Tiny steps forward

As in several posts before, I'm sitting next to Roger's bedside. Lights are dimmed. My brain seems to slow almost in step with the ventilator's rhythm'ed breathing for Roger. One breath in one breath out. One thought in one thought out.


Roger has made progress....small, little baby steps of progress. His vitals look good, the drainage out of his chest is becoming more and more clear and is also less in volume. His fever for the majority of the day stayed in the 99-99.9 range. He was responsive when the doctors came in to talk to him and nurses asked him to turn his head or squeeze their hands. All good things. The chest xray from yesterday looked better than the day before. OK - so this is progress, moving forward. What I am reminded of quickly is what the infectious disease doctor told me the first day I met him ~ this is a long process where Roger's progress will yo-yo up and down as the over all progress moves up. By that he means, there will be bad days mixed in with the progress upward.


The day started to turn a little downward around 4:00pm as Roger's fever has started to climb again. He was up to 101.9 when I walked back in this evening at 8. All you can say is CRAP!!! CRAP!!! CRAP!!!! So they have given him Tylenol to help bring down the fever along with cold compresses to the head. I just did the non-scientific "hand to his forehead" test for temperature and it feels like he's cooler....so maybe the fever has come back down. I'll speak with the infectious disease doctor tomorrow morning to try to identify what keeps giving him a fever. I'm hoping they have a culture back from the bile sample they took. It should help the doctors identify what may be causing the fever spikes. Now you can see why the doctor described this process as yo-yoing up and down while gradually making progress. Personally, I could do WITHOUT the downward part of the yo-yo as I'm sure you can as well.


Because Roger has been improving overall, the ICU/Pulmonary doctor said that he wanted to start weening Roger off the Propafol and on to another drug (the name escapes me at the moment). The new drug would make Roger less sedate and will put him closer to having the ventilator removed. The doctor seemed to think we should be able to remove the ventilator tomorrow sometime. It kinda makes me nervous thinking about it which you probably think is odd. You see, on the ventilator with propafol+pain killer, I know that Roger has minimal distress, minimal pain - he can rest. I'm concerned about the pain and discomfort that he may feel once removed from the vent and the propafol (pain killers will stay on board). Plus, if he's not ready to be off the vent - still needs that assistance - then putting it back in again just increases the potential for something to go wrong....NO MORE THINGS GOING WRONG!!!!

Roger's ventilator has been dialed back as well as the propafol. Dialing back the ventilator encourages Roger's lungs to do more of the work. He has been taking 3-9 breaths on his own a minute over and above the 6 machine-pushed-breaths. That means his lungs are working - that's a good thing. You'll probably get tired of me saying "that's a good thing" but I do it as a reminder for me too. :-) The pulmonary doctor will not let Roger off the vent until he his confident that Roger's lungs are strong enough.

There weren't any real Roger moments today. He was out of it for the majority of the day.

We've decided that we're not going to tell Roger that its Christmas when he comes out of the fog unless he asks. There's no point in making him feel bad about being in the hospital over the holiday - and I mean that more from the perspective that he would feel bad for me and for his family. So, much like the story book character, Rip Van Winkle, Roger may "lose" a little time until we get him out of ICU. Once out of ICU and on the regular surgical recovery floor, then we'll fill him in on all that he missed while snoozing.

So as has happened at this time for the past few evenings, I am battling with myself. The desire to stay here with Roger is overwhelming. I want to make sure that nothing happens...that I can chase down a nurse if I need immediate assistance for him, that I can jump up and help him find his pain button to push if he needs it, that I can be here to change the cool wash cloth on this head. The room isn't set up for me to stay. There are two straight back chairs and that's it. So, I will have to put my faith in the night nurses to be attentive. My aunt Charlotte said she had read recently about people hiring a private nurse to come into the hospital and sit with a patient in recovery... Its a mighty tempting thought. We should be fine tonight with the night nurse ~ there are only three patients (including Roger) on the floor and they all seem relatively quiet. Our nurse has two patients and the other nurse has one. I believe she will be here for him....I'll call in during the middle of the night....just to make sure.

~ A