Today was a day of frustration and disappointment. Shirley remains on the ventilator. They had her do another breathing test this morning and she did not perform nearly to the levels necessary to be considered for coming off the vent. The doctor summed up her current condition as simply being exhausted. He surmises that the reason for the CO2 buildup yesterday was because she just didn't have the energy to exhale deeply enough.
About the only thing she seems to have energy for is for using her tongue to push her tube to the side of her mouth and then bite down hard on it. This sets off screaming alarms, first for pressure build-up and then if she doesn't let go, for too low of air volume exhaled per minute. The Respiratory Therapists were in at least a dozen times to try and secure her tube so she couldn't bite it, but to no avail.
Shirley's white blood count has come down since the antibiotics were started again. They performed a CT scan of her belly and chest looking for some sign of infection, but the scan was deemed "unremarkable."
The discussion has begun about performing a tracheotomy on Shirley, so that she can use the ventilator without having to be intubated. She has now had to have the tube inserted four times in three weeks. It is a constant effort balance ensuring she has the necessary respiratory support and the invasiveness of being intubated. A trach permits them the take her on and off the vent nearly at will. It would also allow her to speak and begin eating food. I expect that tomorrow I'll be asked to sign the consent form so that this procedure can be done.
1 comment:
Is a face mask at all effective for pushing air, as opposed to tubes?
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