My Kindgom for a Laptop!

Ok, not really. I get by with my phone. Sometimes I just have to psych myself up for some serious thumb typing! I've considered collecting all the texts I update family with throughout the day and just sending those to the blog, but some of those are potentially confusing because I have to abbreviate stuff to keep them under 160 characters. Whatever. On to the important stuff

Good day today. It got off to a rough start and weren't really sure what JW needed or how to fix his "numbers". It's Monday, which means a new attending came on duty. All the doctors here are awesome, but it helped to have a fresh perspective. So after a lengthy discussion at rounds today, they made a few simple changes to his vent settings and a couple other small things and JW really seemed to like them. His sats stayed in the low 90s for the majority of the day. They've also started weaning his paralytic. They weren't sure how that was going to go since it did not go well when they tried it a few days ago. That time he would desat when he moved. He's obviously in a much more stable place now because although fingers and toes, and later hands, feet, eyes and mouth, were moving, his sats stayed steady. He's still heavily sedated so it was quite a chore for him to open his eyes just a little. But he's been moving his hands and exploring his surroundings. He even squeezed his nurse's finger. Anyway, just like last time, it's nice to see movement.

They started him on a terbutaline drip last night. It does the same thing as his albuterol nebulizers but they thought "breaking the circuit" on the vent to administer the albuterol every 2 hours was causing him to lose too much pressure we're working so hard to maintain in his lung. Poor guy, his heart is just pounding as a side effect. Earlier today, his chest was just vibrating with the force of it. I believe they backed off on the dose a little (at least I think that's what was discussed in rounds) and his heart has calmed down a little.

The only other development today was the small amount of blood in his urine. Analysis came back negative for white cells so it's most likely not a UTI. Gotta wait a day or so to see if the cultures grow anything. But his night nurse seems to remember reading that's it's a possible side effect of the terbutaline. No one seems too concerned about it, so I'm not either.

Oh yeah, they were able to wean his O2 from 100% to 55% today just because of the little changes made to his vent settings. 55% is the lowest we've been able to go yet. He's gotten down to 65-70% a couple times, but always has to go back up to 100% for some reason or another.