Mr. Sprocket in the ICU - Prayers Needed, Part II

Note: Read each day from the bottom up. Sprocket

This is a NEW ENTRY. PREVIOUS DAYS NOTES CAN BE FOUND HERE.

UPDATE 6/9 7:45 PM
More than one nurse has called the waking up from the propofol, the "sedation vacation," meaning, a short vacation from sedation.

UPDATE 6/9 7:30 PM
Mr. Sprocket's night nurse (Je) just introduced herself to me. So polite. She reached out to shake my hand. I meet these darling, young AMAZING nurses and I try to remember when I was that young and had all that energy.

UPDATE 6/9 7:15 PM
I will be staying tonight until the night nurse slightly brings him out of sedation to check his neurological function. That's when they dial back the Diprivan (propofol) just enough so that he is able to follow commands. After that, they put him back on sedation. Then I will be taking off.


UPDATE 6/9 6:00 PM
Drawing his potassium is just a blood draw. Mr. Sprocket is putting out a lot of urine even though he's not on a diuretic. With a pharmaceutical diuretic you do lose potassium and they had to replace it. Since he is still putting out a lot of urine, they have to keep testing his potassium to see if he's still losing. If he's losing, they add potassium.

It's pretty much a done deal, that he will get a central line tomorrow. (Mi) said she saw his pulmonary doctor (Dr. A), and he put him on the list for a central line. Nurse (T) stopped by to speak to (Mi) and asked what happened to Mr. Sprocket, since the last time he saw him, he was walking to the bathroom in Telemetry.

(Mi) tells me that she is going to have to take out one of his IV lines on the left and insert it in the right arm because it is swelling. Frustrating she has to do this tonight because he will get a central line tomorrow that has three ports.

UPDATE 6/9 5:45 PM
His nurse (Mi) told me that they are going to draw his potassium now. I don't know what that involves; she was just letting me know.

I was wrong earlier. It's not a lung x-ray that he will get but a lung ultrasound. This is to pinpoint "where" the fluid is in his lungs so they can mark the spot. Then tomorrow, having the area marked, they will do the lung tap.

The chaplain Beverly stopped by to say hello. She let me know she has been to Mr. Sprocket's bedside several times to pray for him. She said she was looking forward to meeting him when he's in Telemetry and off the vent.

UPDATE 6/9 4:50 PM
I just took a break and had a late lunch/early dinner, so I'm feeling a bit better. Mr. Sprocket is resting, still under sedation. His nurse is away from her desk at the moment. When she comes back, I'll ask if Mr. Sprocket had the lung x-ray yet.

One of the things I've been missing these past 11 days is Mr. Sprocket's cooking. My attempts at cooking have been comical, however, since his heart attack, I have been able to master a simple "shake and bake" of the organic, free range chicken thighs that we get from Costco.

We make our own 'shake' mix using rice flour (easy to make in a coffee grinder) and a few spices: rosemary, sage, and chili powder from India. Mix spices in with the flour and bread the chicken. Place on a cookie sheet and bake at 425 degrees for 15 minutes on one side, turn over and bake 15 minutes on the other side. Let the meat rest before eating. Mr. Sprocket is a fan of chef Bobby Flay, who cooks chicken and turkey at that high a temperature.

I only got about 40 minutes of sewing in this morning, and I did that right when I woke up. One of the things I'm doing for myself to try to get a bit healthier, is walking a mile every morning. I'm also taking the stairs from the hospital parking garage all the way up to the second floor ICU. When Mr. Sprocket had his breathing tube out the first time, this was one of the things he talked about several times, that we would both be on a work-out regimen every day.

I don't think he had the lung tap yet and the nurse told me he has not had the x-ray of his lungs yet.

UPDATE 6/9 2:17 PM
Mr. Sprocket is going to get an x-ray of his lungs, then they are going to "tap" his lung to drain it. That means, they will put a needle in, pull out what they can and that's it. IF he keeps re-accumulating fluid in his lungs, then they will put a permanent drain in his lungs. The nurse just told x-ray to "get up here" even though they are real busy.

UPDATE 6/9 2:15 PM
I spoke briefly with Mr. Sprocket's cardiologist #3, who will be following him for the next couple of days. The second echo cardiogram, it was less definitive as to whether or not he has the hypertropic cardiomyopathy.  Hopefully, the third echo cardiogram (that is happening as I type) will give them a definitive answer.  You either have it or you don't. It's inherited.

The third echo is done. (Mi) tells me that the pulmonary doctor said that if he can't be weaned off the blood pressure medication tonight, then they will put in a central line tomorrow. I just singed a consent form for that. I also found out that the pulmonary doctor is in charge of Mr. Sprocket's care while his is in "Intensive" care, the ICU.

UPDATE 6/9 12:30 PM
I forgot to mention that in addition to the 8.6 liters he peed out the first night back in the ICU, last night he peed out another 4 liters.  His hands and face are looking more normal. His feet and legs are still a bit swollen, but much, much better than he was before.  Someone had asked about the "cuffs" that are on his legs. These are to help prevent blood clots in his legs. Here is a photo of his legs and the machine they are hooked up to.



UPDATE 6/9 12:15 PM
Mr. Sprocket is on the schedule to get a new echo cardiogram today. It's just a matter of when.


UPDATE 6/9 11:20 AM
The breathing test stopped at 11 AM. He agreed to rest a bit. The respiratory therapist started the machine again and he will be sedated again.

