Sorry that I didn't get a new post out late last night. I took a break yesterday and enjoyed a lovely dinner with Pete, Carolyn and Frances (thanks for letting me crash your Valentine's dinner). I returned to the hospital expecting to spend a couple hours with Shirley and then return to the Hague hotel for the night. It didn't work out that way.
As I was arriving, Sally the night nurse was calling me. Shirley was not exhaling deeply enough and the CO2 was beginning to build up in her lungs. They had put on a BiPAP mask which was supposed to help by monitoring her breathing and by supplementing for her if her breaths were too infrequent or not deep enough. It had been mentioned that if the BiPAP didn't help reduce the CO2 level, they may have to reitubate her.
The fear of having the tube reinserted was at odds with the pain associated with breathing deeply enough to reduce the likelihood of this. But Shirley was a real trooper and fought through the pain. The next round of blood chemistry results showed the CO2 levels dropping into the acceptable range. By morning things looked good and she was told the potential of having the tube go back in had passed. The look of relief in her eyes was as if a huge burden had been lifted.
Still, the pain issue remained. This morning, an anesthesiologist stopped by and checked her epidural. Apparently, it had slipped out of place somewhat, which was making the pain medication much less effective. A little adjustment and wham, she got the full effect of the pain meds. But this is all a balancing act, and an increase in the pain meds contributed to a decrease in blood pressure, so they've now backed off on the epidural and have found the point where is is comfortable but her BP is in the range they want to see it.
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