Carlos has been doing well the last couple days. He got a good night's sleep last night, probably the first in the 3+ weeks he's been here.
He's been working with PT and OT and doing well with that. I'm hoping he will be strong enough to go to the transplant support group on Wednesday, even if he needs to ride some of the way in a wheelchair.
They just decreased the Primacor down to 0.1mcg. Tomorrow, it sounds like they will shut it off. Then no more IV pole! Woohoo! I've become jealous of the IV pole because it spends more time with Carlos than I do. The LVAD controller gets to sleep with him....lucky it! LOL
Carlos weighed in today at 88.5kg which, I will do the math for you, is 194.7 pounds! He hasn't weighed anywhere near that in years. However, some of that is the loss of muscle mass alongwith fluid. He will get some back as he gets stronger.
His heart rate is settling back down, being where it was when he came in....about 105 beats per minute.No runs of Vtach or PVCs all the time.
I got checked off on the sterile dressing change today. It's like being in nursing school all over again! Although I wasn't nearly as nervous :-) We had another session on the LVAD. Tomorrow we will have that as well as someone who will come and do a session on the equipment with us...that will be a lot of hands on.
I went to Bath and Body today before coming. I wanted to get him some yummy smelling hand Sanitizer to keep on his tray and some hand lotion. I also got him a wallflower with some different scents to get his room smelling pretty :-) We are currently using the stress relief scent - eucalyptus spearmint.
Showing posts with label primacor. Show all posts
Showing posts with label primacor. Show all posts
Monday, February 20, 2012
Saturday, February 18, 2012
It Hurts When You're Full Of It
We've had some pain management issues and anxiety issues. I came in this morning to visit and Carlos was snowed big time. I guess he was screaming like a little girl this morning so they gave him our good ole friend Ativan. They hand that shit out like it's candy around this place! He had some pain medicine all through the night as well. He looked like a PSA for drug abuse by the time I got here. Anyway, I got them to get an order for a smaller dose of ativan, and encouraged Carlos to try not to take it. He's hanging in there.
They have done a couple xrays to try and determine any concerning source of the pain. Turns out, Carlos has a lot in common with one of our cats (those of you familiar with the issues of Fatcat will get the reference). 'We' are working on that issue and once resolved, may decrease his pain level a good bit.
Other than these issues, he is doing well. I did the sterile dressing change without any difficulty. The nurse said I could get checked off Monday when the VAD coordinator comes to do an educational session. I'm sure the nurses would be thrilled because that would be one less dressing change for them to do! I hooked Carlos up a couple times last night also - kind of intense because the LVAD computer beeps loudly until the plugs are connected. I did fine but the noise makes you feel a sense of urgency even though you only ever unhook one at a time. They haven't decreased the primacor any further. I guess they do it pretty slowly.
They have done a couple xrays to try and determine any concerning source of the pain. Turns out, Carlos has a lot in common with one of our cats (those of you familiar with the issues of Fatcat will get the reference). 'We' are working on that issue and once resolved, may decrease his pain level a good bit.
Other than these issues, he is doing well. I did the sterile dressing change without any difficulty. The nurse said I could get checked off Monday when the VAD coordinator comes to do an educational session. I'm sure the nurses would be thrilled because that would be one less dressing change for them to do! I hooked Carlos up a couple times last night also - kind of intense because the LVAD computer beeps loudly until the plugs are connected. I did fine but the noise makes you feel a sense of urgency even though you only ever unhook one at a time. They haven't decreased the primacor any further. I guess they do it pretty slowly.
Wednesday, February 15, 2012
My Husband is Amazing
Carlos is doing wonderful. He's been up sitting in a chair, getting stronger fast, eating, etc. And PT hasn't even come!
They pulled the chest tubes finally about fifteen minutes ago. He feels better with those out. They stopped the dobutamine this morning. His oxygen is off and his oxygen saturation awake is about 93-95%. He may still have to wear it at night. LVAD training starts Friday morning. Carlos wants to go home in a week but I think he's being a little unrealistic. The lvad nurse says the average stay is 2 weeks once graduated to the fourth floor. We are shooting for by the girls' last volleyball games on the 25th. We shall see.
He still has the pleural effusion and his left lung sounds are diminished so there is some risk for pneumonia. He has previously grew out staph in his sputum cultures but they are giving him vancomycin (antibiotic) still. We had a discussion about using the incentive spirometer every hour while awake and the increasing mobility will also help.
Today's agenda includes the respiratory work, moving to the 4th floor, double sessions of PT/OT and hopefully the bladder catheter out today. The arterial line will come out today also. He'll still have the PICC line with the primacor and a peripheral IV. And he will remain on telemetry of course. But his strides in the last couple days have been awesome. I'm so proud of him.
I will post a room number on the fourth floor when we get that. There are no restricted visiting hours so people can come and go whenever.
They pulled the chest tubes finally about fifteen minutes ago. He feels better with those out. They stopped the dobutamine this morning. His oxygen is off and his oxygen saturation awake is about 93-95%. He may still have to wear it at night. LVAD training starts Friday morning. Carlos wants to go home in a week but I think he's being a little unrealistic. The lvad nurse says the average stay is 2 weeks once graduated to the fourth floor. We are shooting for by the girls' last volleyball games on the 25th. We shall see.
