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Posted 2015-10-14T05:22:00Z

October 13, 2015 - "Am I Going to Get Out of Here?"

Perry slept through most of the night despite the continued loud stressful groans of the patient in next room.  Josh RN was able to take over the care of Perry from Erica RN ~130a as her other patient required all of her attention & that of many other staff.   Perry intermittently awakened with needs for oral & trach suctioning, position changes, removing & later reapplying covers, & elimination.   [...]

Posted 2015-10-13T06:09:00Z

October 12, 2015 - Start of Week #12 in the J5-5 CVICU

Josh RN provided an update that Perry’s night was uneventful as he slept through most all of the night with just a few awakenings.  Dean met with Perry for an early AM PT session & transferred him into the chair at the end of his session ~915.  Perry had not noticed but as soon as I entered his room I noticed several Cleveland Indian Tribe pictures placed about his room, with "DiGiovannis Love the Tribe" & "Go Tribe" on them.  I immediately knew the culprit was "Warrior Todd" RN.  His efforts & the taped “x” sabotages on the poster with all of the Chicago teams logos made me laugh & brought a smile to Perry’s face.  He tolerated being in the chair until ~1130 due to complaint of lower back/buttock pain, so Dean & another therapist, Julio, helped him to stand up from the chair which he had not done since 8/4 & pivoted him back into bed.  Perry’s seat cushions had been placed under the lift sling, so unfortunately he was not getting the full benefits of the padding.[...]

Posted 2015-10-12T05:10:00Z

October 11, 2015

Perry slept fairly well throughout most of the night awakening with needs of suctioning & elimination. Jay was his day shift RN. He had requested her to awaken me @ 7a, but she told him I might need to sleep a bit longer & that she would take care of his needs until I awakened on my own. Today went well with toleration of trach capping for 31 minutes starting @ 1143 & for 24 minutes starting @ 324p. Bill RT was pleased even though the length of capping was shorter as his chest muscles & diaphragms had an extensive work out yesterday. He began to have lower oxygen saturations to 94%, increased nasal flaring, & more abdominal movements so Bill did not want to push him harder. After each session, he was completely zonked for several hours. I was able to get the Klonopin as well as the Ditropan (for bladder spasms) changed from 9a, 1p & 9p to every 8 hours since the myoclonus & bladder spasms occur throughout the day & night. He was able to hear the Bears game & eventually awakened about 310p to also watch it. The evening progressed with a few additional naps & more OT & PT exercises completed while awake & asleep. At 915p, Josh RN turned him onto his L side so I could complete range of motion & stretching exercises to his R hip as well as a back massage which settled him in for hopefully a good night's rest.[...]

Posted 2015-10-11T05:08:00Z

October 10, 2015 - Great Day for Trach Capping & the Cubs

Josh RN’s morning update was that Perry slept fairly well with a few interruptions to be suctioned & to use bedpan otherwise it was an uneventful night.  It was nice to have my mother here to share some time with Perry & to provide him with encouraging words, touch, & love.  I also have a variety of comfort food healthy meals (with LOTS of vegetables) in the freezer.  We got to the airport by 830a & of course It was hard to say goodbye but it always has been.  On my way back, I stopped for gas & finally I got to have an extra large coffee from Dunkin Donuts!!!!  I was with Perry by 0930a, & he seemed rather anxious upon my arrival.  He said the unit was short staffed & that he had 2 nurses from a different unit, Lucy RN & Ally RN (new employee orientee).[...]

Posted 2015-10-09T05:29:29Z

October 8, 2015

Tracy RN called with report that Perry had slept well during the night, & his labs were somewhat stable within the trends for Perry.  I spoke with Dean PT just before entering the CVICU.  He informed me that he had met with Perry, & that he worked hard with 2 assisted brief stands & then stand to pivot into recliner chair.  He was very drowsy when I entered his room & the Pulmonologist & resident were in to see him.  I inquired about his chest CT scan & was informed the L lung fluid collection was showing an improvement but there are several areas of consolidation present in both lungs that will require effective coughing to lessen them.  I asked if he would be able to use his chest vest to help loosen the consolidation to which he agreed may be helpful.  I again expressed concern regarding Perry's persistent sleep & tremor/twitches that have increased over the last 4-5 days that he has now also been experiencing while asleep, & that Perry has an increase of same when trying to focus & ~1-2 hours prior to when his Keppra, Klonopin, & Depakene are due to be given.  They plan to notify Neurology to consult again.  Perry then began to sleep.  Bill RT capped his trach @ 0950 with Perry being able to tolerate 20 minutes with lots of praise & encouragement.  At 1040, he was returned to bed & fell asleep rather immediately.  Dr. Koval from Infectious Disease visited & I informed her of the increase of sleeping that has been present now for last 16 days that despite his therapies has remained a very prevalent part of his day.  Dr. Poggio, Nephrology, informed me that he will need to have dialysis tomorrow.  During the afternoon, Kim OT & I worked with Perry to do hand, wrist & arm exercises with 1# weights as he kept his eyes closed the entire time & was pushing through to complete 2 sets of each exercise.  OT was followed by more sleep.  [...]

Posted 2015-10-08T04:53:00Z

October 7, 2015 - 7th Inning Sleepy Time Stretch

Morning update call from Jackie RN indicated that Perry slept very well during the night & was still sleeping @ the time of her call.  She replaced his Foley catheter (drains urine) as it had continued to leak intermittently for the last 3 days.  The new catheter also began to leak, so she contacted the doctor.   I have been repeatedly mentioning for ~1 month that he has most likely been having bladder spasms based upon his complaints of the feeling of not being able to urinate & due to noting very small amounts of urine output followed by large bursts.  Finally the problem is being addressed & the medication Ditropan was ordered.  [...]

Posted 2015-10-07T05:14:33Z

Post for October 5, 2015

October 5, 2015   Per Lora RN, Perry slept for longer intervals although he was still up frequently during the night.  His trach adapter disconnected several times from the vent circuitry which set off the vent alarms, & he was aware to press the call light when the nurse was not able to respond immediately & had managed to throw a couple of pillows onto the floor to create noise in hopes of a response.  He had been placed on CPAP setting (continuous positive airway pressure) throughout the night which was a change from other nights.     [...]