Another day.... I saw a man in the cafeteria this morning who has his mother in ICU.... We did the mutual how is it going? politeness and I said its groundhog day He looked puzzled and I realized he had never seen the movie. I explained the premise and how everyday is the same, you just try and get thru it the best you can. Tobias Rent update: the morning started out ok.... Chest xray showed no worsening... no improvement either. Bun and Cr still dropping and dialysis was planned to take off another 4 liters. Well, turns out he only had about 2 liters which could be removed by dialysis. His b/p handled it well. There was discussion that his oxygen level on the vent was 60% and the Dr. wanted to get it to 50% and then he would consider lowering the PEEP, but he is concerned about the possitiblity of ARDS and wants to be cautious. The afternoon they tried to decrease his paralytic a VERY minor amount and his O2 saturation plummeted to 83%.... happened while Lee Mottern and Linda Eldredge were sitting in with him and when 5 nursing/respiratory staff were in the room, LInda send Lee out to get me. Future reference to everyone. My phone number is on the board, pick up the phone and call me if you are in the room and ANYTHING happens. So I walk in to see the respiratory therapist hanging up the ambu bag and Tobys O2 sat at 88% fluctuating bit by bit and it rose up to over 90%. They had already increased the meds back to the preceding level and she said she would let the night staff know to leave it alone. I noticed some dead skin peeling away from his left index finger which was the finger he had been complaining about severely on Sunday-Tuesday (before he was intubated) the skin was dried and flaking off and an open wound was visible. I let the nurse know and she put a dressing on it. Later in the day his b/p and heart rate rose and I went back in and asked the nurse what was going on... she had just turned him so more pressure was on his right hip and I let her know that he has been having severe right lower back pain due to sacro ileitis and maybe repositioning increased the pain. The nurse got an order for medication to reduce the blood pressure and heart rate and gave it to him. He has been without a fever for 2 days... temp about 97.4 is normal for him.... and this evening the nurse said that he had a temp of 99.2. That makes me very nervous. Feet and hands are swollen, but after dialysis I could feel his knuckles on the left hand again. They were concerned that the paralytics had slowed his digestive tract and so had stopped his tube feeding, but things started moving again and so the feeding was restarted. Katya Orshasky (real name is Katie Orshaw) came up this evening and by singing the lullaby she sings to Star, was able to sooth Toby and get his heart rated under 100 and b/p down. Marie now owes her some foot kissing and a bottle of wine. Suction wise.... not a lot coming up, its old blood and fewer times of suction being required. Urine output is very low, because the dialysis is going on. Concerns: fever, unable to wean off the paralytic, unable to wean down the O2 levels, feet and hands remain swollen. Positives: The care he receives is excellent, Julia was the nurse today and she was gentle, compassionate and responsive to input from Marie about caring for Toby. Shoutouts to amazing friends/family: Mary McBride Andrews Andy Andrews, Paul Andrews, Ashley Carter, Henk, Karrie Chambless, Steve Brooks, Leah Korn Palmer, Mary Hengstebeck, Kathy Peeples, Jon Durbin Donna Durbin Bobbie Hamilton Lee and Linda, Joe Angel, Austin Kessler. If I didnt mention you, my apologies, it is uber late and Im about to tuck in for the night. Marie M Mulling is watching over her little brother until Austin gets here for the midnight to 6 a.m shift of sleeping upright in a chair in Tobys room so Marie and I can sleep on the bench sofas in the waiting room and get ready for another day. We have had great nursing care for Toby and ask for certain nurses to return because we feel more comfortable with them. Tomorrow will be same song, second verse, Chest xray, labs, dialysis, trying to wean the oxygen down, keeping him paralyzed so he doesnt fight the vent and sedated/pain medicated so he is as comfortable as possible. If you are in the area, please feel free to stop by and visit. 300 University Blvd. Elevator to the third floor, exit elevator to the left and take the first hall way to the right, we are in the big open waiting room or in Tobys room. BTW, Tobys name is TRAVIS RENT. Thanks again for the love and concern and support. We are so blessed to have each and everyone of you pulling for Tobys recovery. XOXOXO
Posted on: Mon, 06 Oct 2014 03:34:26 +0000