February 15, 2024 – PM Update

David looks much better now than when we arrived, but he’s still in the very critical period. His coloring looks almost normal. I don’t believe he is any worse in any area than he was this morning, and in some areas there has been a little improvement, so the doctors took the small gains as a win this evening. He still is dealing with some issues – like temperature regulation and irregular heart beats and blood pressure fluctuations. 

He had an echo today at the encouragement of the surgeon. David’s dealing with a lot and it’s a puzzle to try to figure out why he’s not necessarily responding the way they think he should. The echo was encouraging, the pericardial area around the heart looked good and so did the heart function.

Neurology stopped by this afternoon after having the probes placed on his head this morning. The neurologist watched the data come in for about a minute and didn’t see any seizure activity.  He said he didn’t personally review the data from earlier today, but those who are monitoring it are supposed to let him know if they see any signs of seizure. Seeing as he hadn’t heard from anyone, it was reassuring that so far David is doing ok on that front. 

They are still working on figuring out David’s cocktail of choice for medications. He’s not always as sedated as I thought he would be, and at one point he was moving all his limbs and his blood pressure and heart rate spiked. His heart rate also spiked quite high and with an abnormal rhythm this afternoon (around the time echo was here). They don’t know why or what caused this – some thought is that David was showing us that he is upset. He probably wants his bear pacifier in his mouth and not the breathing tube. His ventilator settings are pretty high at this point, but his saturations are lower. At one point his oxygen was at 100% while his saturations were in the 60s. They tried a medication to help with that and suctioned him out. The suctioning is very risky in his vulnerable state, so he needed a doctor at bedside before that could be performed. David handled that quite well, so he may get more suctioning in the future.   

Other folks we saw today were his cardiologist. She couldn’t stop apologizing. It was kind of funny because she also noted that David seems to have big things happen around holidays – apparently we see the same sorts of patterns. A researcher, child family life, and the social worker stopped by as well. 

In the end, David is more stable and in a better spot than he was this morning, but he is not completely stable or in great shape. The hardest part for me is seeing how swollen he is – you can really see it in his face. I knew and was prepared for several things, but I was not prepared for his swollenness. His nurse said his swollenness is not unheard of because he was on by-pass for such a long time yesterday. His oxygen saturations are also lower than we’re used to seeing. We were told this is not unexpected because his blood right now if likely going to his major organs first before going to his extremities where his pulse ox is located. This morning it said low perfusion, and I no longer see that, so that’s another step in the right direction.  He also may have clots in his left leg now.

This week has not been a normal week in regards to distractions in the hospital. We got a pizza dinner last night from Red’s Savoy Pizza, and today lunch was provided by Cafe Latte along with Goldie from the University. We decorated some cookies, and picked up some balloons for David’s room (well, two balloons because we know full well, that Eli and Anna will eventually end up with them). These distractions have been very welcome during this time. We did miss Bingo today though – we often miss it when we’re in the CVICU as there is usually a lot of moving parts trying to get David into a good spot. 

I saw his other cardiologist this evening. It sounds like he will be on staff for the evening shift. I don’t remember exactly what he said, but it was something to the effect that David’s circulatory system is not moving the fluid around efficiently. To remedy that, they have been administering a bunch of fluid for him which is contributing to his swollenness.  The hope is that his body will slowly be able to take over, so they don’t have to administer so much fluid. Less fluid in his system will then make it easier on his lungs so they can go down on his ventilator settings, and will also help his blood pressure. Otherwise, I’m happy where he is at at the moment. They will continue to make slow changes throughout the night and hopefully David responds well. The goal is to keep him resting and stable.