WEDNESDAY – a better day

Mid-morning and late afternoon visits and discussions with doctors and nurses, left me feeling a lot better than yesterday.  That’s because Nancy was much better than on Tuesday and surpassed the Monday status. She was sleeping better and eating more today.  When I got there about 4:20 this afternoon she was sleeping soundly.  I stood and watched a silent television for 15 minutes before she woke up. I learned that the mid west was being slammed with a blizzard unlike any since Nancy and I lived there in the 1970s.  Also Yakima broke a record low.  With the sound off that’s about all I learned.

She needs to breathe  more deeply.  When she went to the ER last spring she had fluid in her lungs from the cell damage the bacteria were doing (I think) and the X-ray was first interpreted as her having a “piece of pneumonia.”   Not so as it turned out.  Then this latest episode caused some more lung damage (now healing) but laying in bed doesn’t get you much lung exercise. So she gets to blow into one thing and suck on another.  That’s boring after about 30 seconds.

So, …

I told them she played fiddle and visited nursing homes and such with a group of  ‘old-time-music’ friends and that she started singing in a church youth choir when she was about 3.  So they brought in a music player and tried to get her to sing along with some Christmas music.  We both think Christmas music ought not to be allowed on the airwaves until 12 days before Christmas (not close enough yet).  She was a good sport about it but when David (ICU nurse) left the room she had me turn it off.

If they had had the Virginia Reel, she probably would have known lyrics and been happier.  The rest of us would have been clueless.

So we are looking forward to Thursday.

TUESDAY evening

Today is hard to characterize.  There are no major changes with Nancy.  When I got there this morning she was (again) nearly in a sitting position.  Her vocal volume seemed to be somewhat lower but she still wanted to talk. And she wanted to write when I did not grasp all that she was saying.  With the worrying she is doing she is sleeping very little and so not healing as well as she might.  The result is that her vital signs get a little ragged.  They would like to get her out of the ICU and to a quieter place and one where they can do a bit of therapy but until she settles some that may be unsafe.  They thought of moving her today but in addition to the above concern the ACU on the fourth floor did not have an open room located close to the main observation station.  I got the impression either of these things would stop the move, so, tonight she remains in the second floor ICU.

Mostly she is worrying about things she needs to do at the University although I’ve told her all is taken care of.  As this is Tuesday of Finals Week this is almost true.  By Friday I can say the quarter is over and maybe that will quiet some of the thoughts.

She also wanted me to bring some of the pills to her for this or that ailment because, I think, they are giving her some of these medicines via infusions and/or smaller pills that she can swallow more easily.  I guess she thinks they are not giving her something ( say “the big yellow pill”) that was prescribed weeks ago and she was in habit of taking at certain times and with or without meals.

Before I left there today I asked if she needed me to come back in the evening or if coming on Wednesday morning was okay with her.  She told me I didn’t need to come back unless I brought her cell phone to her.  They don’t want patients in the ICU to have cell phones and she couldn’t use it anyway, but still it bothers her.   When I called there about 6 PM she wanted to talk to me.  So we talked a little but I could not make out much because of the soft voice.  The nurse and I chatted about how we might get her to think about her health and let go of the outside world, especially the interaction with students (in this age via e-mail and cell phone).  We agreed this would not be easy for her.

All for now.  John

Monday

Each day now, Nancy shows considerable improvement.  Her voice is stronger and she can write better.  An occupational therapist got the bed into the shape of an overstuffed chair and had Nancy moving her arms and doing finger exercises, all the time asking questions.  Nancy did well on most of this.

A couple of doctors and a nurse visited and explained what they call ICU-ites.  It happens that when one spends time deeply sedated and in the intensive activity of a unit with things beeping and then someone will yell ‘code blue’ and all h— breaks out in the next room – – – one does not sleep well.  They seem to be sleeping soundly but they never go into deep sleep (REM sleep) and this means their brain isn’t getting the rest and relaxation it needs.  After several full days of this one can get a little disoriented.

They hope to move Nancy to the more restful level of care (the ACU, or acute care unit) on the fourth floor on Tuesday or Wednesday.

Today she wanted her cell phone and laptop.  The nurse and I convinced her she could not have them in the ICU.  Her voice isn’t back strong enough to talk on the phone and her arms and hands are a bit weak so she would just be upset if she had the computer.  I did not even ask if they had a hookup to the internet in there.

Her lungs still have a tiny bit of a rattle but that is lessening daily.  She was hungry and eating Jello and drinking water and orange juice.

That’s all for now.

SUNDAY EVENING

Sunday about 5:30 PM

I called the ICU early today and then waited until this afternoon to go down to Yakima.  Nancy is holding her own without the ventilator. Because of the long time with the tubes in, her voice was very weak and we (nurse and I) tried to talk in a manner that she could nod and not have to speak.  She also tried writing on a clipboard but weakness, attached tubes, and such made much of it hard to read.

The nurse had no luck with the notes Nancy tried to write but I could make out a few words and then guessed at the rest — Nancy would agree or disagree and I would try again.  We made some progress.

She was hungry and finally we got printed “Is food not part of the service here?”  She had been well fed with a brownish liquid via a drip line and that’s probably not going to leave you full when it is taken away.  Because of the sore throat we just got her some jello and orange juice.

We played — or attempted to play — a little verbal trick on her. We have a dog named Shay and I asked if she remembered Shay.  The nurse quickly said “Is that your cat?”  With no hesitation, Nancy let her know that Shay wasn’t a cat.

She insisted on keeping the paper and pencil with her even though the folks there can’t make as much sense of  her attempts at writing as I can.

Her nurse thought Nancy was improving by the hour and by Monday AM would be still better.  I will go back early with some of her favorite yogurt as that flavor isn’t usually available.  I can also help with the communications.

More Monday evening.

Saturday afternoon

There is not much to report at the moment.

As of noon the ventilator was set on its

lowest setting and either later today or

Sunday the idea is to see if she can go it

alone.  If not it will be restarted and

they wait some more.

As I understand this, when her pulmonary

function deteriorated last Saturday there

was some damage to organs which now have

to heal, which is occurring slowly.

As her sedation has been reduced a bit

she has responded to those about her,

but any neurological issues are yet to be

determined.  First the ventilator has to go.

So no news there.

Liver enzymes levels, which in her case

seem to be relevant*, are continuing to

come down – suggesting in-progress healing.

I did not get numbers today but a couple of

days ago they were reduced by 30% from the

day before.  (*may not be in some other

sorts of liver issues)

On the home front I had to replace the

heater in the horse trough (expecting very

cold for a few days here).  And I am

working with the youngest of the dogs

trying to get her to go in and out via

a ‘doggy’ window.  The two oldest are

fine with this from previous experience

but this one thinks I’m nuts for asking.

Friday afternoon 12/4/2009

I visited Nancy mid-day today and she was less sedated

and able to respond – open eyes, squeeze my hand and

such.  Still not off the ventilator. 

I just got home so that is it for now.  I’ll work on this

tonight and add material. John

Comments are off for now.  Thanks.