Friday, February 6, 2009

Trial and Error of a Tracheotomy



We had a safe trip to and from Auburn Hills. Kelsey and Christopher enjoyed the game, despite Miami Heat losing by 3 points. During the game, Kelsey's lips swelled and her face became increasingly red with hives. The ride home was uncomfortable for her. By morning the red blotches all over her body had blended to look like a ripening tomato. Her feet looked like she had walked through hot coals. I called after hours care first thing in the morning and they scheduled her for a 10:15am appointment with her doctor. Due to Showcase at Calvin Christian, the school day ended at 1pm on Thursday, so she missed another day :( Her pulse was at 156, which is high. They asked if she felt like her heart was racing. Dr. Halverson detected a heart murmur, but after a few minutes said it was probably from the congestion. Kelsey had extensive breathing tests done about 2 months ago and nothing significant was detected at that time. She said they will monitor any changes. We think she had a reaction to Diphahydramine. Unfortunately, I did not look at the active ingredients close enough when I gave her Tylenol Night time. We know she breaks out in hives from Benadryl, which is the same thing! I'm usually very good about cross referencing any meds on the computer before I give them to her. Dr. Halverson ordered Prednisone for the hives and Phenergen w/codeine for her cough. She slept the day away.

Mom checked in with me to see how Kelsey was doing. I checked in with Mom to see how Dad was doing. They had come in at 8:45pm Wednesday to do the CT Scan. Dad continues to have a fever, hovering around 101º. They work with celsius so it is in the 38ºC + points range. I relieved mom at 9pm Thursday night. She had been holding ground for 33 hours. My cousin Jim had stayed with Murphy on Wednesday night. Needless to say, when Mom arrived home Thursday night Murphy was elated!

When I arrived, Nurse John was completing dialysis. Dad had clotted a couple of times creating a more difficult path. They have been unable to remove extra fluids through the dialysis. It is very frustrating. Nurse John explained that is the unfortunate side effect of 40 years of smoking, despite his quitting 10 years ago! His heart and lungs can't keep pace with the machine. It also happens to people with asthma. Dad is so swollen. It makes it really difficult to draw blood which they usually need to do a couple of times a day. The doctors said he should be able to gradually release fluids with stool activity. He must have heard the doctors talking about ordering a suppository...lol. Hopefully all those toxins and infection will pass. I was also brought up to speed that the trach that had been inserted Thursday morning was broken. The respiratory team had managed to repair it with a rubberband! Another respiratory tech came in and looked at it and said it was the second one he had seen that had broken. Apparently it is defective. One surgeon came in last night and decided as long as it was working and not causing stress they would leave it until Friday when a complete team could be assembled to replace it. An associate of Dr. Foster came in this morning to check on it. She looked younger than our 19 year old! The nurse and I both did a double take when she introduced herself as a surgeon! She explained that it is best if they can leave a new trach in for 5-7 days before moving it so the pathway has time to heal. Dr. Foster had already advised the nurse he wanted it replaced and would not be available until late afternoon. I guess they will replace it later today. I was unsettled for most of the night. He has an infection somewhere. They don't know yet. Dad's blood pressure was up, he was swollen, his fever continued and he was congested. Due to the broken trach they had to be more careful moving him, which they like to do every couple of hours so the skin doesn't break down. Every time they moved him or checked him they would have issues with the trach. It was oozing more due to the break, plus the rubberbands would come off. He would be agitated and his blood pressure and fever would go up. This morning the respiratory team turned off the vent again. He still has lots of congestion and 'gunk' in his lungs. For the most part his breathing is fairly good. His room is rather chilly due to the staff trying to bring his fever down. I wear a fleece hoody with the hood on and keep a down blanket nearby. Mom says she keeps her scarf on often draping her winter coat over her shoulders. Welcome to the Spectrum Health cooler!

Kelsey called at lunch time from school with a pounding headache and a return of hives. I left and retrieved a red and swollen daughter from 5th hour Global Studies. We will have to make arrangements later to retrieve her car. Thanks to leftovers from the Poms Team dinner we hosted on Tuesday, I have had a base to feed my family fairly conveniently this week. All I need now is to find time to get a much needed haircut.

The Lord himself goes before you and will be with you; he will never leave you nor forsake you. Do not be afraid; do not be discouraged.
Deuteronomy 31:8 NIV

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