Okay, I am going to guess that no one has heard this one before... Ileus. Paralytic Ileus is the explanation being given for Dorothea's gassy stomach. Basically part of her intestine was obstructed(collapsed), so food could not pass through her system, and was causing all this gassiness. Yes that is a new word, although I don't think you will find that one in the dictionary. Today they determined that the obstruction is no longer there, so they have started her on the peg tube feeding, but at a much slower rate. They had it set at 50 (I think that might be ml per hour) and now they are giving her only 20. Because they are not ready to give her a normal amount, they are continuing to feed her with the TPN feeding through an IV. Her IV stand was quite full today... She had a slight fever yesterday (100) and they have not been able to grow anything in their cultures, so they are not sure what was causing the fever. So... they started her on all sorts of antibiotics...5 different ones - that is why her IV stand was full! Apparently one of the medicines did the trick, she was at 98 degrees late this afternoon.
She was put on CPAP mode no the vent at 6 am, still on it when I left at 5pm. Wow - that is great improvement! She is keeping good numbers, and not complaining about feeling like she can't breathe. Harold says that they are shooting for Monday probably for switching her to the T-tube. That is a tube that will allow her to breathe regular air.
The respiratory tech told us today that she really wants to get the Speech Therapist in working with her on her swallowing. She does not swallow good enough to get stuff out of her mouth, which causes her to gag... you get the picture, not a good thing. The resp gal (Melinda) is very nice, and is very encouraging, praises her a lot and takes very good care of respiratory and oral care. She had her teeth brushed today and a royal lip treatment! So many things that we take for granted, are a really big deal when you are in a situation like Dorothea is.
She had dialysis this morning, removing 1.8L. Her left chest tube may come out soon, she is not draining much from that side. Her right chest tube is still draining quite a bit though, 300ml during the day shift. She is still producing small amounts of urine...we are hoping that will continue to improve.
PT and OT came in today, but she did not want to participate. I talked with her about that briefly... because she really cannot continue to refuse the 'workouts'. She knows that, but she wants to wait until she is breathing easier. I think it takes a lot of energy out of her to simply breathe. Add exercise onto that and it makes it much harder to breathe.
John came up while I was there today... with a broken hand! She got to hear his story of him being bucked off of his horse. I brought up pictures from our trip last week, and she got to see them on the computer, nice and big. Harold brought in more "movie star" roses, and I brought in an Easter Lily. She has quite the beautiful collection of foliage.
Wishing you all a wonderful evening!
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