Thursday going on Friday Repeat!

On Wednesday at 3.00 am a roof tile in Iain's room disintigrated and proceeded to drip nasty brown liquid on poor Elodie, Iain's nurse.  Although she dealt with it calmly without waking Iain up, by 7 am the ICU team decided that it would be too risky to let Iain stay in that room so he moved down the hall and then actually got downgraded (or is it upgraded?) to floor status as he seemed to be doing quite well.  That, of course, was the kiss of death, as he his SATs started to trend downwards and by yesterday he was having trouble breathing, could not get a break from the secretions, had a temperature and the nausea came back with a vengence.  By the evening, his doctor Rachel, decided she wanted him back and so although his room is the same, he is back in the CICU service.  Prevailing thought is that he may have pneumonia and is being treated for that.

TIme to Break Out the Smart Watch

Iain did 6 laps in a row around the unit today which is his record.  So I will bring in his watch so we can start recording his progress more consistently.  Remember as he is doing this he has to be attached to various pumps as he still has a chest tube pumping out the air around his lungs.  Fortunately the nausea has finally abated so his feeds are being restarted.  He still does not feel like eating as he cannot smell or taste with the tracheostomy.  His nurses and doctors all promise to go and get whatever he wants from outside of the hospital if he were to be tempted by non hospital fare, which is, of course, not difficult.  Wonders of wonders though today the cafeteria had installed a refrigerator full of healthy meals that actually looked quite appealing. Iain is unlikely to want these.

Thursday going on Friday

Yesterday and today have been miserable for Iain with the feelings of persistent nausea.  He was not amused as I tried to commiserate with him by likening it to morning sickness.  His look of disgust quickly made me shut up.  Yes, I know, not one of my smarter moves.  The nausea started a week ago but was manageable as it was only in the evenings and not interefering with his rehab.  Unfortunately today and yesterday he woke up with it.  Another Iain problem that is perplexing the great and the good in this hospital and they are taking it very seriously as they know it affects mood and rehab.  On to the bigger issue - the pneumothorax.  We thought it had been easing off but instead it grew overnight as the remaining chest tube got clogged.

Iain "the Beast"

As Iain walked by yesterday with his two chest tubes and no walker, one of the cardiology fellows, Manish, mentioned that Iain was a beast and he should be set up as an example to other patients to what they can achieve.  I have to admit, it has been easier to share his advances.  What I do not share are all the daily things he deals so stoically.  This week he has a lot of nausea.  He does not complain about it or anything else, he just deals with it.  But I can see it is miserable.  Nevertheless he pushes on and rarely takes a break from his daily routine (well apart from the algebra).

Iain's Orders

Is that we need a much better photo. This is from yesterday on the roof top garden with Sarah Dorman wearing his new Adidas hoodie from the professional climber Libby Sauter who is also interestingly enough a pediatric ICU nurse.Today was a better day for Iain in the sense that he was not suffering from the nausea that he has had for a few days.  This would be good news normally but it is most likely related to the fact he stayed on the vent all day due to the procedure to change the location of the chest tubes.  A bit of a double edged sword.  Nevertheless, it looks like the new location of the chest tubes is a big hit with the lungs.  The tubes are bubbling away and I think the last XRay saw a decrease in the pneumothoraces. Yippee!

Today's Goals

Iain is currently in Intervention Radiology where they will use the images from yesterday's CT to try to repostion the two chest tubes to better extract the air around the lungs.  These pneomothoraces are his real remaining medical issue, granted a significant one.  I really feel that he will take off once these are resolved.  The dark area on the left lung is the largerpneumothorax.  On the right it is not visible in this picture as it sits lower down.  Fingers crossed that this will be gone soon,


I was lured away by Marie-Laure who came down from Cincinnati and Sarah D. who flew in from Virginia for good food and very good wine on Saturday night.  The fellow this week, Rachel, and Iain's nurse, Daniel, who were on duty during the day colluded to persuade Iain it would be a marvelous idea for him to allow me to have a night off. It was very sweet as they all trooped in to tell him how they were all going to take care of him - like they don't anyway!  As you know these doctors and nurses are incredible.  On Friday night Dr. Sandeep signed out of his service then played 45 minutes of Xbox with Iain and was soundly trounced.

Brownies on the 4th Floor

Iain started to recover last night from the collapse of the lower left left and although back on the ventilator yesterday he managed to walk around the whole heart center.  He did the same again today and also went to the 4th floor with a wheelchair to make brownies.  

Thursday - One Day it Will Be Funny!

This morning, I awoke to Iain asking the Pulmonologists how quickly he could get off support.  Everyone had been encouraged how yesterday he had done 6 hours off the trache and walked 250 ft without ventilator support.  He asked to go back on the trache collar quickly which just administers a minimal amount of oxygen to speed up his rehab.  As he transitions to the trache collar the secretions which are kept down by the pressures the vent administers start to make him cough and these can be exhausting but he knows it and knows he has to get through it to be able to breath comfortably.  This time, his sats just kept dropping and his heart rate rose.  We initially thought it was  bit anxiety and tried to talk him through it. Eventually we all realized that something was going on.  Ultimately his left lung has collapsed.  The good news is that it may be due to a build up of secretions.  So they are trying to treat that.

Defying Expectations

Iain's goal this morning was to walk with the walker to his doorway and by the end of the week it was to be about 100ft.  This morning he kept walking out of the door.  By this afternoon he had done a solid 250 ft to the acclaim of the entire CIUC unit. He looked so strong people were utterly astonished.  Carol, his PT was positively giddy with excitement.

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