Day 15 ICU

I struggled so much in days 13 and 14 because my mom's outward appearance was worsening. Her edema came back, severely in her hands. Due to her low platelets (clotting components of blood) she started developing a condition called petechia, small red spots on the skin caused by broken capillary blood vessels. 

The pulmonary technician performed my mom's first spontaneous breathing trial on Day 14. Mom lasted 10 minutes. Ideally they want to see slow, large breaths. This test didn't come easy, but it was a start. My mom ended with rapid, short breaths. 

The night of day 14, they started to work on motility by sitting her on the edge of her bed. This takes a team of 2-3 nurses. They stabilize her while she sits there for up to 5 minutes. 

Day 15
Goals: alertness, check blood sugars every hour, tube feed tolerance, rest and comfort, motility (sitting) and spontaneous breathing trials.

In the early morning they did another SBT, spontaneous breathing trial. Mom lasted for 20 minutes. 

I was fortunate to spend a good chunk of today with my mom. The edema and reddened skin is difficult to see, but once again she began demonstrating her will to get better. She kept moving her feet to exercise them. I sat with her and read many of your comments and words of encouragement. She began shrugging her shoulders and lifting her swollen arms ever so slightly. More exercise. She wiggled her finger, like she wanted to write on her board again. Sadly, it just wasn't possible with her severe edema in her hands.  

Anything the nurse asked of my mom, she nodded, yes I will do it. Do you want to sit up? Yes. So a team of three nurses stabilized her at the edge of her bed for 5 minutes. My mom grimaced and it didn't look easy. The nurse asked, do you want to try to stand up? My mom nodded, yes. She wasn't able to stand, but her willingness to try amazed me.

Her sodium level was moving in the right direction. Her blood sugars were staying within normal range with a few outside range ever so slighting. This allowed the nurses to cut the volume of D5 solution, a sugar solution, in half and lower IV insulin levels. Protocol for checking sugars is: if she gets 3 consecutive blood sugar readings between normal range of 80-150, then they can begin checking her levels every two hours. She had three normal reads, then a 152. Bummer. 

She was tolerating her tube feeding better last night, so they adjusted the rate to goal, I believe 45 cc/hour. I saw the nurse check residuals (how much remains in the stomach). They were decent, 275 cc, especially with the tube feed running at goal. If they get to 500 cc they have to stop the feed. 

The third spontaneous breathing trial was performed. Mom lasted almost 20 minutes.

Part of her recovery after chemotherapy is giving her units of platelets and RBCs, packed red blood cells, until her bone marrow kicks in and starts making its own. My mom's MDS, bone marrow disorder slows this process. She has been given many units of platelets and RBCs in the ICU. Today she received a unit of platelets, but didn't need RBCs. 

My mom continues to press forward. 


***(Thanks for your patience with my posts, proof reading isn't as important to me as just getting the daily reports out).