Comfort Care, Do Not Resuscitate

After my last post, thngs continued downward. Her breathing was labored, shallow, vitals all over the place in both directions high and low. Blood sugars irratic, pain level increasing, flow from the chest tube very minimal to where they decided to remove it. Feeling that it might help her be more comfortable. The decision made that she was very depressed and in lots of pain and the talk of taking back to ICU only highten that depression. So, family discussion and DNR order written. The doctor felt if the tube went in, it would never come out and thats not what anyone wants. Once the decision was made and she was able to discuss her wishes, see family members she became more calm and that seemed to help her breathing. Changes in her meds with the inclusion of a mood elevator also helped; not only her-- but family as she looked better. The tough part is is it an elusion? Her vitals are better, her breathing was better, they took out the G tube also. Her hemaglobin continued to drop farther and got down to 8 again; 2 more units of packed cells were given. This now makes 12 or 14 units of packed cells she's been given; so clearly the bleeding is still an issue. After the cells are given she has a little more color, a little more energy and her level actually got to 12 one day, the next day it dropped to 11.5, wonder what it will be today. If the count levels out or maintains, they may feel the bleeding is coming under control; but we've been many times before. Confusion and pain increase when hemaglobin drops.

Yesterday, they decided to see if she could tolerate any food. This is the 3rd attempt since surgery 7 wks ago. She had small amounts of hot tea at all 3 meals yesterday with some very thin diluted brooth, a little Italian Icy. She didn't throw up, or have more pain as she has in the past; but it's too soon to tell if her stomach is going to process it this time.

Her partially calapsed lung has worsened in the past 2 days, and yesterday 2 Interns/Residents were talking about chest tubes again. I told them she's already had 3, and I didn't think she'd let them put another one in. They wrote orders for an occlusion dressing at the site of the last chest tube to hopefully prevent air from the outside from entering, feeling that might help the situation. They'll do another chest x-ray today. The other possible reason for the calapsed lung would be a hold in the lung; but that isn't showing up on x-ray.

She's so very tired of this all, depressed. I don't think I can count the number tests, tubes, holes etc. her poor body's been through.

Thanks again to all for your continued support both here via comments, emails etc. I truly appreciate each and every hug, good vib, and prayer.

Sunday....I just don't what to think, Day #40

Not much new from Mom's bedside there at the hospital. Hemaglobin still being watched carefully to assertain how much bleeding is going on, and whether or not things are recovering in that area. She was 11 something after the last 2 packed cells given about 5 days ago, she dropped to 10, which while to low seems to be leveling out. She's coughing up less blood. The chest tube drained quite a bit out of her lungs for the first day and has slowed down since then. The color is less bloody, so that would appear to be a good sign.........on the other hand, they say her lungs aren't clear and were hoping to get more fluid out. Respiratory therapy treatments continue around the clock every 4 hours. Her vitals.......well, we wish we knew. One minute they're bad, then they get a little better for a few minutes, then go bad again. Initially yesterday am, she looked very bad and was in lots of pain. Later in the day, her pain level seemed better and she was more responsive and better color.

Each day as we walk down the hall to enter her room, we wonder how that day will go. It's sure been a long hard hospital stay. I've been pretty impressed with the level of caring nurses she's had over this long haul. Some better than others, human nature; but many who truly care and help not only her, but us family members as well.

Continued thanks for your prayers and support.

Today, Day 36! Better or Worse?

The last 4 days have been hectic, emotionally up and down; though mostly down. Mom continued to bleed, continued to throw up blood and became increasingly more uncomfortable. Her breathing became more labored, hemaglobin was up and down though more down than up. She received more packed cells.

Once again the surgeons thought about doing an endoscopy to try and determine the source of the bleeding. Once again they scheduled and cancelled it. This now makes the 4th one scheduled, and 2nd one cancelled. This wasn't communicated very well, and there seemed to be confusion to do it or not.

Enter, Dr. Iscabar!!! A wonderful doctor and communicator. FINALLY! She's a Pulmonary and Intensivist. She explains she's got too much fluid in her lungs to do endoscopy and that would heighten the risk, she ups her Lasix's, ulters the IV's, and indicates she needs closer watching. Transfers her to A step down unit (where she went right after being ICU), a much lower nurse to patient ratio, more equipment etc. Further she indcates the primary difficulty needing immediate attention is her lungs, full of liquid, the need to stop the throwing up, emphysema being a major problem. Cardiologist get involved and the decision is made for added suction to get some of the junk out of her stomach, insert a chest tube (now her 3rd one) to drain off this liquid (which appears to have lots of blood in it) from her lungs. They did all this yesterday. She's in pain, but actually is breathing and resting better. Her hemaglobin is starting to recover.

For the time being, status quo. Everything seems to be monitored more closely and she makes rounds more often and communicates and toes and fingers crossed; we might be seeing some minimal improvement. She's far from out of the woods; but...maybe a light at the tunnel can be observed.

Thanks to all for your continued support and prayer, all is much appreciated. Managed a few updates here on the blog with my charity numbers. My yarn bag stays with me at the hospital. Most recently, I've made 6 pair of booties and 5 infant hats.

I hope to get some pictures proceesed to update the bridge, so please check in later there. Would love you all to pop over to my SIL, Jan's site (some of you have before), to see her really awesome new blog banner. We're both pretty excited about it. Badges for both in the right side bar.