8.01.2009

Day after Surgery

First of all here are the kidney photos;
WARNING!!! DO NOT CLICK if you get sick at the site of body parts. It's pretty graphic. But very interesting to me now. CLICK HERE for PHOTOS

Not much progress - very frustrating. He can't be moved out of ICU until blood pressure is stable because it is still too low unless they are giving him IV medicine. He can still only have ice or sips of water. His throat is killing him and he complains about it all the time. He is still out of it and starting to get very pissy.

They say this is normal for such a long surgery and the fact that they moved his intestines 2 times to get kidneys out. They have to adjust and start working again. I just called nurse and mentioned trying to get him moving a little at least to sit on side of bed. The surgeon said they would have him up the next day so maybe he will make it happen if nurse does not. He had the hemodialysis today for 3 hours. It seemed very normal to me even though its different than the PD. Bruce was about to come unglued the last hour though because the machine was so noisy and it was right in his face. Normally noises don't bother him. They only cleaned the blood, they did not pull any liquid out of him because it would make his BP drop more. He is starting to swell especially his hands. I've never seen them look like that.

He is not in pain from the incision yet because he has not moved at all. He is hooked up to everything:
small oxygen tubes in nose, large tube in his nose in case he starts to vomit badly from anesthesia, heart monitors on chest, IV monitor in artery to monitor every heart beat blood pressure, blood pressure cuff, IV with fluids and the blood pressure medicine or antibiotic, legs wrapped in things that inflate every few minutes, pulse and oxygen thing on finger...

Let's hope tomorrow things move forward.

7 comments:

  1. Sometimes these situations seem like a "catch-22", whatever you do to fix one thing causes a problem with another. You seem to be a strong advocate for Bruce while he is unable to do so for himself. I strongly encourage you to continue to do so. Recent cancer surgery for my brother at MD Anderson Hospital was an eye opener for me. Couldn't figure out why he was "out of it", loopy and so weak for so long until I found out the "pain drs" had an intrathecal line (directly into the spinal column" that was infusing pain meds on an ongoing basis. They achieved the goal of my brother being "pain free" but he was also not having bowel sounds, hardly able to get up and walk, etc. He slept around the clock. Only when I asked that they stop waking him up in the middle of the night to ask about his "pain level" did I find out he was on the continuous drip. Within hours of changing this he was more responsive and the weakness dissipated. It still took awhile for bowels to function, as morphine side effect slows the bowel function. Also a little pain can be a good thing when not out of control, it can increase the BP. Perhaps they could ease up on the meds and allow Bruce to decide when and if and how much pain control he needs. Can't do this when he is "snowed".

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  2. Thanks. We did seem to have same situation. They reduced it to where he could give as needed but he is still not with it. I think there are other factors in play now.

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  3. Clearly his bloodwork will tell you a lot about some of the other possible issues that can cause loss of mental acuity. Assume the BUN is elevated with the kidneys out and the limited dialysis. This alone causes confusion and poor mentation. Such a difficult balancing act to try to keep all the balls in the air at the same time. Hoping things will begin to level off and some slow improvement sets in. Also with the lack of perfusion, the drugs he has had and continues to take "on board" are not being eliminated at the usual rate, if at all, and the retention can cause higher levels than what are therapeutic.

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  4. I have spoken with Bruce several times but never met in person. My son has had two kidney transplants among many other issues. He is now 17. Please let me know when Bruce can have visitors. Your family is in our prayers. This is a great blog.

    Jon MacDonough
    239-289-2778
    jon@maccontractors.com

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  5. continued hugs and prayers going out to you. you inspired me to start blogging again. i only wish it was about something more positive. click on my name to access it.

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  6. Whoever posted about about the bloodwork and other factors about mental state, THANK YOU! I know it is a nurse, but can't figure out which one of you yet. It helped me today because the doctors did not get it at all.

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  7. Amy, I am the one who has been posting about the bloodwork, morphine, etc that has to do with the medial side of the post-op care. I am a retired nurse and your Mom is a dear friend. You are being a great advocate for Bruce, especially considering your lack of medical training. I will try to continue to follow what you report and add what I can. I am an old school nurse who remains appalled at what currently passes for medical care. I read that the Dr. wrote for certain orders for Bruce (to be up and moving,etc) but was shocked when he came in on MOnday and it hadn't been done. These are things I cannot understand as when a Dr. wrote an order, we nurses carried it out faithfully. This kind of care is why I cannot return to nursing today....I could never tolerate this lack of real care. I feel so sorry for those nurses who try to make it better, but this whole thing has become a business, not a vocation.

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