ICU Day 23 – Keeping the doctors guessing

Today Rachana’s health kept the doctors guessing. Her BP dropped a little and they had to get her on a low dose of pressors to keep her stable. Her ventilator settings kept going up for the last 2 days and finally stabilized a little. The doctors have no explanation for these things. Now that they found a possible bacterial growth in a valve of the heart they are worried where else this might have happened. They want to do more scans but delayed it as they want her to be a little more stable with lesser ventilator setting and higher BP, before they do that. They also want to do the tracheostomy when she is more stable, so maybe another 1-2 days delay. About the bacterial growth on a heart valve, they want to do another procedure where they put a small pipe down her oesophagus which then does a ultrasound of the heart from inside the stomach. It’s crazy and cool at the same time. It seems this procedure gives them a more accurate analysis of what is actually on that valve. The want to be sure if it’s a bacterial growth or an abscess i.e. a pus formation. The treatment options are different based on what it is. There are risks to this procedure so they want to wait for a day or two and see how the fever and BP behave before they try it.

Rachana was probably more awake and aware today since she’s been on the ventilator. See was on low dose of sedatives which were perhaps keeping her calm and the right amount of sleepy. She was trying to say a lot of things and I maybe got a few. The nurse did a basic test to see her cognitive ability and here is what she wrote. As you can see, other than the date and year,  she did pretty well.

cognition

Later she asked me to get the young nurse’s name and address and I’m not sure if she was being sincere or trying to get me trouble! I’m not making this up…

nurse

 

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