Post for Tuesday, October 27, 2015
Essentially Perry’s night was uneventful. A chest xray was done @ ~0330a. Day shift started with dialysis beginning @ 715a followed by day shift assessment from Peter RN.
Dr. Douglas, Intensivist, rounded & was pleased with the amount of drainage from the pigtail chest tube status post yesterday’s tPA administration. Perry’s chest x-ray has improved rather significantly for his L lung compared to chest xray done yesterday. Dr. Douglas is waiting to hear back from Dr. McCurry as to how they plan to proceed. The nutritionist visited & ordered for a final Metabolic Cart to be done. Perry slept through most all of his dialysis treatment. His dialysis line clotted off @ 1035a & had to be restarted. Dr. Koval, Infectious Disease, rounded & was also pleased with the amount of drainage thus far from the pigtail catheter, the improvements for his L lung on his chest x-ray, & that she could now hear breath sounds over the affected areas of his L lung. Nothing has grown on the blood cultures done on 10/21. Dr. Maryam Valapour, Pulmonologist, then rounded & she too was pleased with the results from the tPA.
Dialysis was completed @ ~1115a with 800 mL fluid removed. PT session with Dean began ~1130a with leg exercises completed, followed by dangling on the edge of his bed with the need apply counter-pressure to lessen the myoclonus to his lower extremities, & then assistance from Dean & Larry to stand briefly. After additional rest, Perry requested for Matt RT to begin his trach capping. At 1245p, he was capped initially on 4 L of oxygen via nasal cannula & after a few minutes the oxygen supplementation was decreased to 2 L. Perry ran out of steam by 125p after 40 minutes of trach capping. Matt RT then switched him to BiPap with the need to change to a different face mask. Due to dialysis, PT, & the many position changes required for cleansing after having had 4 loose stools since morning, Perry had truly maxed out all of his energy stores & was returned back to the vent. He almost immediately fell asleep.
Kim OT had stopped by later in the day & Perry awakened briefly to decline OT therapy as he was still exhausted. During the evening after a bit of prompting, he completed wrist & arm exercises with 1# weights.
Perry expressed feelings of discouragement & the need to cry, & statements “I don’t know that I have the strength to do this,” It’s all so overwhelming & I am so weak.” He expressed concerns, “I won’t be home until after the New Year” & “I miss my family” & so many, many more. It was good that he was able to vent & get out a few of his many concerns. Yes indeed it is all truly so very overwhelming, the progress has been slow due to his weakened body prior to transplant, & there is not much of anything that he has any control over. Lots & lots of comforting was provided. His night shift RN, Hannah, did her best to reinforce the progress that she has noticed since the last time she had cared for him which was a few weeks ago. I will ask for Psych to become involved in his care in order to facilitate his healing & recovery process & progress. He also needs to be held & embraced. Our daily devotions were once again on point…. Mine: “Lord, I know that only You can deliver and heal, but use me as Your instrument of restoration. Help me not to be pulled down with my husband when he struggles. Enable me instead to understand and have words to say that will bring life.” His: “Lord, I pray that you would help my wife to be successful in her work. Thank You for the abilities, gifts, and creativity You have placed in her. Continue to reveal, develop, and refine those gifts and talents, and use them for Your purposes. May her skills increase in value, and may she excel in each of them. Open doors for her that no man can shut, and bless her with success.”
He asked to receive Melatonin tonight to facilitate getting a goodnight’s rest & that I continue to stay here beside him. Thank you God for answering the many prayers for Perry. Help us Lord to accept & be thankful for what all is to come on Your timeframe. Thank you all for your continued love, support, graciousness, friendships, & continuing with us on this journey. May you all know how much we sincerely appreciate your presence in our lives. God’s blessings for you & yours!!!