Ventilator Fears

I was at the apartment when I got a horrifying phone call. Teresa had barely been in her new room in IMU on the third floor, had been okay to have some liquids, and then the call came.

The PA told me: Teresa’s being sedated for possibly permanent intubation for ventilation. Her oxygen dropped into the 80s after vomiting (with signs of GI bleeding – “coffee grounds“). (The link is to Wikipedia; it is simple and without images if you want an explanation.)

I got to tell her I love her over the phone, and the doctor who called me said T did nod her head to acknowledge it, but she can’t talk. She had an oxygen mask on but it wasn’t helping enough. She’s being moved to ICU. As long as she is intubated, she will be sedated. 😟

As I said, I was at my apartment with my Mom when I got the call and they couldn’t wait for me to come down first because of risk of brain damage with low oxygen for too long.

But when I finally was calmed enough to eat and go down there (with my parents), we found something amazing. They did NOT end up needing to put her on a ventilator. I just wish I hadn’t had to get down there to find this out. Someone couldn’t have told me?

I wanted to wait a day and be sure before posting, so that is why, for those of you on Facebook, you got this second half of things on January 6th.

She didn’t throw up again and they got her back up to 100% oxygen. Her blood pressure, RR, and heart rate have all been pretty stable. Even when her BP is low, her mean arterial pressure has been within normal range.

The morning nurse nearly caused her to vomit again but luckily, Sara and I questioned her actions heavily and got them to wait awhile before turning Teresa to clean her bed sores (which are really awful).

They just assumed Ts dobhoff tube was sitting in her intestines, so they gave her meds, crushed into huge syringes with lots of fluid into the tube. But she’s NPO so …what then was the difference between tube feeding and loads of fluids with meds?

They’d never looked at the X-ray (and finally owned up to that) and didn’t know the tube couldn’t be placed further than the top of her stomach. 🤦🏻‍♀️ If anyone causes her to vomit, and require a ventilator, out of carelessness, I’m going to be furious.

I want to ask her doctors if she could handle a thoracentesis as her pleural effusion is only on the left side…her PleurX catheter is on her right…

I also want to ask about VATS for the nodules in her lungs, as well as the mass that us now nearly 4cm. Has anyone here had VATS? Are you under full anesthesia or conscious sedation?

She’s been on zosyn (broad spectrum antibiotic) as a precaution against aspiration pneumonia.

But she’s tested positive for MRSA and VRE (Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant enterococci). What I’ve read though says a positive swab for either just means it’s colonized wherever the swab was done and you don’t necessarily have an infection. But….this led to everyone having to be gloved and gowned before going in her room.

If she continues to be stable, Mom and I are overnighting records to Dr Tomoaki Kato in NYC. We did send an email, but all I got was a read receipt. His PA called, but only in reference to the referral from Ts oncologist.

They requested her records and most recent CTs; they only had reports not imaging. The CTs were easy to get. The recent records not so much because Select Specialty Hospital isn’t digital yet….

I got a huge box of records that weighed more than one of our cats, and then we had to sort out all the useless notes and documents.

Fingers crossed. Really don’t see any good outcomes if he says no.

She still is very much wanting surgery and refusing hospice.

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