Well, this was an interesting day, and an indication of the emotional ups and downs that are ahead of us. This morning Lea had overcome her usual post-operative temperature, but her blood pressure was running a little high, about 145. She was receiving a reduced dosage of sedatives to try to bring her up a little closer to consciousness. This is the course of action the surgeons want taken to avoid her dependency on narcotics when she is finally able to come off pain medication,

After breathing on her own for four hours last night, the respiratory therapist, Jason, prepared her to breathe unassisted again this morning, but almost as soon as she lost support from the ventilator, she began struggling a little and her blood pressure rose to about 155. The therapist watched her for a while, until he was satisfied that she was going to be okay, and went about his other duties, saying that he would check back in a bit.

Almost 15 minutes into the session Lea started working really hard to breathe and her blood pressure shot up to 165, 175, then 200! I went looking for a nurse, because she no longer has a dedicated nurse, but shares one with a patient in another room. The nurse gave Lea some medication to bring her blood pressure down, and had the respiratory therapist come back in and evaluate what had happened.

The upshot of the session was that Lea had worked so long last night (4 hours) that she probably had sore lung muscles this morning, and the pain was causing her to panic, and raise her blood pressure, since she couldn’t do anything about her situation. As soon as she went back on the ventilator, she began to calm down, but her blood pressure remained elevated for several hours.

Dr. Mah came to the room at about 9:15 a.m. and said that he wanted to do another procedure at the bedside today, since he is leaving on a week’s vacation, and offered to do it at 10:00 or noon. The nurse had been working on controlling Lea’s blood pressure, and didn’t feel that she could get her ready by ten o’clock, so it was agreed that they would do it at noon.

I ran David to the airport right after that, hoping to get back in time to talk to Dr. Mah before and after the surgery, which I am usually able to do. David flew back to our home in Indiana to join up with mom, who flew out earlier this week, to tie up some loose ends for us, He will then fly next week to his own home in Hawaii. His help has been tremendous during this time, when I can’t seem to concentrate on anything but Lea.

So, when I got back from the airport, I called into the ICU to see if the surgery had started, and found that they had already completed it, and that Dr. Mah had to rush to an emergency surgery on another floor. So, I went in to see Lea, and talked briefly to the nurse, who told me they had tried reducing many of the medications given to Lea during surgery, but had to really go heavy on one because her blood pressure suddenly dropped dangerously low during the procedure. She then left to check on her other patient.

As I worked with Lea to get her settled, I brushed her hair out for her again. I had washed it for her earlier that morning, and she seemed to enjoy that, so I tried braiding it, and figured out real quickly that I couldn’t figure out how to do it. J I had one of the nurses show me how to do it. I’ll try again one of these days. Maybe.

As I was wiping Lea down with a damp cloth, to lower her temperature, I noticed that her face was red, her arms and legs were red, and her temperature was climbing fast. I grabbed a passing nurse and told her that Lea was having an allergic reaction to something they had used during the surgery. After a quick examination, the nurse went down to the pharmacy and got a syringe of antihistamine and immediately injected it. Lea’s rash started clearing up within minutes, and she returned to normal within about 45 minutes or so.

Most of the afternoon was spent trying to figure out what she might be allergic to, and it turns out that it may simply be a reaction to the large dosage she received of a medication she has been administered all along. It was just simply the amount of medication that was the key factor. So, now they are searching alternatives for use in future surgeries.

It’s pretty frightening now that Lea is only getting half a nurse. Since she is no longer getting a dedicated nurse, to have to go find someone to help if the assigned nurse is busy taking care of her other critically ill patient who is having trouble across the floor. It makes you worry about what happens during the hours you can’t be there to help.

So, it was rather a frustrating day, and yet, as my son Link said to me today, “We are so much farther along than we were at this time last Friday! That’s why the doctor said to look at progress on a week-long basis, rather than day by day.” It helps to put into perspective the emotional roller coaster that you ride as you become a caregiver for a critically ill loved one.

We are all a little concerned that Lea is not responding as well to commands as she has been. Things like “squeeze my hand,’ “stick out your tongue,” “wiggle your feet” are not producing consistent results. She is opening her eyes spontaneously now, but they are not focused, and she has no ability to move the eyeballs. This is the reason for reducing her medications and bringing her a little closer to the surface. Hopefully she can regain some of the mental functions at a level of medication that will still keep her pain under control.

Thank you very much for the email messages, the eGreetings, cards and gifts that have been received. I will make sure Lea sees each and every one of them when she is conscious again, and she will send you a thank you note for your kindness. She seems to relax when I am reading a handful of your messages to her, and often wrinkles her forehead as though to say, “Aw-w-w-w, that’s sweet!”

Thank you, and God bless,

Larry

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