Thursday, May 27, 2010

Post Op and ICU

I got out of surgery around 10:30 PM.  I remember waking up on the table after intubation and gasping for air as I had a huge amount of phlegm in my throat.  The first few seconds weren't bad as I thought I could cough them up, but as it continued, I was really struggling for air until they were able to suck it out or squeeze it out:  Shortly after that little adventure, I blacked out again until waking up in recovery.

I was in a terrible amount of pain and they were having a difficult time managing it.  My blood pressure was severely low, at around 60/40 at the lowest that I can remember, although my wife seems to remember a 50 mixed in there as well.  My heart rate was racing around 145 BPM.  My wife and I chalked all of this up to the pain and the surgery, but at the time, they weren't telling us how severe the situation really was.  I was conscious over the next four hours as they managed me in post-op recovery until they could get me into ICU.  The doctors and nurses were coming in and out as they monitored me, but mostly it was just my wife and I, with me doing a lot of moaning.

It was about 2:30 AM on Thursday morning that they finally got me upstairs and my wife headed home for some sleep as she had a pretty long day waiting around while I was carted from floor to floor.  Once in ICU, the docs were still concerned, although at the time, I could only see the looks on their faces and not really what they were concerned about.  Not sure why I didn't ask... I'm pretty nosey:  Assuming the pain sort of distracted me from the rest of my environment.

The docs decided to insert a central line into my jugular to better monitor my blood volume and prepare for a blood transfusion, should I need one.  I was conscious for this process and got to ask the one doctor all types of questions while the other was sterile and actually dropping in the line.  I must say, this was one of the more interesting points in my life, as I started to realize at this point the criticality of the situation, yet somehow disappointed that this wasn't being taped.  (I obviously couldn't see it as they were putting the line into my neck.  This may sound odd, but how often does this type of stuff happen?)  I remember the CVP number starting out at 2 or 3, which the doctor mentioned wasn't so good.  Once the line was in place and adjusted after a few x-rays, they immediately hit me with IVs to the central line at a wide open rate.

The rest of the morning is sort of a blur as they started to administer pain medication and I floated in and out of sleeping.  As today has progressed, my blood pressure has increased, if slightly, to where people don't seem to be freaking out about it.  Infectious Disease was in again today to discuss the issue with the infection, which we are still trying to narrow down.  They have started hitting me with a bulldozer of antibiotics, around 4 I think, to try and cover many of the bases that they think it is.  The final results of the cultures won't be available until tomorrow:  At that point, we should be able to choose the appropriate antibiotic for the infection and move forward from there.  The fever seems to have broken sometime this morning or afternoon with only a slight spike, so the irrigation from last night, as well as the antibiotics seem to be working it's course.

I have a feeling I'll be getting to stay another night in the ICU as they get my blood pressure and the infection under control.  I'm not in a hurry to leave, as the care here has been really good and the nurses have actually been quite entertaining.  My father always said you should take care of your nurses:  They not only administer the needles, they also administer the pain medication.  Remember to tip your waitresses!

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