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Posted 2015-09-22T13:03:39Z

September 21, 2015 & September 22, 2015 - Starting Post Op Week #9

I got good news from Steve RN that Perry slept until midnight & was up for a short bit, received his medications & soon afterward returned to sleep. He was still asleep at 740a. Perry's formula feeding was turned off at midnight as it was uncertain as to when he might be added on to the bronchoscopy schedule. Prior to my arrival, Kim OT had been in for session & had gotten Perry to dangle on side of the bed & worked on hand exercises. She added a foam adaptive grip to the oral Yankauer suction catheter to allow Perry to become more independent doing his own oral suction as he has been in need of increased oral suction to remove saliva, acid reflux, & post nasal mucous drainage. He requires hand over hand assist to prevent injury to himself as well as to grip & hold onto the catheter, & to provide arm movement assist. The nutritionist was in briefly & our conversation was cut short as Dr. Lane, this week's Transplant/Pulmonology Attending physician arrived. We made him aware that Dr. Akindipe had discussed with us that Perry was to be scheduled for a bronchoscopy in the OR today if possible. Dr. Lane's team had not been informed of a time as it being a Monday it may not occur. We also informed him that Dr. Akindipe did not want Perry to be doing trach collar breathing until he's much stronger. I requested that he write an order for Perry to be dangled at least 4 times daily to facilitate his progress & expressed concern that such has not been the case. I also mentioned to Dr. Lane & the team that Perry had undergone dialysis on Friday for a BUN of 72 & higher creatinine level as the resident presenting Perry's case in rounds this morning stated it had been a week since he had been on dialysis. I also mentioned that Perry's femoral IV line has been sluggish & almost clotted off on Friday with medication needing to given to reduce clotting to increase their awareness. Dr. Lane stated that the myoclonus (jerks/twitches) are most likely the result of the ProGraf which I informed him that was contrary to what Dr. Valapour had informed me of when I specifically asked that question & she had said the ProGraf tremors are typically fine (slight) tremors. Dean PT provided range of motion exercises to his legs & then with 2 other assistants helped Perry with leg presses with the Mini Shuttle Press. He was then raised by Dean to a brief stance & pivoted him into chair with a lift sling, sheet, his new seat cushion beneath him & an extra pillow & another seat cushion behind his back. It was the best positioning in the chair he's had to date. After ~45 minutes, Dean utilized the ceiling lift in his room to return him to bed which took ~5 minutes instead of 1-1 1/2 hr wait for the lift team. I was elated that the existing ceiling installed lift resource was finally utilized. At ~1230p, Jack from RT came in with the intention of putting Perry on the trach collar breathing for 20 minutes per Dr. McCurry's order to which I reinforced that Dr. Akindipe did not want him on trach collar until he is stronger & that I had mentioned the same to Dr. Lane. I requested for Dr. McCurry to contact me to ensure that he & the pulmonologists had conversed & to make sure he knew that Perry had been off of his feeding for 12+ hours. Reluctantly Jack RT stated he would contact Dr. McCurry of my request, but that it is Dr. McCurry who is Perry's Attending Dr. who determines his orders. At about 3p, we learned that he would not be going for the bronchoscopy today (Monday) & not yet given a scheduled time when he would have the bronchoscopy, so his feeding was resumed at 60 mL/hr. At 405p, he was dangled by 2 Nursing Assistants & me. Dr. Lane returned ~6p to inform us that Perry was scheduled for the bronchoscopy Tuesday @ 330p. And that he agreed with Dr. Akindipe that Perry was not ready for trach collar breathing as discussed in a team conference of the pulmonologists & that Dr. McCurry has been out of town & not fully aware of Perry's progress as he has not been here to see him. I was able to complete my move early this AM with the help of Karla whose husband had lung transplant & was next to Perry in the CVICU & is making great progress. I got to bed this morning ~4a so need to be on my way soon for my 9a requested appearance by Perry. I called to have the nurse inform him I will be there shortly. Nathan reported this morning (Tuesday) that Perry had fallen asleep watching the Cubs game & slept well until 2a. Perry was becoming very frustrated with trying to complete his oral suction so Nathan assisted him & eventually Perry was able to calm down & return to sleep. He is to have dialysis this morning & his feeding had been stopped at midnight for the bronchoscopy.

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Comments (3)

  • Joni DeBusk
    Joni DeBusk

    WHEW! Good thing you are "on top" of Perry's needs. Thankful you got moved into a ground floor but going on 4 hours sleep? UGH! Hope you get to bed early tonight. Praying that the bronchoscopy is completed today. Sending big E-Hug! Prayers lifted constantly. Love, Joni & Ken

    5 years ago · Reply
  • Denise Witt
    Denise Witt

    Praying, petitioning & praising! What a post! So much in one day! Thanking God for you, Misty & your attention to detail. Thanks for keeping us in the loop so we can be on our knees! God is so good! And as the Dr.Akindipe stated earlier, your man is "remarkable"! WE are grateful for Team Perry at CC; so very many to keep in the loop & to keep the ball moving in the right direction to goal! 🏆 You two are are a formidable force & God is for you! Grateful to God for your visitor today! ❤️ Love you! And as we pray for you we are always praying & thanking God for our dear donor & family! Garry & Denise & sons & daughters Proverbs 2:7-8 (NIV) "He holds success in store for the upright, He is a shield to those whose walk is blameless, for He guards the course of the just & protects the way of His faithful ones."

    5 years ago · Reply
  • Dianne Cook
    Dianne Cook

    Misty, what can I say other than that you are an amazing person. How you are keeping up day to day with not enough sleep, questionable food and the stress of keeping everything straight is just astounding to me. You don't take shit from any of the staff when they try to bully or talk down to are tough as nails! I wonder if it is better to have your "inside" knowledge from being a nurse or does that make it harder sometimes? Maybe since I met you 100 years ago, you are a doctor now!! I have no idea. I just hope that you have a secret bottle of wine stashed somewhere in Perry's room to take "the edge" off in the evening. I can't think of a single person that needs an adult beverage more than you do!! I'm thinking of you...I'm praying for you....and I just wish you were in a hospital in Chicago so I could come give you a hug! I have a glass of wine with you! I'd steal you away to my house so you could bury your face in my dog's hair since you miss your dog. I'd have you sit and teach my 8 year old son how to be a wonderful grown up son like your boys. And lastly, I'd love for you to explain to my girls what it means when to be an OUTSTANDING health and in are the person they should talk to. ❌⭕️🙏🙏

    5 years ago · Reply