Mike has been going on and off teh vent these past few days, increasing the amount of time hes off it each time, but also experiencing crashes in his blood oxygen levels at an increasing frequency, with a cause that remains unclear. Part of it is caused by anxiety, a small part seems to be caused by phlegm in his lungs, a part caused by fatigue and possibly fluid build up from the pause of dialysis, and the larger remainder is of unknown origin, and occurs suddenly whether on the vent or off. I have noticed that it occurs less frequently when the machine is doing all the work of his breathing, as opposed to just part of it (SIMV versus CPAP modes). It is deeply worrying, and I have nagging doubts he will be able to get off the vent by Tuesday (or possibly Monday), and remain off it. If he fails in this mission, he will end up being transferred to Minnesota, where he would remain until he no longer required the vent. More likely, he would remain out there, in a lesser care environment (a nursing home instead of a hospital as mandated by medicaid) until he would give up on life after being left alone, or develop a problem that would not be treated efficiently or correctly as a result of the loss of monitoring, as he has benefited from here. I wonder if we did the right thing in saving his life, and I intend to ask him. Something needs to be said of suffering, and the point at which it eclipses the value of life. I fear we might cross that point if we havent already. In light of the present situation, I am going to ask that he be supplied with narcotic anxiety medication, as it would serve to help him remain off the vent by lowering his anxiety and breathing rate, while causing other problems less serious, most namely the failing of his feeding tube, which is currently failing anyway. Hopefully the next post involves better news. On teh bright side, he has increased his time on the trach collar (unassisted breathing) from 4.25 hours yesterday to 7 today. He will have to do 24 hours every day if he is to stay here.
Posted on: Mon, 19 Jan 2015 03:38:30 +0000
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