We just returned from the hospital. Kirsten’s friend Maggie is the SCU 4 CNA tonight, and is going to give Kirsten a spa treatment. For dinner she ordered a lobster roll, tea, ginger ale, fruit, and apple crisp. If they keep treating her so well she’s not going to want to go home. The girls and I took turns feeding Kirsten, which was nice. She talked to us, and laughed.
Report from the nurse tonight was unremarkable. Kirsten is off of the pressors and isn’t on any pain medications. She’s still receiving oxygen through a nasal cannula, and levels are good.
I know this is short and boring, but, quite frankly, those are the kind of updates we like for a bit. Am I right?
Good night, my friends. We love you all.
Kirsten is presently enjoying her first solid food since Monday (the only other food she had was through a feeding tube last evening). I ordered her peaches, whipped potatoes, squash, strawberry Glucerna, low sodium V8 juice, and blueberry yogurt from room service. She is alert and can carry on a conversation. She wasn’t aware of the damage to her right wing, but doesn’t seem too bothered by the news.
Emily, her endocrinologist, called while I was having lunch with my buddy Adam at Portland Pie. She said Kirsten is responding very well to the metyrapone, which has reduced her cortisol levels. She is still on high doses of steroid, which compromises her immune system.
I had a long consult with Dr. Patty Lerwick, the ICU attending physician. Nobody expected Kirsten to improve this quickly. She is completely off the pressors (except a small maintenance dose) and is receiving oxygen through a nasal cannula. Oxygen levels are hovering in the high ninety percent range, which is the goal. Kirsten’s rapid recovery in the last day indicates she probably does not have an infection, so we’ve eliminated two of the four antibiotics. She will come off the other two when the bacterial cultures come back negative from the pathology lab in the next day or so.
Patty apologized to me for the approach of the anesthesiologist who spoke with me yesterday and who clumsily suggested that low oxygen levels and the lack of the SCU nurse’s urgency, might have–probably did–lead to some damage to Kirsten’s brain. There is no indication that that happened, and the low O2 levels which concerned us post-op and lead to intubation and ventilation, were not dangerously low.
If Kirsten continues to improve today and tonight, the SCU team might put in a transportation order to another room in the hospital. There is very little bed availability, so even if there is a transportation order there is no guarantee she will be moved. I, of course, would prefer she stay here where she has a far more dedicated team.
She remains on Keppra (Levetiracetam) to prevent additional seizures. They still believe the cause of the seizures was high blood pressure, and say that it isn’t common for patients with high blood pressure to seize. Kirsten, as I’ve heard so many times, is atypical and complex (we knew that already, right?).
Because she’s now extubated, Kirsten is on a long lasting pain medication, Dilaudid (Hydromorphone) via the PICC line. The nurse said if I want some I have to first go through the Emergency Department (ED). I think I’ll stick to Cold River Blueberry Vodka, thank you very much. :)
I spoke with several people about the reasons Kirsten had to be placed on ventilation. Heather, the attending respiratory therapist, explained to me better what is a pulmonary edema following a postoperative laryngospasm, which Kirsten experienced. She explained it to me in a way that I could understand. I love learning this stuff. If people weren’t so gooey, I think I might like medicine. It’s so complex, which is incredibly appealing.
When I walked into Kirsten’s room she was smiling, off the ventilator, and changing the channel on her television. What a difference a couple days make! I asked her if she knew she had a seizure and broke her neck. She said she did. I told her she broke it good, to which she replied, “If you’re going to do something, you might as well go all the way.”
A sonographer is doing an ultrasound of her legs to check for blood clots. Around noon Kirsten will go to x-ray for an image of her neck, which is standard after surgery. They’ll be looking to make sure everything is in the correct position.
She gave me a high-five, which was pretty freakin’ awesome. I’m so indescribably excited and relieved to have her back from the brink. She’s sleeping now, which is very much a good thing. She’s going to need plenty of rest over the next couple days to prepare for the next round of tests and procedures.
I spoke with Kirsten’s nurse from last night, Peg, by telephone. Kirsten had a “very good night.” She’s on a tiny amount of one pressor, and is going through CPAP trials to get her to breathe on her own to exercise her breathing muscles so she can come off the vent.
She was washed up this morning and has been being fed through a tube. Hopefully the ventilator weaning will continue to go well, and that there isn’t any swelling which would prevent extubation sometime soon. It would be great to hear her voice again.
I had a beer with my friend Jill last night after having a nice dinner with Soni and the girls. It was nice to talk to someone about what I’ve been going through. Emotionally I’m feeling very strong, and pleased that the precipitous decline in Kirsten’s condition seems to have been halted. The weekend should be uneventful, and provide much needed time for her to get stronger for next week’s activities.