternoon. After the stretch chair she had the Occupational therapist sit her up at the side of the bed, the exercise period lasted about 40 minutes. The Respiratory Therapist works with her every 4 hours. Her Ventilator numbers remain the same, they will put her on CPAC (breathing on her own) when the Therapist feels she has the energy. She is doing a lot of the work at this point. The Pulmonary Doctor is happy with her progress. The Renal Doctor reported that her urine output is acceptable and that her Toxin numbers are improving ever so slightly. This is what they are looking for. Today, she did not need Hemodialysis. Doctor Perry stopped by this afternoon to tell us that their plan for next week is to have her standing and taking a step or two. Brenda was very happy to hear his plan. Please remember that she still is in Surgical/Medical ICU as a critical burn patient, she still has a long way to go. Your prayers are greatly appreciated.[...]

Brenda is still in the Medical/Surgical ICU listed as critical and their focus remains on her kidneys and on monitoring her Lungs. Again, the first thing this morning was her dressing treatment. This is the third day that no pain medication was needed! Next, was her Respiratory treatment. Her Occupational therapy focus was on using a Stretch band to exercise her legs, this is like a deep knee bend. They spent a total of 40 minutes. Her Ventilator are still at a PEEP of 7 and Oxygen level is at 30%. Urine output was good and they are monitoring her process of Toxin's. The Renal Doctor said that her output is acceptable, but tomorrow he will do Hemodialysis to remove Toxin's. Another day that found her in the Stretch Chair starting in the morning and ending in the afternoon, this lasted for 3 hours. The Physical therapy came and worked with her mouth.[...]

 Brenda is still in the Medical/Surgical ICU listed as critical. The focus is on the Kidney and watching the Lungs. The first thing this morning was her dressing treatment. This is the second day which no pain medication was needed. Her burns continue to heal, just small spots here and there remain. Next, was her Respiratory treatment, and Occupational therapy moved her legs / feet. They used a Stretch band to exercise her legs, this is like a deep knee bend. The Physical therapy moved her upper body working her arms and mouth. They spent a total of about 1 hour with her. Another good effort on her part. Her Ventilator setting is PEEP of 7 and Oxygen level is at 30%. They got her off the Vent for about Two (2) hours today, yesterday they were able to do this for about an hour. The plan is to wean her off the Vent a little each day. She is receiving antibiotics via the Ventilator, fourteen day cycle that will hopefully be ending Friday. Her white cell count is normal. Urine output was good and they are monitoring her process of Toxin's. The Renal Doctor said he is satisfied with her process levels and he did not order Hemodialysis. He does want to see more Toxins processed. She was in the Stretch Chair this afternoon for 3 hours at which time she was able to watch some TV and catch a nap.[...]

Brenda is still in the Medical/Surgical ICU listed as critical with focus on Kidney and watching the Lungs. This morning was her dressing treatment and the process took only 45 minutes. Next, was her Respiratory treatment, Occupational therapy moved her legs / feet, and Physical therapy set her up for about 35 minutes and at that time did her exercises. Again, she did an amazing job. She really is fighting. Her burns are healing as well. Her Ventilator setting is at a PEEP of 7 and Oxygen level is at 40%. She is receiving antibiotics via the Ventilator, fourteen day cycle that will hopefully be ending Friday. Her white cell count is normal. Urine output was good and they are monitoring her process of Toxin's, but she still needs to process a much higher level. If she continues to improve her process levels of Toxin's they will not need to do the Hemodialysis. This is a day by day decision based on her kidney toxin process levels. She was in the Stretch Chair this afternoon for 3 plus hours at which time she was able to watch some TV, and Jack managed to work with her on speech exercises. While the last two days have been very uplifting we are reminded that Burn Patients have a different recovery cycle, and that means that at anytime she could have a major problem that would pause her recovery. Celebrate the little steps, but pray that big problems do not arise. [...]

 Brenda is still in the Medical/Surgical ICU listed as critical with focus on Pulmonary and Kidney. The first thing this morning was her dressing treatment, it took only 45 minutes, and then they did her Respiratory treatment, Occupational movement of legs / feet for abut 28 minutes and then Physical therapy arm movement plus they set her up for about 15 minutes. This was one of her best days since her move to the Medical/Surgical ICU. Her burns are healing. Her Ventilator setting is at a PEEP of 7 and Oxygen level is at 40%, this down from the 50% she was at. She is receiving antibiotics via the Ventilator, fourteen day cycle that should be ending Friday. Her white cell count is normal. Urine output was good and she did process an increased amount of Toxin's, but she  still needs to process a much higher level. If she continues to improve her process levels of Toxin's they will not need to do the Hemodialysis. This is a day by day decision based on her kidney toxin process levels. She was in the Stretch Chair this morning / afternoon for 3 plus hours. Jack is working with her with speech exercises which she is working hard on. Doctor Perry, her team lead, said he is going to order an increase in her physical therapy since she is doing so much better. If her pulmonary keeps improving she may move back to the Burn ICU, still critical, but the focus is on burn care.[...]

Brenda is still in the Medical/Surgical ICU listed as critical. First thing this morning, they did her Respiratory treatment and then her dressing change. Her burns are healing. Her Ventilator setting as at PEEP of 7 and Oxygen is at 50%, up from 40%. Urine output was good, but she did not process Toxin's. This means she has Acute Kidney. They treat this by doing Hemodialysis starting to today continuing with treatments Tuesday, Thursday, and Saturday. The goal is to clean the kidney and have the kidney start processing the toxins. The Physical Therapist had Brenda setting up at the side of the bed this afternoon. The plan is to have her in the Stretch Chair this afternoon.[...]

First thing this morning they did her dressing change. Her burns are healing. The respiratory doctor changed her PEEP setting from 5 to 7 due to her struggles breathing last night. She is breathing better today. She was in the stretch chair for about 5 hours today, this helps her breathing. The renal doctor put her on dieretic to increase her urine output. They are monitoring her kidneys to make sure she is processing toxins. No dialysis today.[...]