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 last week was
My husband had open heart surgery with complications! He’s not
“waking up”, he needs 100% of oxygen and now he’s bleeding from the stomach, I’m so scared, help! (PART 2)
You can check out last week’s episode by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED“, I want to answer another the next question from one of our clients which are excerpts from email counselling and consulting sessions with me and the question this week is
My husband had open heart surgery with complications! He’s not “waking up”, he needs 100% of
oxygen and now he’s bleeding from the stomach, I’m so scared, help! (PART 3)
This was another great series of questions where I was able to “hand-hold” a very anxious and distressed client through a very stressful and complex situation.
Katie writes
Hi Patrik,
Oh, my goodness, I have been so grateful for your advice and information…you have been right on with everything and I have been able to ask good questions and to communicate more effectively with the doctors due to your explanations to me.
Mostly, though, you have given me and my family hope and encouragement. For that I am so thankful.
I am thinking tonight I may be
able to sleep a bit…
My husband is still in ICU…his ventilator is still being used (5th day)…he had 2 open heart surgeries 2 days apart. His ventilator is 45% of oxygen and he has shown no improvement since early yesterday morning.
He has come off the Nitric Oxide (NO) and he’s still on vasopressors/inotropes for low blood pressure.
I don’t get that as he had an aortic valve replacement and then another surgery to repair a hole in his heart. His blood pressure is controlled, blood count is better, pulse rate all over the place.
Skin coloring is much
better than after 2nd surgery. I will see a doctor later this morning…any suggestions or advice. I am trying to be more in control and not follow the crowd but go in the opposite direction. Late yesterday they were starting to wean him off sedation slowly in anticipation of the tube being removed sometime soon. Thank you for anything you can send my way.
With many thanks
Katie
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Hi Katie,
what do you mean when you’re saying his pulse rate is all over the place?
Have they mentioned that he’s still in a normal and regular heart rhythm or is it irregular? Many Patients after AVR go into AF(Atrial fibrillation) which is an irregular heart rhythm.
The usual treatment for AF(Atrial Fibrillation) is correcting Potassium and Magnesium level as well as giving Amiodarone or Digoxin. If all that fails a Cardioversion is an option for management as well.
Also, ask them what his Haemoglobin level is. Haemoglobin is the red cell count in the blood. If it’s low he might have lost a fair amount of blood and he might need a couple of blood transfusions. This will also help with weaning your husband off the ventilator.
Normal Haemoglobin (HB) levels are 80-135
Patients with low HB levels below 70 or 80 usually require blood
transfusions.
The higher and more normal the Haemoglobin levels are, the more red blood cells are available to carry oxygen around the body. Therefore, the likelihood of the oxygen levels on the ventilator will come down.
Overall day 5 after 2 open heart surgeries and still in an induced coma is no reason to panic.
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article/video:
It’s a good sign that your husband is now down to 45% oxygen and that he’s off the nitric oxide (NO). That’s a sign that his pulmonary hypertension has come down and that he’s getting more and more stable.
So far, there is nothing unusual from what you are describing and from the information you have shared.
Again, keep in mind that your husband had two major surgeries
within 48 hours. Therefore given that oxygen levels are down on the ventilator from 100% to 45% is progress!
Yes, I know and understand how frustrating it must be to watch your husband in the induced coma where you can’t see him progressing physically.
At least you can see that his skin color has improved! That’s a sign that the VSD has closed and that now the oxygen is going where it’s
meant to go.
Be patient Katie!
Recovery and survival in Intensive Care are not a sprint but a marathon. It’s often two steps forward and one step back.
I’m very glad to hear that you’re not following the crowd and that you are doing your own research! Don’t look at what other people are doing and follow your own path and intuition, that’s
very important!
In anticipation of talking your husband off the ventilator in the next couple of days, it’s good to hear that they have lowered sedation to get him out of the induced coma.
I don’t expect that your husband will “wake up” quickly after the induced coma and after two major surgeries within 48 hours, as well as the stomach bleed.
Your husband will “wake up” in his own time and he will take as much time as he’ll need to come out of the induced coma.
“Waking up” after an induced coma is like turning on a light with a dimmer as opposed to switching on a light with a switch.
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The reason I can predict things and look ahead is that I have seen these types of situations over and over again after nearly 20 years Intensive Care nursing in three different countries where I literally worked with thousands of critically ill Patients and their families.
It’s helping you and your
family to minimize the emotional roller coaster that you are already on and it’s helping you and your family to look ahead.
More importantly, it’s helping you and your family understanding what’s really happening without only relying on the doctors information.
Doctors in Intensive Care are often not very transparent and they often assume that families don’t understand the medical language
and the medical terms.
Families understand very well what’s happening if people are taking the time to explain things in detail and explain things in a language that can be understood by non-health professionals.
Furthermore, there is so much stuff happening “BEHIND THE SCENES” in Intensive Care that the doctors are trying to keep away from you at all cost.
The reason for that is simply that they want to stay in control of the meaning of what’s happening with critically ill Patients and they want to stay in control of what’s happening with their Patients and their beds!
The closer you get to your own truth and
meaning, the closer you get to staying in control of your critically ill loved ones fate and destiny.
Try and be patient. Your husband may need time to wake up from the coma.
