A Long, Long Road Ahead

After taking Cathy and Kayce to the airport for their return to Chicago, I first saw Joy for a few moments about 9:30AM. She was placed back on the Bipap machine after significant drops in her O2 (55% on 12 lpm) and BP during a brief attempt to walk. Since she was on a full face mask and slightly sedated, she was unable to speak. One of our "nurse buddies" from the Step Down Unit was providing back up the Acute Care and was assigned to Joy along with another good male nurse. So we are back to two on one. Cheryl (RN) told me the chest X-ray taken this morning showed improvement from yesterdays (pneumonia) and the immediate plan was to allow her to rest.

About noontime, I was advised they planned to do a biopsy bronc later in the afternoon and they must reinstall the ventilator since this type bronc required some sedative. I was then informed that they may decide to do a Tracheotomy later today or maybe tomorrow and then remove the ventilator. The "trach" should make her more comfortable and make it much easier for her to breath. She continues to labor hard to breathe. Joy does not yet know about the "trach" ! And, I can tell she does not like the vent! She also doesn't like arms restrained but who can blame her? But.........................as the doctor told her, she must have the vent or stop breathing.

Both RN's said the biopsies showed something but what I do not know and they will await initial lab results expected in about twenty-four hours. They are having a difficult time balancing her sedation and keeping her BP and respiration in line. BP goes very low and respiration goes up to 45 sometimes with a goal of 20.

Her care is fantastic. Two of the Social Workers that we know came by primarily to check on me first and then Joy. This was thoughtful but part of their job. Neither could talk to Joy but waived at the doorway so I don't know if Joy acknowledged that or not. She probably didn't care either way.

Dr. John Hollingsworth, her Pulmonologist that she has seen for the last year or so, has been in Europe and returned yesterday, knew Joy had her surgery and came by as an unofficial courtesy visit. He has now moved to a teaching position. She really likes and respects him so I think her eyes lit up a little when he saw her for a few moments. He told me essentially what the Resident physician indicated earlier about the need for the "trach" and how it would help them help her more efficiently and lessen the chances for bronchial infection and irritation. He said "all" other basics are sound including her kidneys which usually take a big hit with all the new meds and surgery trauma. As far as compromised lungs, he didn't know but felt that they could work around that but it would be a slow, slow process and encouraged me to not get hopes up for a quick and speedy turnaround. We have not.

Overall, we only saw her for a few moments today and unable to converse. So I do not expect to see any change in Joy over next 24-36 hours. The plan is for no activity and allow those new lungs to rest. For whatever reason, they are not able to carry the load and working extremely hard.

I can only imagine what is going through her mind.