Intubated, day 2

the tube in his nose vacuums out his stomach acid

So today was kind of frustrating. Trevor and I slept through the rounds (when the docs come through and discuss Oakley as a team) and he didn't have the same nurse as yesterday. When I got to the hospital, the nurse told me that they were starting Oakley on anti-seizure medications-which the neurologist told me they weren't going to start yesterday. I asked her why, and without answering my question, she told me she'd call the attending doctor.

The attending told me that the EEG came back, and Oakley had a seizure during it. They had done some more investigative work, and found that seizures can happen as a result of one of his medications. His tacrolimus (which is his immunosuppressant, and all the doctors pronounce it differently...we've heard tack-row-lime-us, tack-rah-lime-us, tack-rah-limb-us, tack-rah-lime-us so far) has a side effect list that rivals War and Peace for length. They don't want to stop it, so they decided to start an anti-seizure med called Keppra.  

Since he was on the ventilation during the EEG, they couldn't tell if the seizure was concurrent with an apnea spell. So tomorrow, they will repeat the EEG until he has an apnea spell, so they can tell if that's what's causing his spells of not breathing. They will be able to tell because they turned down his ventilation to CPAP, so instead of the tube forcing air into him and regulating his breathing, he is breathing on his own, unless he goes for a few seconds without breathing, and then the machine helps him. He's barely above room air oxygen concentration, and he does have extra support when he does breathe, because he's basically breathing through a straw, but he's doing well. He has had 5 apnea spells since they turned him to CPAP at 3 pm. One of the spells included a bradycardia event (that means the lack of breathing affected his heart rhythm), but it's not too worrisome to us, because it was pretty short-lived. He seems much more at ease on the CPAP, he's a control freak.

His blood sugars are still varying pretty good, and they have been changing his rate of insulin infusion quite a bit. He got lower than they like, and they even turned his insulin off a few times. His poor little feet are starting to look like hamburger, they've moved from his heels to his toes and the balls of his feet for poking to get blood. Three of the apnea spells he's had tonight were during blood sugar checks, so I almost wonder if he's holding his breath when they make him mad-and then it registers as him stopping breathing, so the CPAP forces a breath.



His morphine drip-I keep asking for mine, haven't gotten it yet!



his sedative



They still have him sedated pretty heavily, and I doubt he even fully realizes when Trevor or I are here because he's so out of it. He's on a morphine drip because of the pain of being intubated. When we were there today, he kind of started fidgeting, which sucks because they have to keep him tightly swaddled so he won't jerk his tube out. I felt like we were doing more harm than good, so we only stayed 3 or 4 hours today. It's nice to be able to spend some quality time with Trevor. Today we got lost in Seattle and ended up on the other side of town. It was a pretty cool adventure. We found a cheap food stand by the Sound for dinner.



He can't keep his hands out of his mouth when he's got nothing in there-it must be so hard for him not to grab that tube that's in there now!