Tuesday, September 8, 2009

This Morning

They are planning on taking Elias back to the operating room this morning. They are going to do another flexible bronchoscopy to take a look at the pouch repair they did last Thursday. After they evaluate that the plan seems to be to replace what should be Elias new trach sizing although we have some concerns about that in terms of what they might put in. The concerns are not ones that are horrible it is just we have noticed a few things with Elias while he has had the various 3.5 diameter trach tubes in and the length of the tube doesn’t seem to impact things, but the diameter does. We have brought it up several times and I do not think they are ignoring us there is just other things going on that could also contribute to these concerns (elevated heart rate being one) and so they always decide to defer to those and “continue to watch.” We are really hoping to be discharged late today or possible tomorrow. That really depends on what they see today I suppose.

Elias is getting very tired from lack of sleep. Many things are contributing from vital signs around the clock, tons of residents coming in to poke the stomach (checking on G-tube) and just general discomfort that remains post surgery. He fell asleep so many times, but was only successful achieving a good nap once yesterday. He does have a very in descript cough that is high pitched and dry. While I did not think it was anything other than possibly effects from the surgery the fact that it just began yesterday bothered me. I figured if I mentioned it then it would be just that, nothing to be overly concerned with, but if I let it ride it would turn into something a little more serious. The consensus it that it is nothing, but they were not really prepared to say it was an effect from surgery. As always we will monitor that. Elias’ secretion level is still very active. They were having a difficult time hearing his lung sounds yesterday because he was so coarse and junky. Unfortunately, this is very close to base line for Elias and they do not understand why, but do not seem to be concerned because there is no real pursuit for an answer. So we accept it just as a baseline. With all the shifting of priorities and services some of the things that need to be evaluated again, like his medicines, have become a great source of confusion as they have started to resume his home med schedule that we have had on hold for a little over 3 weeks now. I have had 4 different conversations with various medical staff in the last 2 days about this and it is still confusing to everyone. I am sure the fact that it was a holiday weekend was not helping matters any. So they are trying to get that sorted and cleared up prior to discharge. Other than those few little issues Elias has been doing fairly well. I think he is just ready to go home! Thank you all again for the thoughts,prayers and words of encouragement. As always they are very appreciated. Hopefully, our next update will include the words going home in it.

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