Today, Rachana’s heart stopped from 4:40 pm to 4:51 pm.
In the morning she complained about chest pain on the left side but the pain went away with a few setting changes on the ventilator. Later in the afternoon her BP dropped and there was a rush of nurses to stabilize her with pressors (BP meds). They also ordered a x-ray to be sure and that showed her left lung had collapsed. This was a much bigger collapse compared to the right one. Again, they rushed to get a chest tube in to relieve the air that was probably accumulating in the chest cavity. They asked us to go to the waiting area and a few minutes later a nurse came to asked me to rush to her room. What I saw was probably the worst sight of my life; the room was filled with doctors and nurses, they were taking turns compressing her chest i.e. doing CPR, and on the left side a couple of doctors were trying to make a hole in her chest cavity to help the collapsed lung. It felt like a lifetime standing there and watching her slip away while the doctors tried to resuscitate her. After a few minutes, one of the nurses asked someone to call the chaplain, I started saying my goodbyes and she suddenly opened her eyes. The monitors showed her heart beating again and they stopped the CPR. I don’t think I’ve been through a steeper roller coaster than that moment. They gave her some sedatives to keep her calm and continued the frantic pace to putting the chest tube in. I cannot be appreciative enough of the hospital staff and their skill. Imagine making incisions to cut through the ribs and into the chest cavity, without cutting into the inflated part of the lung and doing more damage, while other doctors are pumping her chest with incredible pressure 120 times a minute. There was blood everywhere but they saved her life. After they stitched her up, she briefly opened her eyes about 30 minute later, looked at me and actually smiled the sweetest smile ever!
The last 3 days have been very difficult for all of us. She is increasing more dependent on pain medication as her legs are troubling her a lot. Both her feet and soles are very painful, sometimes to the slightest touch. Her toes are getting darker and she has lost sensation in them. Her hands are also painful but not as much as the feet. The top of the left index finger is all black, shrinking, and losing the underlying muscle; it does not look or feel like a tissue that’s alive.
Yesterday, after a few very difficult, lengthy and sometimes emotional discussions with the doctors, we were basically told that they have very few options and a bad prognosis for her current condition. The main arteries that supply blood to the legs have severe clots. Some of the secondary arteries are still open but not carrying enough blood. Due to lack of blood the legs are slowly turning blue and painful. The clots are way up in the pelvic region of the legs, so the entire and both of her legs are in danger. The clots are happening because of DIC from the staph infection. The only way to remove these large clots is surgery but the vascular surgeons have recommended against it as she is unlikely to survive a procedure like that because of low platelets. Even if they transfuse a large amount of platelets to handle the surgery, any arterial procedure will create clots post surgery and they have to use blood thinners to manage the post surgery clots – which is a dangerous action in her case as she will likely have internal bleeding, again due to low platelets. So the doctors have really no options to manage the clots at this stage. They are, however, consulting a coagulation expert to see if there can be some intervention in terms of blood thinners or some changes to the drugs she’s getting to help boost her platelets. The small ray of hope is that the DIC situation is improving from a blood test numbers standpoint, and her bone marrow is working and creating WBC and some Platelets, but the clots are eating the Platelets up before that can be put to good use. The next few days will be critical to see if the doctors have any options to resolve the clots situation.