He still has the pleural effusion and his left lung sounds are diminished so there is some risk for pneumonia. He has previously grew out staph in his sputum cultures but they are giving him vancomycin (antibiotic) still. We had a discussion about using the incentive spirometer every hour while awake and the increasing mobility will also help.
Today's agenda includes the respiratory work, moving to the 4th floor, double sessions of PT/OT and hopefully the bladder catheter out today. The arterial line will come out today also. He'll still have the PICC line with the primacor and a peripheral IV. And he will remain on telemetry of course. But his strides in the last couple days have been awesome. I'm so proud of him.
I will post a room number on the fourth floor when we get that. There are no restricted visiting hours so people can come and go whenever.
Monday, February 13, 2012
Progress
My tablet is malfunctioning which fits the theme of my life....malfunctiong car (fixed), malfunctioning husband (in the process of being fixed). So I'm typing this on my cell phone so please forgive any errors and I don't think there will be any links.
Carlos came off the ventilator around dinner time last night. I was not there for that...had to go home and relieve the babysitter (thanks Beth). He was very happy apparently. He could talk though only for a few minutes at a time due to being so weak and exhausted. They are keeping him very busy with PT/OT. I wasn't feeling fabulous last night despite the good news. I was just feeling sad and pissed off at the world.
Today, was late coming here to the Batcave. Got some issues with the car resolved. I did speak with him on the phone this morning. He said he was ready to go. LOL! I said, you got some work to do first. He can't get out of the ICU until he gets down to one < inotropes(the primacor). Once he does that he will be transferred to the fourth floor, perhaps in the next 2-3 days. They just shut off the Nipride and they will switch the amiodarone to pill form. That just leaves the dobutamine to wean off. The nurse says he will probably be on the primacor for awhile. They will give him oral antihypertensives if need be to maintain his blood pressures.
He had a swallow study a bit ago and was given the ok to have a mechanical soft diet. Probably regular diet by tomorrow. When they asked him what he wanted and he asked for chicken noodle soup!
OT came by and worked him out. They started with range of motion exercises a couple days ago. Today I guess they had him sitting on the side of the bed! By tomorrow he will likely be standing up. The nurse said they are asking him to use his arms and hands as much as possible. Apparently he asked the therapist to do more so I'm very happy he remains very motivated.
X-ray did show a pleural effusion so they did a thoracentesis shortly before I got here. He feels like he can breathe better. They got out about 300mls, which isn't much. But his breathing has definitely slowed down.
He lost about 6 pounds overnight! Only another 12 to go.
So things are progressing faster now it seems!
Carlos came off the ventilator around dinner time last night. I was not there for that...had to go home and relieve the babysitter (thanks Beth). He was very happy apparently. He could talk though only for a few minutes at a time due to being so weak and exhausted. They are keeping him very busy with PT/OT. I wasn't feeling fabulous last night despite the good news. I was just feeling sad and pissed off at the world.
Today, was late coming here to the Batcave. Got some issues with the car resolved. I did speak with him on the phone this morning. He said he was ready to go. LOL! I said, you got some work to do first. He can't get out of the ICU until he gets down to one < inotropes(the primacor). Once he does that he will be transferred to the fourth floor, perhaps in the next 2-3 days. They just shut off the Nipride and they will switch the amiodarone to pill form. That just leaves the dobutamine to wean off. The nurse says he will probably be on the primacor for awhile. They will give him oral antihypertensives if need be to maintain his blood pressures.
He had a swallow study a bit ago and was given the ok to have a mechanical soft diet. Probably regular diet by tomorrow. When they asked him what he wanted and he asked for chicken noodle soup!
OT came by and worked him out. They started with range of motion exercises a couple days ago. Today I guess they had him sitting on the side of the bed! By tomorrow he will likely be standing up. The nurse said they are asking him to use his arms and hands as much as possible. Apparently he asked the therapist to do more so I'm very happy he remains very motivated.
X-ray did show a pleural effusion so they did a thoracentesis shortly before I got here. He feels like he can breathe better. They got out about 300mls, which isn't much. But his breathing has definitely slowed down.
He lost about 6 pounds overnight! Only another 12 to go.
So things are progressing faster now it seems!
Monday, January 30, 2012
Status 1b
We are definitely moving into new territory. They moved Carlos' status to 1b today since he was started on Primacor. They are hoping to only have him on one IV medication but if they don't get good results then they will move to a second one, which will necessitate being moved to a different floor ( icu?). They are going to give him until tomorrow before they decide. This would also mean his transplant status would be changed to 1a, which is top of the list. If one medicine works then he would get to go home with a PICC line and a continuous infusion. If they have to use two medicines, then he will not be allowed to go home. At all. We are really hoping to only need one at this point.
They just started a Lasix drip. He's refused the bladder catheter for now. I told him I'm not getting up all night to hand him a urinal so he better keep it close by.
The lady who does the pacemaker checks is here now interrogating his pacemaker. She said the last time she checked it in November and there were 92 episodes of non-sustained ventricular tachycardia in a two month period. From 11/14 until now, 216 episodes. Nice to know :p
They just started a Lasix drip. He's refused the bladder catheter for now. I told him I'm not getting up all night to hand him a urinal so he better keep it close by.
The lady who does the pacemaker checks is here now interrogating his pacemaker. She said the last time she checked it in November and there were 92 episodes of non-sustained ventricular tachycardia in a two month period. From 11/14 until now, 216 episodes. Nice to know :p
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