Thursday, August 26, 2010

Update on Dad

Things have definitely taken a downturn. I was hoping it was just a bad day but after the weekend which was actually quite good (though I didn't see him) - I was told he was alert, responsive and watching PGA on Saturday. Sunday, still alert and they took him outside on the helicopter pad. Monday he aspirated and things have been pretty depressing since then. I talked to Dr. Purl that night but he just reiterated the "it will take time if he's going to live" stuff. Numbers were going the right way and WBC was down to 17 - all good. He was getting breathing treatments due to the aspiration and increased O2 needs but they were feeling pretty positive that they caught it "in time."

I saw him yesterday afternoon and he was resisting the efforts to get him to sit up. He has no strength and it's such an effort! I went back again at 9:00 last night and still pretty much sleeping and not waking for me. I spoke with respiratory who said he has ARDS and that his "lungs are shot" - basically from pre-existing lung damage due to years of smoking. He said the cilia in the lungs has been broken off in a smoker and he must rely strictly on his cough to bring up secretions, whereas a person with healthy lungs gets help from the cilia pushing everything back up. At this point his peep was up to 7.7 and O2 at 60%. He said the computer was telling him to move it up to 80% so things were not looking good. Apparently the WBC went up a little (don't know how much since I didn't see his nurse) but that would be understandable considering the lung insult.

I mentioned to the respiratory therapist that Dr. Purl hadn't mentioned that. He said Dr. Purl will keep fighting long after everyone else gives up. Maybe some denial? I find him not so "friendly" - competent I'm sure but not talkative. So I was a bit confused. He also prefers to just have contact with Sandy I guess - as the primary informant. He doesn't realize that I really need to know and can understand. I know that's why dad always made such a big deal of me introducing myself to the staff and letting them know I am a nurse.

Apparently these critical care docs at LDS have been involved in some groundbreaking work along with Dr. Orme (now at IMC) with ARDS patients and that their mortality rate for these patients runs around 30% while most hospitals are around 80%. Most institutions even discredit the possibility that ours could be so good and refuse to adopt the protocols they have developed at IHC. Although somewhere in the neighborhood of 200 facilities throughout the country have read the data and implemented the program with increasing success rates. The bottom line is he is in the best possible place for this condition but I was warned that someone with healthy lungs is an entirely different story from someone whose lungs are damaged like his.

I had written on facebook that dad had taken a step backward. Apparently that brought up some alarms when Gary read it, wondering if he should come back from the bow hunt. I don't think anyone wants to hear that things don't look so good. Right now, he needs lots of prayers and some healing of lungs that have been damaged. At this point his lungs are a greater risk to his life than the abdominal stuff.

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