Day 6 - August 25: Updates/Recap

🌇Today's Recap:

Today did a Pan culture- collected urine, sputum, blood. Takes 1-3days to grow/result. Sputum showed wbc so likely some sort of bug but need to the culture to result to know what/how to treat. 

His Vitals are very affected by agitation/activity. & Hourly cooling via central line (being cold makes it hard to stay relaxed). 

Continued Propofol (& intermittent small dose fentanyl IV push to control agitation/ pain). 

Propofol can affect liver labs if prolonged use. 1 indicator of the liver being affected negatively would be green urine. His is clear yellow. Current dosing 25-40mcg (80-100 is max). So he's on a relatively low dose.

We talked about the Presidex (a preferred ICU sedative) that they previously tried. This med has tendency to lower heart rate & w/ agitation dad's HR lowers anyway (to the 40s), so Presidex is not a safe alternative for him. So they'll continue with low dose propofol. 

Also give Morphine which lowers HR too. 

She said dad is very self-soothing after agitation from neuro exams. 

Goals ahead- Extubation (breathing tube out), but they like to see consistency in alertness, opening eyes, & following commands. Has not repeated the thumbs up but this can be normal & they just want to see more consistency with these types of following command & wakefulness. 

Main Goal right now: temp control. 

They have to rule out if temp is bug related or insult to brain. If brain impaired it can't regulate temperature as well. 

He's getting Tylenol around clock, w/ temp control. 

Co2 level (lab was 44, within normal limits this am.) Nurse will inquire about repeat arterial blood gases (labs in morning) bc they've been doing them regularly. 

The monitor has consistently shown high CO2 levels (50s) but actual labs show (40s). Sometimes there's a monitor discrepancy (as is in this case). So his actual CO2 is normal/has been normal. 👍🙌 

Range of motion done every morning with PT for knees, arms, and feet. 

No pressure sores, continue to have padding dressings on bony prominent areas. 

Bruising right armpit/chest, is from their neuro checks (pinching him there). 

Redness on right side of chest d/t accident. 

Watching for pneumonia. If present, it could be aspiration pneumonia possibly from the initial intubation @ the accident (life saving measure to protect airway but sometimes this can occur in the process and takes several days before it shows itself). 

It may seem like a lull in progression because they're in the "gathering phase." They need to gather more information to know the right steps forward. 

Pending MRI bc dad can't quiet lie flat yet without his Vitals being affected more (low HR etc). 

With monitoring fluid on lung start with less invasive measures first (i.e. Lasix vs more aggressive measure i.e. chest tube). 

🙌🏻🎉Praises:

We had such beautiful God given encounters with people around us! 🙌🏻🙌🏻❤️ He is so good!! We had the opportunity to pray with several and hear their hearts. 

Dad looked really comfortable today. 

Mom and I got walk in around the surrounding campuses. It was such a beautiful day today! 

We know God is continuing to work! Scotty counted 163 respirations initiated by Dad before a missed one and then he started right back up again. He also raised his left arm twice spontaneously! 

I just can't get this song out of my head tonight:

"As long as I'm breathing

I've got a reason to

Praise the Lord, oh my soul"

~Praise by Elevation Worship

❤️🙏🏻Prayer Requests:

Complete, restorative healing for Dad that we know can only come from God!! So that people will see Christ in this situation, know His love and come to know Him. 

Wisdom for our family. In asking the right questions, in advocating for Dad, in the day to day, knowing how to take care of things that need taking care of, etc. 

Health, rest, and continued seeking of Christ in all of this. 

Our family and friends also impacted by all that's going on with Dad and are supporting us in many wonderful loving ways in this time. 

Please pray for our new friends in Christ. We have several prayer requests that were shared and would love prayer for them from you, too. 

The other patients and families with varying situations in the Neuro ICU.