9.19.2009

Finally

Bruce got off the ventilator and is breathing well on his own.

This morning they turned the settings down and he was able to tolerate it but they were still getting the blood gas to "follow the rules", meanwhile he was gagging non-stop and throwing up everywhere because of the tube. It was pretty apparent something HAD to be done immediately. The critical care doctor (different than the one from night before that refused to do it without correct blood gas #) came in and said "let's go for it!" I had to leave but when I came back Bruce had just thrown up again but what a relief to see the tubes gone and hear his voice even though its like a rough whisper now.

I had to go over everything that has happened - once again. They gave him the sedative drugs all night last night so it was like the mental clearness he had yesterday never happened. He was back to remembering nothing. All week I have been reminded of that movie "50 first dates" (Adam Sander,Drew Barrymore) or "Groundhog Day"- where we start all over everyday.

I put up a poster few days ago that has large photos of Beck, Roan and one of Bruce and I that says we love you. Just to help him remember things are ok. Apparently last night the drugs got to him very bad -just as I had predicted and warned the night nurse about, but the nurses have no choice but to follow Dr. orders. They said it took 2 nurses all night to fight with him to keep him calm and had him fully restrained. According to him, he woke up and they wouldn't tell him where he was or why he was there. He thought he was in Tennessee he didn't know what month it was or anything. It makes me angry that any of that even had to happen. They should have had that tube out yesterday and NEVER should have put him back on drugs that they knew would make him this way again. One of them is meant to give you amnesia, so they should be more sensitive to this effect on patients.

I spent an hour reviewing everything but that was the most I got to really communicate with him. The rest was talking with Nephrologist and nurses. But all seem to be thrilled he is so much better. He was very tired, had a headache, was hungry, and slept most of the day when he wasn't throwing up. They are trying to get that under control so he can start clear liquids, then jello and such. Same ole routine he's been through before.

Thank God we had Kathy again. She worked her butt off all day for him and she gave me a big hug tonight when she left. She has been our angel the past 2 days. Tonight I told her that last time he had Nexium through and IV and that no blood pressure meds were working on him in IV. She said they had tried the antacids but it was orally and tried the full arsenal of IV BP meds and nothing was working. So she took my input called dr and asked if they could go ahead and try his normal BP med orally and give the Nexium in IV. That was approved and he was waiting on it when I left. If that had been one of the other nurses we have experienced, they would have listened to me and done nothing! I don't know if what I am saying can help but I think they need to know what we have experienced in the past and at least think about trying it. So thankful for good nurses!!!

He should be moved to regular room tomorrow if he stays stable over night.

7 comments:

  1. Thank God the tube is out and now he can start to recover from that. I'm curious about what other drugs they were giving him...we use propofol as our anesthetic induction agent for dogs, and although it works great and is very safe (despite what everyone thinks now that MJ used it as a sleep aid--WTF), I can tell you that most dogs sedated with only propofol wake up from it the same way, thrashing and wild, totally disoriented. We use it in combination with several other drugs to make recovery less stressful. Poor Bruce. I hope once he recovers fully he doesn't remember that part very clearly. Hope you get Kathy again today!

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  2. Yeah!!! Great news--sounds like Kathy is a great nurse and gets things done, and listens. Things will improve quickly now. I'm praying for Bruce to have a rapid recovery!! I really hope Kathy is there today!!!

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  3. Great nurses make life easier for everyone, but as you have experienced, not all are the same. That's why what you do is important. Even if the nurse is less than spectacular, you now have a lot of knowledge gained through experience and you are getting good at insisting on Bruce getting what he needs. Keep being the squeaky wheel.

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  4. It is too bad that people actually have to be the squeaky wheel. I would just love for people to do their best at their jobs. But thank goodness for good people!!!! Hang in there.

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  5. Testing something b/c I can't tell which Hoefling is posting :-)

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  6. I added "-amy" to my Hoefling name because I thought it was getting confusing with both of us.

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  7. Bruce had propofol, Versed, and fentanyl for a few days, they kept increasing amounts but he was still waking up non stop and combative. Then they changed to Versed, Dilaudid, and something else I think. That one worked better for about half a day. Then they took him off all of them on friday and he was calm as could be. They took off restraints and he was miserable but never tried to pull tube out. Then they decided to not take tube out and drugged him back up Friday night. That was the worst ever, the night he fought everyone all night long.
    The doctors were amazed at how much they were giving him and it wasn't working. The Nephrologist questioned me 3 times about whether he was heavy drinker because that causes liver to metabolize things faster. I told him he hasn't had a drink in a year probably and even years ago was never a "drinker" just social drinking on occasions. I told him that since the kidneys were taken out every drug seems to do the opposite - just like the ambien not working. i warned them it would be bad idea to put him back on it that night. Bruce has vivid memory of that night because he has talked about it non-stop. How they were mean to him and he kept asking them why he was there and where he was and he says they didn't tell him. who knows?! it must have been bad.

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