Post for October 23, 2015 - "Thank You" from the Bottom of Perry's New Heart & With the Breath of Perry's New Lungs
It was another uneventful night with Erica RN taking care of Perry. I have continued to sleep pretty well too. For those of you who worry about me sleeping in a recliner (& I know who you are), you must remember that I am used to sleeping on a 30-40 degree incline for at least the last 15 years on our mechanical bed at home. Sleeping in the recliner has actually prevented me from sleeping on my stomach, so I am not experiencing the effects of excessive back hyperextension that I normally would be. Besides I have the quilt my mother made me to keep me cozy, warm, & with a feeling of safe security.
Peter was his day shift RN. Dean PT & Tina began PT with dangling Perry at edge of bed with increased shortness of breath experienced & body tremor shakes. In time, the shortness of breath subsided & a lessening of the involuntary body tremors. He was assisted to very brief stance & then pivoted into the recliner per Dean & Larry @ ~1010. Margaret RT capped Perry’s trach @ 1118a with 4 liters of oxygen via nasal cannula. I videotaped Perry @ 1210p only expecting him to say a few words, but as it turned out he was able to say quite a lot & stated things that he obviously needed & wanted to say. I later watched the video over & over & over again with tears of both sorrow & much joy. We do have a LOT of hard work ahead. I will try to send the video on PostHope, but I am not certain if videos are able to be posted. If not, I was able to post it on my FaceBook & Perry’s FaceBook page. Friends are counted as family to us so keep that in mind as you watch the video.
After about 2 hours of sitting in the recliner, he wanted to be returned to bed due to discomfort to his buttocks. He also wanted to discontinue trach capping. Dr. Conway, Intensivist, wanted to observe Perry when he was ready to come off trach capping. We were able to encourage & reassure Perry that all of his monitored numbers were absolutely fantastic & although he was tired if he could continue to keep going to give it a try & do his best. He agreed with additional praise, encouragement, & reinforcement & was returned to bed via sling with use of the ceiling lift, Dean, Larry, myself & another RN. With Van Morrison Pandora music station, dimmed lighting, ice cold forehead washcloths, holding his hand, & being fanned intermittently, he was able to continue & tolerated trach capping until 132p. A HUGE accomplishment & record of 2 hours & 14 minutes. He went the distance!!!! My Rocky!!! He received lots of kisses & praise from his Adrian. Margaret then started him on CPAP (continuous positive air pressure), he received Tylenol for discomfort to the lower lateral aspect of his ribs & abdomen for their extensive work out. He soon he fell fast asleep. Kim from OT stopped by about 3p but being completely exhausted & desiring to sleep, he declined therapy.
Laura, Music Therapist, came to play guitar & piano & sing some songs for him @ 345p receiving a subtle nod that he was okay with it. She performed the Beatles songs “Here Comes the Sun,” “Blackbird,” & “Imagine.” He continued to sleep peacefully. He awakened @ 410p with complaints of sudden nausea. His formula feeding was stopped, encouraged to breath slowly, head of his bed elevated more, & ice cold washcloths applied to forehead. Tracy RN had taken over for the remainder of the shift. He returned to sleep without the development of related symptoms without having to receive anti-nausea medication.
A lung ultrasound was repeated ~640p as the original order was entered without the necessary detail for exactly what was desired according to the sonographer. He remained awake & watched Wheel of Fortune & then Jeopardy. I then went to get soup from Au Bon Pain & noticed that the room previously occupied by the gentleman whose wife I had given my apartment key to was now barren of him, his bed & his family & the room had been cleaned. I’ve shed lots of tears not only for Perry’s circumstances but for many patients & family who have shared in this realm of our world known as J5-5. When a death is imminent & life support measures have been withdrawn, there is a purple heart displayed on the CVICU entrance doors, at the desk & at times outside of the drawn curtain to increase awareness & respect. Death is a part of life. It’s just hard to know that with death must come the pain & suffering of the grieving loved ones. It is however comforting to see family gathered together, surrounding their loved one, & then trying to walk & comfort each other out of here after their final earthly goodbyes have been said. Although we cannot place ourselves in each other’s shoes, we can at least witness the existence of love’s presence in our realm of the world. I am saddened that tragedy, time, distance, or other burdens can & do enter into this realm for other patients who have had to leave this world without a loved one by their side.
Upon my return, we watched Shark Tank. Erica RN was his night shift RN. He continued on CPAP until he received his bedtime nebulizer treatments @ ~930p. Cat RN came to visit & was touched by getting to watch the video & then reinforced with him the great progresses he has made. About ½ hour after lights out & lots of fidgeting & tremors, he finally fell asleep by 1030p. He had frequent awakenings with lots of fidgeting throughout the night.