Friday, December 7, 2007
ICU Update 7 Dec 11am
Dr Fry or Dr Doom and Gloom as Maureen and I call him just stopped by.
Andrea slept great last night and her vital signs were the best since she has been in the hospital. I called three times through the night and each time her signs were the best since she got here. Her heart rate was and still is under 100, (It was 147) her breathing rate is around 30 and when she is resting it is around 23 (It was 59). I was so excited last night and this morning that I came to the hospital at 7:30. Andrea was a wake and said she was feeling better. Her color looks good and I was encouraged by everything.
A nurse that took care of Andrea last week walked in with me at 0730 and she looked at Andrea and said, "You are looking at a miracle." She said, "Don't get me started or I will be praising the Lord." She is so nice when she took care of Andrea she saw the Bible Andrea sleeps with and she prayed for her. I thought it was just me who saw such an improvement, no one seemed to think anything about how Andrea looked but me. In a way I felt let down. I guess in some way I thought when I arrived today the Doctors would be proclaiming the huge advancements in Andrea's condition and would be telling us it was time to take her off the vent. Instead I was greeted by a silent room, the nurse busy hanging bags of fluids. Just like any other day.
Then in walked Dr Doom and Gloom for his daily rounds.
Dr Doom and Gloom comment to Andrea was. "Well you are about the same, your heart rate is down but that may just be that you are relaxed. We will wait and see how you do over the weekend." I felt like I had walked in with balloons and Dr Doom and Gloom walked up with a pin and popped them. Maureen and I told Andrea not to listen to him because she was doing great. She smiled and nodded yes.
The nurse gave her a relaxant so she is sleeping. The nurse said I only gave her a little bit, 1mg. Well that is a little for a normal sized adult, but not for Andrea. When they gave her 1mg on Wednesday she was asleep from 11-8pm. Yesterday they gave her 1/2mg and that was just right. Oh well she will sleep good today I just want he to be able to sleep tonight. The other problem is if she is too sedated her breathing slows down and her lungs don't have to "exercise" has much.
Right now the vent alarm is going off for her breathing rate being too slow. That is a first at not really a bad sign. It has been going off all the time for too high of breathing rate or too high of a pressure. Her breathing rate right now is 20-22! Almost normal numbers. Her volume of air she is taking in is okay, could be higher but she is taking less breaths so the volume/min is lower. It will improve as her lungs heal and she is able to take deeper breaths. That makes since with her pressure right now which is a little high at 38-40. This is showing that her lungs can't hold much more air, so to get the right volume she has to breathe shorter and faster. When she is relaxed and breathing slows and her volume goes down. As long as her lung pressure (indicates the health of the lung) remains high she can only control the volume by her rate or breathing. So we want her lung pressure to drop allowing the doctors to increase the volume of air going into her lungs. Think of her lungs as a balloon, they are a closed space and can hold a set volume of air. You know how you blow up a balloon and try to get it really big but are afraid it will pop in your face? And when it is new it is really hard to blow up and you turn red in the face. That is what they worry about with Andrea's lungs being stiff from the infection. If they give her too much pressure or the volume is too high the lung cannot stretch anymore and could pop like a balloon. So her volume is what is controlling the pressure right now. We want to see her rate go down and her volume increase (Deeper breaths) and the pressure decrease (More room in the lung or a more flexible lung).
So with her heart and breathing rate going down, and her volume staying about the same I see that she is taking slower deeper breaths. She is feeling better and looking better. I think those are the first signs of healing. Her lungs will be the last to heal and so we are still seeing higher pressure then we want. When that goes down we know the infection is going away.
All I can tell you is she looks better and her signs look better. The Doctors said they may adjust the vent later today. I would think they would and we will be one step closer to getting out of here. I think the only sign they would like to see improve is her lung pressure.
Please pray for her lungs to heal, for the pressure to go down and the volume to be increased. Please pray for God's power to be reveled to Dr Doom and Gloom!
Posted by Jim Ravella