Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!

This is another episode of “YOUR QUESTIONS ANSWERED” and in last week’s episode I answered another question from our readers and the question was

Why Transfer my Mother-In-Law from ICU to LTAC Even if She is Unstable? Help!

You can check out last week’s question by clicking on the link here.

In this week’s episode of “YOUR QUESTIONS ANSWERED”  I want to answer questions from one of my clients Albert, as part of my 1:1 consulting and advocacy service! Albert’s sister has a tracheostomy and is critically ill  in the ICU. Albert is asking why they are pushing them to send his sister out to the rehab facility.

My Sister Has Tracheostomy & is Critically Ill in the ICU. Why Are They Pushing Us to Send Her Out? Help!
 

Patrik: Hi Albert! How’s your sister?

Albert: Hi Patrik! Now, she is critically ill, but she is trying to be better. But the hospital, they’re trying to push us to send her somewhere else. She has a heart problem and she has a kidney problem and she has a lung problem, I explained to you before. She has so many things, but now they think she is a little bit better, but they’re trying to send her out. And the case manager is pushing and then the doctor say she is fine. And one time they say like, “Oh, she is not going to make it. We cannot help her.” Now, they send her everywhere in rehabilitation center, they refuse her, because they know she is not stable.

Patrik:  Okay. So, they want to send her out, but all rehab centers are refusing.

Albert:   Yeah. They refuse. Then actually, one of them, they told me clearly, they say she needs to be stable. And then the other one they told me she has a problem with her oxygen. We don’t have that kind of things to take care of her. But the hospital, the doctors, they say she is fine. She has to go.

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Patrik:  Do you have access to the medical records?

Albert: Yeah.

Patrik:  Okay. That would be helpful. Other question, and I know you’ve mentioned  it to me before, but tell me why is she in ICU? Because I’m talking to many people simultaneously. Remind me, why did she go into ICU in the first place?

Albert:  In the first place, she has a pneumonia.

Patrik: Oh, yes. Yep.

Albert: She has pneumonia and then get a heart attack through there. Then she was really fine over there. And then when she got another pneumonia and they send her in another place before the pneumonia’s getting healed. She was sick and then it started from there. She went there. She got so many things, she got another pneumonia, she got infection, urinary tract infection, she got another heart attack, you name it. And then that’s why she’s ended up in this place.

Patrik:  Okay. When you say she ended up in this place, which hospital is she at? Is it the big hospital?

Albert:  Yeah.

Patrik:  Right. And how long out of those months, how long has she been on a ventilator for?

Val:  Well, the actual story is, so she was in the hospital and then, halfway through, she was sent to a rehabilitation. And then they took her off from the tracheostomy. She was doing good. She was exercising and things like that. And then they said she caught a super bug. And back to square one. So, she went back to the same hospital. And then she’s been on the tracheostomy now. I think for how many months now?

Albert:  8 months.

Lorie:  8 months?

Patrik:  8 months. Okay. So, she had the tracheostomy, she went to rehabilitation  and then bounced back into ICU?

Val:  Yeah. When she went to rehabilitation, they took the tracheostomy out. She was doing exercise. She was walking. Oh, she was doing really good.  And that was one of the problems, because they just sent her-

Lorie: Not to rehabilitation. Yeah, I don’t think it was a rehabilitation facility. I think it was more of a nursing home.

Val:  Well, it was a rehabilitation. Then they sent her to a nursing home, and that’s where she caught the bug.  And then she ended up back in the hospital and then tracheostomy again.

Patrik:  And how old is your sister?

Albert: 55

Patrik:  And previously fit and healthy, prior to this?

Albert:  Yeah. She was healthy. She has diabetes only, but other than that she’s healthy.

Patrik:  Independent. Came out of nowhere.

Albert:  Yeah.

Patrik:  Okay. And, on top of the pneumonia, she had a heart attack, but not a cardiac arrest. A heart attack?

Val: Yeah. Not cardiac.

Albert: Not cardiac, but she has, they say like heart failure. And then now she had the first one. And then, when she comes here, she got the second one, because she choked when she was coughing. And then they told me they have to put the breathing tube again in his mouth. And then since then, they say she’s not going to make it. We believe in God and we ask them to try to do whatever you can and then do the surgery. And we pushed and they did the surgery and she’s still here, thank God!

Suggested Links:

• 5 POWERFUL THINGS YOU NEED TO DO IF THE INTENSIVE CARE TEAM IS NEGATIVE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!
• THE 7 ANSWERS TO THE 7 MOST FREQUENTLY ASKED QUESTIONS IF YOUR LOVED ONE REQUIRES ONGOING MECHANICAL VENTILATION WITH TRACHEOSTOMY IN INTENSIVE CARE!

