That was my goal on the white board yesterday. It was meant a bit tongue in cheek as the Dr had said in the mid day rounds that the plan was to keep him on his back for 8 hours and then flip him to his stomach and then flip to his back again. Hence rolling him over time and again and hoping he maintained or get better with each rotation.
It turned out, the message was as much for my attitude as his physical response.
When I called the night nurse at O’Dark Thirty this morning, she relayed that they did not flip Ted as had been previously scheduled. When they looked at his stats at time of the proposed turn, he was maintaining decent stats and they felt it was worth keeping him on his back and seeing how he did. The night nurse was decently positive about his non-eventful night and said that they had even cut back on the sedation slightly. I drove in nearly giddy that he might be turning a corner.
My elation was slashed when I arrived a few hours later to find that the day nurse was just about to administer the paralytic once again. Ted had started taking too many extra breaths and they needed that to stop or they would have to increase the ventilator settings and they didn’t want to do that. I could rationalize the need to keep his body from fighting the system, but it felt like a step backward and I was dejected.
The doctor came to speak with me and said that they were going to take a chest x-ray and then prone him. She stated that at some point, the prone position starts loosing it’s benefits and they will likely leave him on his back and do a tracheostomy. It had already been mentioned, so this wasn’t a total surprise, but I guess I had hoped that he would ween off of the ventilator sooner than later and not need that.
Don’t get me wrong, I am so very happy that they are talking about next steps and how to proceed instead of the talk earlier in the week that there was no place to go from where he was at that extremely fragile time. Rolling with the ups and downs and the constant adjustment of where his functions are, is something that I guess I need to work on.
So as of now, he is back onto his belly, his O2 is within range and due to the paralytic, his breaths are even and steady due to just the ventilator without his body trying to take over and compensate. The chest X-ray showed: “Some areas of patchy airspace opacity on the prior study are improved, with persistent diffuse interstitial opacities in the mid and lower lungs bilaterally. There is no pneumothorax.” I interpreted that as: Lungs still basically shitty, but showing slight improvement in the upper regions only – and he hasn’t thrown a clot.
I’d say it is slightly encouraging.
They will take another blood gas sample here in a bit, but I’m needing to head home.
Thanks everyone for your support.