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 4)
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 5)
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,
his heart rate is irregular…all over the place, ranging from 102-120, I mention it everyday but they don’t seem too concerned about it at this time. Should they be doing something???
I will ask about the Haemoglobin…he did have one blood transfusion during the 2nd surgery but none since. They said his blood count was on the low side but not enough to warrant more blood.
Thanks again for your advice and kind words. I really appreciate how promptly you respond…I find myself waiting for your response prior to calling or going to the ICU.
Thank you…getting ready to go and talk to the ICU people and the doctor and surgeon…I have written down your thoughts and suggestions. Thankfully I checked my e-mail before I left as once again you have given me hope. I am attempting to eat …and sleep
hasn’t been good. I am trying to be strong and have courage.
My daughter from up north is with me but we are both so scared and know our father and husband hates being like this. I am afraid he will get himself depressed and not want to go on.
He has always put us first and I don’t want him thinking he is a burden. The hospital is an hour away. He has always been active and wouldn’t want
this for a long time.
Thanks for being there for me.
He also has a fever 101.7F (=38.7C) …he had irregular heart beats as I mentioned…shocked it to a better level but still showed beats that were irregular.
They are giving him antibiotics and he’s back on sedation…back on the ventilator…we were called to the hospital this AM and told he
was in very critical condition.
He’s had some blood in his lungs…very, very swollen from fluids, I guess. Couldn’t not get a blood pressure reading. When we went in hours later, he still had a fever but his heart rate looked better but I’m still completely overwhelmed…
Many thanks
Katie!
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Hi Katie,
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.
I would say that about a good 50% of Patients in Intensive Care after open heart surgery will experience an irregular heart rhythm, mainly AF (=Atrial fibrillation). It is usually a result of the conduction system of the heart not working properly and the electrical system of the heart is firing off electrical signals at the wrong spots. That’s why the heart beat is
irregular.
The usual treatment for AF (= Atrial fibrillation) is correcting any Electrolyte imbalances such as Potassium and Magnesium or giving Amiodarone and/or Digoxin. If medication management isn’t fixing the problem and Patients don’t go from AF back to Sinus Rhythm(SR)- which is the normal and regular heart rhythm- a cardioversion (=sending electric shocks to the heart through electrodes placed on the chest) might also be an option to
reverse the AF back to Sinus Rhythm.
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. The more Haemoglobin, the more oxygen can bind to the blood and therefore oxygen levels in the blood will be increasing. This will therefore also
increase chances to reduce the oxygen on the ventilator and then hopefully wean him off the ventilator and the breathing tube.
Generally speaking, a Haemoglobin level of less than 70 g/dl requires a blood transfusion.
I would imagine that with two cardiac surgeries and the stomach bleed all in the span of a few days, there is a very good chance your husband’s Haemoglobin levels might be low, therefore you need to keep asking them for his Haemoglobin levels and
how they manage it.
Also ask them if they suspect any ongoing bleeding.
Overall day 5 after 2 open heart surgeries and still in an induced coma is no reason to panic.
Try and be patient. Your husband may need time to wake up from the induced coma.
Again, your husband had plenty of sedation and opiates in recent days, including two surgeries, he therefore will need time to “wake up”.
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Furthermore, I understand how you and your daughter
may feel about your husband being so sick and being so critical while in Intensive Care.
Again, this is all about having perspective.
Whilst I’m certain your husband wouldn’t want to be in this situation in the first place, I’m also certain that he wants to live.
Critical illness and Intensive Care are not the equivalent of a death
sentence.
Whilst your husband is currently being as close to death as he probably has ever been in his entire lifetime, he still has chances to survive.
Yes, he is on life support with the ventilation and the support for his heart, however just because your husband is on life support doesn’t mean he can’t come off it.
We have many families
contacting us at INTENSIVECAREHOTLINE.COM telling us that they don’t want their loved one on life support, because they wouldn’t want to live like that.
They often say things like, “my loved one doesn’t want to be a vegetable and live on a machine!”
It’s really important to understand the difference between being on life support and in an induced coma for a critical illness temporarily, as
opposed to “being a vegetable”.
Again, the difference is that once Patients come off life support and out of the induced coma they can get back to recovery. It might be a lengthy recovery, but it’s not equal to “being a vegetable”.
Your husband’s brain is intact there are no indications he has any brain damage, therefore there is a very high chance he will “wake up” eventually and hopefully
leave Intensive Care alive.
It would also be much better to have him awake and off the ventilator so that he can say what he wants for himself.
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I know how terrible you must feel Katie watching your husband like this! Critical illness is a massive challenge and sometimes Patients stay in Intensive Care for long periods of time and yet survive. As
you can appreciate, most Patients and their families are very grateful to be alive despite all the challenges and obstacles they had to overcome whilst being a Patient in Intensive Care.
Saying he wouldn’t want to live like this is very short sighted and almost rules out a recovery in your mind!
Most Patients leave Intensive Care Units alive and “only” about 6-10% of Patients don’t survive
their Intensive Care stay.
Even though your husband is certainly very critical and very sick, giving up is way too premature.
Also, it’s nothing unusual to be swollen when being immobile in an Intensive Care bed for many days.
The blood from the lungs may be a result of the surgeries or of any Bronchoscopies he may have had. He’s probably
also on some blood thinning medicine like Clexane or Heparin which may cause some bleeding!
Stay strong Katie and don’t give up!
