Monday and Tuesday 09-30-08

We have some major changes today. Over the weekend, the feasibility of removing the ventilator was tested. Mother passed the tests. The doctor is now taking her off of the Propofol, which is used to sedate her. She is being prepared for removing the ventilator altogether today. This will require the family to make a decision on what to do should this fail. That is, do we put her back on the ventilator if her lungs suddenly fail to do the job or let her go? This gets rather complicated for our family. It has to do with the doctor’s vision of her future and dependence on dialysis. The attending physician discussed her general condition with me this morning and he is predicting her to be bed ridden for more than six months and in a nursing home for the next year.

Over the weekend, mother had bleeding and lost a couple of pints of blood in her bowel movements. This is believed to be an ulcer related to the event that led up to the current situation. They gave her a rest from tube feeding and went back to the IV feeding method. Today, after three units of blood being given her over the past 3 days, she has stopped bleeding visually and her blood tests indicate that she has stopped losing blood. Therefore, they will resume tube feeding but at a lower rate and keep with the IV feeding at the same time to keep her system active but working less to see if this problem just goes away.

Her white blood count is 14800, dropping quite a bit from yesterday. That shows her infections have not gotten worse and maybe a little better. Her skin continues to have a lesion on the back, buttocks and calf. Those are the worse lesions needing to heal. The good news is that all three continue to get smaller. On the other hand, she has developed another one on her right back heel and that has grown a bit over the past few days. This may be a bedsore although she has a special bed. They are propping it up to relieve the pressure on it. Her mouth and skin continues to improve. The area of most general concern is the buttocks area because it is difficult to keep her weight off of that part of the body.

Her dialysis took 2.5 liters of water yesterday, which was the goal. Her blood pressure was normal. It took a 4 mic dose of heart pressure elevator medicine to get it high enough for an effective dialysis. The nurse says she is weaning her back to zero today.