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Posted 2015-09-13T06:04:05Z

September 12, 2015 - Uplifting Signs

Perry was able to get some additional rest from some of the extraneous movement for a majority of the night with the Propofol titrated up to 40 mg/hr. He was not able to respond to commands or open his eyes throughout the night & early AM, but thank God he was less actively agitated & much more @ rest with an occasional furrowed brow. According to Joanna, his day shift RN, the Drs have finally seemed to agree that Perry most likely has what is known as ICU Delirium even though he presented with the signs & symptoms much later than the average patient. I had continued to inform several of the Drs & nurses that Perry was exhibiting signs & symptoms over the last ~2 weeks & had requested an anti-depressant which can take up to 2 weeks to become therapeutic & it is why I will continue to request that he be provided with augmentative communication tools that will benefit his "total" well being despite such tools not being provided for patients who are long term in an acute care setting. For more information refer to: http://www.icudelirium.org/cognitive.html Joanna tried to find a "happy medium" for Perry this AM & afternoon as she titrated the Propofol downward from 40 mg/hr to 10 mg/hr with ordered Haldol 2 mg, Keppra 750 mg, Klonopin 1 mg, Seroquel 25 mg, & now Depakane 250 mg every 6 hours. He was not clenching down during his oral cleansing & suctioning today as he probably welcomed the moisture as his mouth gets so dry as he has constantly kept his mouth open to breathe especially on CPAP mode. He tolerated being on CPAP rather well today with good tidal volumes according to Bill RT. TPN continued @ 65 ml/hr throughout the day, & it was discontinued this evening to lessen the risks for Perry associated with giving him TPN. The formula continued @ 50 ml/hr. The NG tube was not reinserted today as his abdomen was soft & not too distended. His kidney function result for BUN went from 60 yesterday down to 38 today & creatinine dropped from 1.69 to 1.17 - which was great improvement with the dialysis & Lasix. As the day progressed, he was definitely more aware of his surroundings & located the end & edge of his bed & began to slant his body in that direction for his many attempts to make a great escape. He reminded me of the Chief from One Flew Over the Cuckoo's Nest & unfortunately I was Nurse Ratched trying to keep him safely contained. I'm thinking a new slogan for a t-shirt for Perry: "I survived J55!!!!" I took off his soft restraints to exercise his arms & legs to some good 'old Rock & Roll tunes on Pandora's Aerosmith Radio. He was responding by participating in some moves with increased tone @ intervals but kept his eyes closed. He eventually took ahold of my cell phone that I had purposefully placed on his chest to feel the vibration & beat of the music & moved it off his chest, pulled on his gown for it to be taken off, & drew his arm out of the sleeve & then scratched his chest incision. He briefly opened his eyes for Bill RT as I was giving a sweet lady several hugs & kisses when she sought me out in Perry's room to tell me that her husband had had a stroke & was bleeding. She was waiting for her daughters & granddaughter to arrive as she had made the decision to take him off life support. I walked her back to his room & comforted her some more & visited throughout the evening until her family arrived. We said the Lord's Prayer joining hands at her dear husband bedside. Rachael, his night shift RN titrated the Propofol up to 25 mg/hr to decrease his almost constant attempts to escape from his bed. He was able to nod a "yes" that I could go home to do laundry, & he briefly looked at me a couple of times tonight 😊- which were so uplifting!!!!! Soon after receiving his night medications he was beginning to calm, rest & sleep. So I'm sure you can guess why I'm still up....the never ending chore of laundry; however I'm rather enjoying the sounds of "home" & finding it rather comforting!!!

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Comments (3)

  • Darlene
    Darlene

    theres no place like Home Sweet Home..You and your hubby.I sure can see our Lord is using you in so many ways.You are Blessed and I Pray Our Father in Heaven gives Perry and Family Favor.Have a very Blessed day.Harvey starts tomarro for heart rehab,we is now driving but I plan on going with him his first work out[to see how he does and if we needs me to drive home or give comfort.]Praying for a super day,God Bless Harv and Dar,Amen.

    4 years ago · Reply
  • Lisa Lewis
    Lisa Lewis

    What a roller coaster ride for sure my sweet friend! That ICU psychosis is scary ... Perry will come through, may take him a while but he will! I simply cannot imagine what your days are like ... you both are constantly in my thoughts, my prayers ... going to church this morning to listen to how wonderful our Lord is and pray for both of you in 'his house' today and also know that Perry is on our prayer list at church ... BIG HUG to you! Kiss Perry and hug him from me! 😇

    4 years ago · Reply
  • Joni DeBusk
    Joni DeBusk

    ICU Delirium is a very real but scary thing. I was care giver to my aunt who Is only 4 years my senior. I put her into the hospital Nov and did not get out until Feb. She had three operations and in ICU 12-14 days with each one. I remember telling the doctors I could take her home in a wheel chair but not with scrambled brains. It was unbelievable. Perry flew through the surgery, he will pull out of this with the Lord's help and the help of his loving wife and I of course his entire team. "Be still and know I am God" - may you feel His presences always. E-Hugs and lots of prayers. Love, Joni & Ken

    4 years ago · Reply