Sunday, December 9, 2007
ICU Update 9 Dec
Well week three begins with a little excitement. Last night at 3am Andrea decided she did not like the tube in her mouth anymore so she just pulled it out. Actually she pulled it most of the way out but they had to remove it and put it back in. The doctor called me at 3:30 and told me that everything was okay. After yesterday going so well, I decided I was going to come by and see Andrea at 7am then go to church at 8:30 and meet the boys and Kate back at the hospital. When we walked out last night Andrea was falling asleep her lung pressure was between 20-24 when she was awake. A drop of almost 50% in a day.
When I came in today Andrea was upset and her hands were tied down again, the doctors response to her liberating event last night. Her tongue is swollen from the new vent being put in and she looked uncomfortable. I asked her if she was upset and she said yes, I asked her if she was mad she said yes. She did not like her hands tied down at all. And to top it off her lung pressure was back up to mid 40s and I thought here we go again. We just can't seem to put two good days together. Now we will spend the next 24-48 hours trying to recover from last night.
Okay I just blew up at Dr D&G and I have to calm down.
Let me tell you what his comments were today. There was nothing about how she is doing, nothing abut her doing better yesterday. These were his first words to me.
Dr D&G "One of our concerns are that with higher lung pressure a lung could bust. If this happens it is a life threatening event. How do you feel about us placing a tube in her lugs to release the pressure?"
Me "I don't think we are at that point so my answer is no. Her pressures are not any higher then they have been."
Dr D&G "Yes that is true. It was just in case and it involves significant pain"
Dr D&G "Have you discussed what you want us to do if her heart stops?" Do you want us to restart it, it will involve significant pressure on the chest."
Me "Well if her heart quit this moment I would say yes because of her overall condition. If her condition was to the point of heart failure then my answer may be different. This is not a broad brush answer. I don't think we are at that point right now."
Dr D&G "Well if her condition worsens then eventually her heart will fail."
Me "So will mine and so will yours."
Okay this is when I lost it. Thankfully I asked him to have this conversation outside the room so Andrea could sleep.
Me "I have had enough of your negative attitude. Sure she could die but I don't understand why you always jump there. Why do you go to that extreme. When she had the bruise on her back you told me this is internal bleeding and she is dying. That turned out to be nothing. Now you want to talk about her heart quitting and her dying. You told me you always go to the worst extreme first. Well you could die tonight in a car crash. Do you want to live everyday waiting to die because it is a possibility? Do you want you wife to fear everyday that you will die in a car crash? Because it is a possibility? I don't want that attitude around any more. If this is all you have to say then I don't need to hear from you again. You can talk what ifs all you want with your students but don't you ever do it with me and don't you ever say it in front of my wife.
And I walked away.
I will be the first to tell you I know the reality of Andrea's condition, and I don't stick my head in the sand.
I prayed for peace in this room today. Everyday there is tension when he walks in. I just feel like we are fighting to live and he is waiting for her to die. Each day he presents we with another reason she is dying. My day is a battle to fight off his morning visit. By the time I leave I feel great, Andrea is smiling and there is hope. Then I come in the next day and it starts all over. This is exhausting me and I can't continue going on this way.
Well I just talked to Dr D&G alone and we aired our feelings. I told him I trust him as a doctor, if I didn't we would have left a along time ago. But I don't trust his bedside manner. I told him I want him to believe she will live. He said he will be more optimistic but truthful and I said I was sorry for handling that conversation in front of everyone...the nurses the interns and the fellows.
We shook hands and parted. But I'm left to deal with his past negative words and thoughts.
On top of that they don't want visitors today other then me and maybe Nic and Kate if I'm not here. They want Andrea is catch up on her sleep. That will make the day harder on all of us. For me being alone in the room is very difficult and it is equally hard for the boys to be kept from seeing their mom.
I asked Andrea again how is was and if she still wanted to fight. She said she was good and yes she still had fight in her. I said squeeze my hand to tell me how hard you want to fight. She gave it a good hard squeeze.
Then she said "I want to go home." I said you can't. She said "Why?" I said because you have the vent in, how would I do that at home. She said "I have it at home." Meaning the oxygen. I had to tell her it was not the same, she is too sick to just use the oxygen at home.
Those are hard conversations because she truly feels she can go home and she does not understand why she has to stay. Sometimes I wonder the same thing. I think if she could just go home she would be fine. She did not have any of these problems two weeks ago. Her stomach was a little bad but she could eat. Now she can't have liquids through a tube. In a way I would like to tell them to take it out and let us go home, but I know what would happen if I did that and so I told Andrea we just have to stay here. Get some rest and hope we can have another day like yesterday, then another one and another one and soon that tube will be out.
Andrea lung pressures to go back down,
Her stomach to be able to take food again. She has not eaten in about 10 hrs.
For Healing, for so many things that are out of balance in her body
For the boys, for this day
For each other as we all grow weary
Posted by Jim Ravella