Hi, it’s Patrik Hutzel from intensivecarehotline.com , where we instantly improve the lives of Families of critically ill Patients in Intensive Care, so that you can 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 last week was Part 4 of
MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE
CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO? (PART4)
You can check out the answer to last week’s question by clicking on the link here.
In this week’s episode of “your questions answered” I want to answer the next question from Heather, as part of her consulting sessions with me.
Previous questions(Part 1, Part 2, Part 3 and Part4) from Heather you can find answered by clicking on the
links
Today, Heather asks
MY PARTNER IS IN INTENSIVE CARE ON A VENTILATOR! THE INTENSIVE CARE TEAM WANTS TO DO A TRACHEOSTOMY AND I WANT TO HAVE HIM EXTUBATED! WHAT DO I DO? (PART5)
Heather writes
Hi
Patrik,
thank you so much. When I went in and seen him today, after I talked to the doctor about him being to weak to ever get out of bed and to cough up secretions which he was coughing up and spitting them out which was gross because it landed on his chin or his gown but he was doing it.
His cough and talk was weak on Sunday but after a shot of morphine he was talking and coughing and scratching his head. They say he is to weak to ever get out of bed then why is he still restrained if he's so weak why did the even extubate him
today?
What about the delirium? My grandmother can't take pain meds at all and she is delirious the whole time. I think people underestimate what anxiety and stress can do to a person and I don't know why they won't give him Valium but they keep ignoring me.
Related article:
The Physiotherapist called his parents today to explain that the reason they they couldn't do physical therapy is because of something to do with his neurological status. I asked them if he has neurological damage or anything and they said that they don't know yet.
They
called in a neurologist to see him before he was extubated as well as a psychiatrist. They said they couldn't do anything while he was that sedated. Then afterwards when he was extubated I wanted them to have a neurologist look at him and they didn't.
Are there good neurological reasons why they wouldn't do physiotherapy? Especially since they don't even know if my partner has neurological issues.
Many thanks Heather
Hi Heather,
I hope you're well!
Thank you for your question.
I don't know what they are referring when mentioning your partner’s "neurological condition".
From what you have described in the emails and on Skype, he has had some weak muscles, as well as some odd movements where you couldn't quite point your finger towards.
In any case, a prolonged period- by now, it’s more than four weeks- in Intensive Care with sedation, ventilation, induced coma plus the surgery you've mentioned would alter anybody's neurological condition.
One of the ways to tackle an altered neurological condition is to get back to normality as quickly as possible. This includes Physiotherapy.
Recommended:
Even if Physiotherapy is only done in the bed through moving limbs etc… as well as doing some Physiotherapy for the lungs, there needs to be some Physiotherapy.
Everything else is BS and it looks to me like they are making excuses.
The only reason why
someone couldn't be having any Physiotherapy for an altered neurological condition would be seizures or severe head or brain injuries and you haven't mentioned anything about your partner having seizures or a head or brain injury.
Physiotherapy should be part of any Intensive Care therapy, full
stop.
If they have concerns about your partner’s neurological condition they should as a starting point do a CT or an MRI of his brain and assess from there.
If they are finding anything unusual in the CT or MRI they can then get the neurologist involved.
This is all I can see from what you are describing.
Not doing Physiotherapy on a long-term Intensive Care Patient is cruel and generally speaking delays movement, recovery etc…
Especially since your partner is blind, Physiotherapy and stimulation
is even more important!
I think they are making excuses and come up with some stories because they realise that you are doing your research and that you only accept the best! Keep doing that, you are on the right track!
Let me know what other questions you have and we can go on Skype or on the phone again or simply send another email.
Take
care!
Patrik
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Patrik Hutzel
Critical Care Nurse
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