BMT Day +82 Still in the ICU, but improved

5/8/11

Teri is improving – thanks again for your long-distance input – but remains intubated on a respirator which is set to an assist mode where she initiates the breath and it helps her take a full breath.  She was on 100% oxygen the first night, but was weaned to 60% by Friday, 50% Saturday, and 40% today.  Her left lung was greatly diminished initially but opened up by the next day.  However, the pleural effusion (fluid around the lung) remains and also the abdominal ascites (fluid in the abdomen) are causing enough pressure to restrict both lungs from fully expanding.  Today, they removed 3.5 L (7¾ lbs) from her abdomen.  Tomorrow, they plan to remove additional fluid from her lungs and hopefully extubate her (remove the breathing tube).  During the hypoxic period (lack of oxygen), both her liver and kidneys suffered some damage, which should recover.

This episode of acute respiratory failure was a complication of upper endoscopy (to look into the stomach) during which she aspirated gastric contents that immediately compromised her left lung and caused necessitated intubation and a respirator.

One of the most challenging aspects yesterday was communicating.  In a shaky script, she wrote letters on a piece of paper CWWWW IIIII.  She inscribed them with her finger on her blanket.  She mouthed them.  She pointed to IIIII OOO on an alphabet card.  She wrote OOP and I I I I again.  She answered our questions yes or no.  But the three of us plus the nurse and respiratory therapist could not make an intelligible guess about what she wanted although we eventually determined that her abdomen was causing her more pain.

I shed tears on Thursday when Teri was transferred from the BMT ward to the MICU (medical iCU):

- for Teri’s immense and prolonged pain and suffering

- for Teri’s even greater loss of autonomy, being unable even to speak or communicate

- for Teri’s fear that this could be the end

- for my being overwhelmed

Ben was here to support me through the initial difficult hours.  Brother Tony from CA arrived on Friday.