Patrik: What surgery? What surgery did they do?

Albert:  Tracheostomy.

Patrik:  Tracheostomy.

Albert:  So now, she’s still breathing. Sometimes the tracheostomy is leaking from her neck and then inside the balloon, and then we ask them to change it. And then they call us here and they say like, ”Oh, we are going to put back again in his mouth.” And then I say, “No. No.” And then when I just try to go there and they say, “He’s fine. We changed the balloon. Now she’s breathing.”

Patrik:  So, no more leak?

Albert:  No.  It’s leaking still?

Val:  No. There’s still a leak. So, this is a recent incident she’s talking about.

Albert: It was two weeks ago. They changed-

Val: Yeah. So, they called them at night and said, “Okay, there’s a breathing problem.” And they said they were going to intubate her and Albert then said, “What’s going on? “They live not too far from the hospital. So, by the time they were about to go to the hospital, they called him back and said, “Actually, we changed the tracheostomy size, I believe, and everything is fine. She’s okay.” But the thing is there’s still a leak. So, what they said was, they might have to special order for her size.

Patrik:  Sounds like it.

Val:  But, that has been a while and we haven’t heard anything. And-

Albert: It seems like they’re not going to do it.

Val: They said they’re not going to do it?

Albert:  No.

Patrik:  That’s the first thing that I would’ve said. A leak change, upgrade the size. If it’s still leaking after you upgraded the size … Maybe she had a size seven and now she’s got a size eight, whatever the case may be. And if it’s still leaking, I would argue she needs some special tracheostomy.  Does she have a short neck?

Val:  A what? Sorry?

Patrik:  A short neck.

Albert: No.

Patrik: Oh, okay.

Albert:  They say, because of the trache that she was using.

Patrik:  I see.

Albert: So that’s what they say.

Patrik:  I see. Okay.

Albert:  Yeah. But they still have that, the special order. And then one place when they ask, they have 10, 11, but they don’t want to order it. They don’t even want to give her exercises, the Physiotherapist and the Occupational Therapist. They’re not coming now, because they want to kick her out.

Patrik: That’s terrible.

Albert:  It is terrible.

Patrik: That’s terrible. Does she have any time off the ventilator at all?

Suggested Links:

• TRACHEOSTOMY AND WEANING OFF THE VENTILATOR IN INTENSIVE CARE, HOW LONG CAN IT TAKE?
• THE 7 ANSWERS TO THE 7 MOST FREQUENTLY ASKED QUESTIONS IF YOUR LOVED ONE REQUIRES ONGOING MECHANICAL VENTILATION WITH TRACHEOSTOMY IN INTENSIVE CARE!

Albert:  She did.

Patrik:  She did?

Albert:   She has a time off for … They took off everything and they took the cuff and the she was breathing by herself and she has started eating for a while in the hospital. And I think because of the fluid, when they stop us between the COVID time because they stopped us to visit. So, we were at home and then she got back again the tracheostomy after a week.

Patrik:  And, as of today, does she have any time off the ventilator at all?

Albert: Yes.

Val:  Yeah. What do you mean by off’? Completely off?

Patrik:  Yeah. Completely off. So, basically they disconnect her from the ventilator and put on a mask with either humidified air or humidified oxygen. It’s called a trache mask or a trache shield. Basically, she’s breathing-

Val: No. Not at this time.

Albert: Yes. Yes.

Val:  Yes? At this time with the mask?

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Albert:  Yes. Last week. She was off last week sometimes for three hours, sometimes for five-

Albert: Seven hours before, because of the fluid. When the fluids come back because of her heart. And then they will take the fluid and they have to take chest X-ray. And then after they took the x-ray, they took off the fluid and then she will be fine. Otherwise, when the fluid comes, it’s hard.

Patrik: I see. I see. So, with the-

Val: One thing I wanted to mention, we didn’t mention. So, one of the things, because of her lungs, she does have fluid buildups. Okay? So, a couple times they have to use a needle to drain out the fluid. So, now what she has is, she has chest tube on the side. That’s how they’re draining the fluid out. But now, lately the fluid has been lower and lower.

The 1:1 consulting session will continue in next week’s episode.

Kind Regards

Patrik

PS

I only have one consulting spot left for the rest of the week, if you want it, hit reply to this email and say "I'm in" and I'll send you all the details.