Confusion

April 22, 2016

ICU Day 5

Den woke me up at 130AM. He said his bed was wet and he didn’t know why. I called for the nurse and we found that he had pulled the arterial line out of his right wrist. There was blood everywhere! It took us a good hour give him a bath and get the bed and floor cleaned up. Den was confused as to what he had done, but went back to sleep quickly. The nurse also changed all his dressings.

At 330AM, I was again shocked away by Den yelling for me. He said that he was wet again! This time he had managed to pull out the NG tube from his nose. He told me and the nurse that he thought is was a “booger”. The nurse talked to him for a while and told him,”Den, if you touch anything else, we will be forced to put the restraints back on. It is for your safety, not to be mean or cruel. We need you to get better and there are things that if they are moved could really hurt you.” He looked like a little boy being chastised for spilling his milk on the table, but he understood and we had no further issues.  The nurse and I discussed the  possibility of ICU psychosis setting in. She said she would leave a message for Psych to come and evaluate him tomorrow.  Before Den went back to sleep, respiratory was in for his breathing treatments.  Den fell asleep again and so did I, I had a feeling it was going to be a doozy of a day.

Den woke up again at 5AM. He was extremely confused and had no memory of having surgery or being extubated yesterday. He did remember the family visiting and where he is at this time. When the nurse checked Den’s blood sugar is was very low. He was not cleared to eat or drink so he was given a cup of apple juice and a small sponge on a stick. He would soak the sponge then suck the juice off it. I think he was in heaven just getting to taste something again. We were all hoping the low blood sugar was the cause of his confusion, but the doctors didn’t think so.

Today, Den’s urine was back to a normal color and had no odor. His stats were all stable and his chest tube drainage was beginning to slow down.  All good news.

Around 830AM, they decided to switch Den off his Bi-Pap to the nasal canula. He was very argumentative and combative with everyone. He seemed to want to argue about every little thing. He insisted that no one was talking to him or helping him. We all knew this was not the case.

The LVAD team came in to deliver batteries for Den’s LVAD, in case he needed to go anywhere for tests. They also downloaded the data on Den’s controller since surgery. The doctor said that Den’s blood work looked much better after the duiretic therapy during the night. It would be a take a couple of days of adjustments to get the LVAD tuned in to Den, but that is normal.

Respiratory was in again…only one breathing treatment this time. And right behind was Physical Therapy. Den did much better than yesterday. They worked with him on ease of movement without using his arms. He took a few more steps and stayed in his chair for a while.

When the nurse came to check his blood sugar again…it had been fluctuating wildly since surgery…is was again very low. Back to the sponge and apple juice!

Around 2PM, Den asked if he could go to the bathroom. The nurse brought him a bedside commode and we helped him move over to it. He sat for quite a while and finally had a bowel movement! This was great news! It had been 6 days since he had any kind of bowel movement.  When he was finished, he asked to go back to bed. He was utterly exhausted from his efforts. I teased Den that he was trying to stink me out of the room for a long time after he was done…we had a really good laugh. It was the first laugh we had shared in more than a week.

Dr. Bloom, came by to see how Den was progressing. She did some exercises with him and had him drink some juice both with and without a straw. She cleared him to start a soft diet and said that she would see him again on Monday. If he didn’t have any problems eating/drinking over the weekend, she would clear him to go to a standard diet. More good news!

Respiratory was in again. Breathing treatment and compression/vibration therapy on Den’s chest and back. This would help to break up the congestion and get it to move out of Den’s lungs.

Den ate half an orange, some applesauce and chocolate pudding.  He also got to take his pills orally for the first time….more progress. Den’s dinner consisted  of some chicken broth apple and orange juice. I think he loved every bite of both meals, just to actually eat again.

The rest of the day seemed to be a normal day..all be it in the hospital in ICU. Dr. Hart stopped in to see how Den was doing. He told us that the confusion and loss of time/days is normal after this kind of surgery. He would continue to check in overnight and throughout the weekend.

By 7PM, Den was sound asleep. He woke up confused and argumentative an hour later. He seemed to be in pain, but would not ask the nurse for pain meds. He finally relented about 10PM. The meds kicked in and he slept well. The doctors had ordered his diuretic therapy be continued, so we were happy that he still had the Foley catheter.