I have a FB friend who is having surgery today, BRM, so I'm thinking of BRM today and hope that surgery goes well. I'm also thinking and praying for my FB friend, MCR, whose husband is also ill.

He didn't go under quite so quickly. He was tapping the side the rail again so I came over with the alphabet pad.   He spelled out BRET, but that's as far as he got. His nurse set his Diprivan back up and he's out for the count at the moment.


JUNE 9, 2014 10:40 AM
I'm at the hospital. Mr. Sprocket's nurse last night was (Ch), a very handsome, Baywatch looking young man. So nice. This morning, his nurse is the same as yesterday, (Mi).

His pulmonary doctor stopped by. He asked me if there was anything I could add to what happened when Mr. Sprocket was in Telemetry; if he was complaining about his breathing.  There was nothing I could add. He said that Mr. Sprocket "went into heart failure," and that's why he was brought back to ICU. He does have pneumonia.  He had a lot of fluid in his body/lungs. The Pulmonary doctor did say they would try to get the tube out tomorrow. It will all depend on how he does on his breathing tests today.

When I arrived, Mr. Sprocket was awake and doing the breathing test. As soon as he saw me he wanted pen and paper. I told him he couldn't write, but he insisted. I put a paper with the alphabet in front of it. He pointed to letters on the page and spelled out "I Love You."  He asked to sit up more, but that caused him to cough too much so he asked to recline again.  He wanted to write again, but I told him he needed to concentrate on his breathing. If he concentrated on his breathing for five minutes, then I would bring the pen and paper back. I told him I was going to write on the blog for a few minutes.

Oh boy. Mr. Sprocket is tapping the side-rail of his bed, so I'm going to see what he wants. He probably wants to communicate through the alphabet again.
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UPDATE 6/8 8:00 PM
The shift change is complete. I haven't met Mr. Sprocket's night nurse yet.  Mr. Sprocket still has a little bit of a temperature. It's now 99 degrees, down almost a full degree from when I first got here.  I have some company today. My friend JG stopped by to sit with me.  I'm going to try to get here much earlier tomorrow, so that I won't miss talking to his doctors. Once I talk to them, I'll probably leave much earlier.

UPDATE 6/8 6:25 PM
I just learned that tomorrow, Mr. Sprocket will have to have a central line put in for the blood pressure medicine. That takes my approval. The reason is, he's not able to maintain his blood pressure on his own yet. The blood pressure medicines are quite strong; 'toxic' is the word that (Mi) used.  Right now, in an emergency (when he was brought back to the ICU yesterday am), they can put it in a tiny vein, but that's usually only for a short time. There is a risk that the medicine could 'leak out' that tiny vein and affect the surrounding tissues.  The IV they originally had in his femoral vein was also a central line. This is a bit disappointing to hear.

UPDATE 6/8 4:40 PM
The finally found a comfortable rubber strap to hold the vent in his mouth instead of the tape they had completely around his head. That's an improvement. He just got repositioned a minute ago. He's not completely out on the propofol. He's just slightly aware. He nodded that he could hear my voice, but he didn't squeeze my hand back. The nurse put a fan on him to cool him down a bit, and put a wet wash cloth on his forehead.  (Mi) tells me that the little excitement of being moved around put his blood pressure up a little.

JUNE 8, 2014 4:15 PM 
I just arrived at the hospital and got an update from Mr. Sprocket's new day nurse (Mi). There have been some minor adjustments on the ventilator. He's not weaned off of it yet. He is at 40% oxygen. When he came in, his rate was 20. This morning the rate was at 14 and now the rate is at 10.

Mr. Sprocket's blood pressure has been up and down. He's on an IV blood pressure med, Levofed. He's no longer on the diuretic. Cardiologist #2 discontinued that this morning. Still has the feeding tube in his nose. Still on an antibiotic.

He is back on the leg pressure cuffs to prevent blood clots. They will start weaning him off the vent tomorrow, and it will all be based on whatever he can do.

He really did have a lot of fluid build up in his body! He peed out 8.6 liters in 24 hours!  That's a lot of fluid. It would have been hard to breathe if a lot of that was around his heart/lungs.

It remains to be confirmed if he does have pneumonia, but the congestion is definitely there, or there wouldn't have been that much fluid. The fluid that the nurses are suctioning out is clear, it's not yellow. Dr. #2 ordered another echo cardiogram which may happen tonight or tomorrow morning.

When (Mi) cuts back on Mr. Sprocket's Diprivan (propofol), he does follow commands.  She said he did this thing where he was making a circle with his hand/finger. He was trying to communicate, but she couldn't figure it out what he was trying to say. She asked a lot of the normal things (that she would be concerned about) like, are you in pain, are you uncomfortable, do you want to sit up more, but the answer was always a head shake "No."  I'm sure we'll find out what it was, once he's off the vent... if he remembers, of course.

So, not a lot of change.

I only got about an hour sewing done today. Two of the three places I went to go this morning didn't open until much later, the water store and the recycling center. These are things Mr. Sprocket usually takes care of. Hopefully, I can get to those tomorrow.

I brought some reading/editing to do (for my friend Matthew) and I think I'll get started on some letters.  It's very difficult, but I'm trying to stay just in the moment. I'm trying not to think too much about tomorrow or weeks ahead, but it's hard. At the moment, I'm doing okay. Wish I had gotten more sewing done; maybe tomorrow.

Here is what the ventilator looks like next to Mr. Sprocket's ICU bed.
I started a new entry because the other one was getting very long.