ICU Day 64 – Keep going?

This week was rough for Rachana with two incidences of left lung collapse, and she is having a tough time recovering from them.

Early in the week she was more awake and comfortable and also did two breathing trials for an hour each on consecutive days. She was also much more awake at night and wanted me to be standing by her side, all the time. After a few hours of comforting her I finally slept and was woken up by the doctor around 4ish to hear that her left lung had collapsed and they have to put a new tube in urgently. She already had a tube on the left side but it was not draining this new air pocket. So, they put a new tube in which helped a little but didn’t drain all the air and the lung was still partially collapsed. They then took her to Interventional Radiology that uses a CT machine to guide them to a precise area to put another chest tube. The doctors has warned that there is a possibility that even with the new tube the lung might not revive as they are quite damaged and possibly stiff. But fortunately, after the procedure, the lung did expand again. She now has two tubes on the side of the left chest, one on top of the left chest and another one on the side of the right chest. She was sedated for two days to help her recover while the high ventilator settings tried to get her O2 and CO2 back to normal range.

On Friday she had another lung collapse. This time they were able to revive it back up by flushing the new chest tube; seems like something has got stuck in the chest tube and was not pulling the air out. The lung is expanded now but the doctors are still having a tough time to get her CO2 under control. The ventilator is just pushing and pulling air to and from the lungs, while the body is still relying on her lungs to exchange O2 and CO2 with the blood. Her lungs are now unable to clear out CO2 effectively. Her CO2 numbers are more than 106 (they stop counting after 106), while 40 is normal. The doctors say a healthy person would be unconscious at those high level. Even with pain medication, other sedatives and high CO2, Rachana is still waking up often but struggling as her body is sending distress signals.

There is nothing medically that the doctors can do other than keep her as comfortable as possible and keep the ventilator running. We are hoping that her lungs recover and can eliminate the CO2. Last night the doctors told us that it’s very unlikely that she will recover, while agreeing that miraculously something could still happen. They asked us to consider if we are prolonging life or prolonging suffering. They finally asked me if I want the doctors to continue supporting her and if she should be revived by all possible methods, in case her heart stops again. I said yes.