She's been awake for the last four hours. No pain but she's uncomfortable with the ventilator. The plan is to keep reducing the ventilator numbers and around midnight tonight, have her breath on her own. She'll still have the ventilator in and it will help her breath if she needs help. If she does good, she'll get the tubes removed tomorrow morning. Her spirits seem good and she understands what's going on, she just wants the tubes out, as you can imagine. We communicate through a notepad and pen. Sometimes she'll write and sometimes she'll point to letters I've drawn on the page to spell words. They've increased her sedatives to help her sleep through the night. They'll reduce them a few hours before taking the tubes out. Her vitals are still excellent and everything is still heading in the right direction. Her fluid output today has been excellent and her swelling is down just slightly. Overall I think today has been a very good day for her.
She woke up a few minutes ago. She wanted a pad and paper so she could write to us. That didn't go too well, but we finally figured out what she wanted. She wanted to know everything about what was going on! So I started at the beginning and told her everything. She understood and it seemed to calm her down a bit. She's now sleeping again. They're continuing to lower the ventilator settings. They do it in steps every two hours then monitor how she reacts to the lower settings. So far, she's done great.
Dawn semi out of sedation right now. In the last few minutes we've been able to talk to her. She responds by nods. Her eyes have been opening and she can see us. Dr. Costa and the oncology team just visited and she tried to wave at each one of them. She seems to be feeling ok, I'm sure the tube down her mouth isn't comfortable but she nods that she's not in any pain. The report we just received was all positive. She has a long way to go, but her liver numbers are getting better for the first time, she's getting output from her kidneys, and her breathing stats are all excellent. They want to get some of this fluid out of her before removing her from the ventilator. I think they're deciding whether to give her kidneys more time to work or to proceed with dialysis. I showed Dawn the picture of Buddy and she smiled as much as she can and I think she tried to laugh. They did another echocardiogram a few minutes ago. The tech seemed to think the fluid around her heart looked better so we await the cardiologist report. As I write this, she seems to be falling back asleep, listening to music from Sirius Coffeehouse.
Respiratory just came by. They said her breathing is "excellent." They're continuing to lower the settings of the ventilator and they hope to have her off it in a day or two. The ventilator causes fluids to collect in the mouth and tubes and bacteria can grow causing pneumonia. They frequently suction the tube and clean her mouth to help prevent that. The sooner she can get the ventilator out, the better. They're also going to change her sedation. It will make her a bit less sedated but still comfortable. She's responding a lot more today to touch and sound. At one point she opened her eyes and focused on me. I asked if she was in pain and she nodded "no". She squeezed my hand and then fell back into sedation.
I just received this picture from my dear friend Mandy who is watching Buddy while Dawn is here at the hospital.
No change in status overnight, her vitals are still normal. The nurses were able to wake her and ask her some yes/no questions this morning. She appeared to be in some pain yesterday and last night so they've increased her pain drip. Her kidneys are doing better. The numbers are better than yesterday and she's finally having some output. There's a kidney team monitoring her and they're very happy with what they're seeing. I haven't seen oncology or cardiology teams this morning but I'll report when I do.
Thursday, December 4, 2008