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 one of my clients and the question in the last episode was

I DON’T WANT OTHER PEOPLE TO GO THROUGH THIS HORRIBLE EXPERIENCE ME AND MY SISTER HAD GONE THROUGH IN THE INTENSIVE CARE UNIT, WHAT SHOULD I DO IN ORDER TO PREVENT THIS?

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 the next questions from one my clients Andrea who has her 34 year old sister in Intensive Care with non-Hodgkin’s Lymphoma and is currently experiencing decrease in blood count as well as having second thoughts about the treatment her sister is getting.

The Intensive Care team is wanting to stop or “withdraw treatment” against Andrea’s and her families wishes and she’s not prepared to let her sister go without a fight!

“I’ll continue to fight for my sister even she’s gone. What can I do, so I can reveal the mishandling of patients in the ICU?”

“You can also check out previous 1:1 consulting and advocacy sessions with me and Andrea here.”

PART 1

PART 2

PART 3

PART 4

PART 5

PART 6

PART 7

PART 8

PART 9

PART 10

PART 11

Andrea:  Alright, thank you Patrik.

Patrik:  Oh, you’re most welcome. You’re most welcome. Take care.

Andrea: Have a good day. Okay. Bye.

Patrik: Bye-bye. Thank you, bye-bye.

Patrik: How are you.

Andrea: Hi Patrik just at the hospital here. I’m trying to get in touch with doctor, but I don’t know where he is. Can you just hold on?

Patrik: Yeah, for sure.

Andrea: Is it possible to speak to a doctor? I mean I know they’re busy… okay.

Okay. Did you want to speak to the doctor or a nurse?

Patrik: It doesn’t really matter. I guess it’s a starting point whoever you can put me on with is probably fine.

Andrea: Are you the nurse who’s looking after my sister?

Patrik: You know I think if-

Amanda: I’m sorry my name’s Amanda.

Andrea: Hi Amanda. I’ve just got someone on the line who would like to speak to you if that’s okay? His name’s Patrik. He’s a family friend.

Patrik: Hello.

Amanda:  Hello my name’s Amanda. I’m the registered nurse, can I help you?

Patrik: Yeah look I’m a family friend and I’m registered nurse myself. I’ve worked in ICU for a long time and the family just doesn’t seem to understand what happened this morning. So, she had high brain pressure (cranial pressure) and she went for a CT. Is that correct?

Amanda: Yes, that’s correct, yeah. Yeah. About 6:00, between 5:00 and 6:00 this morning, she deteriorated and we had to take her down for a CT scan and it shows that, yeah, it’s not really my place to say what the scan shows. The Doctors haven’t spoken to the family yet.

Patrik:  I see, I see.

Amanda:  Yeah, she deteriorated this morning, if the family had been told. I really, as you’re aware, until our doctors have spoken to the family, I really wouldn’t want to say anything.

Patrik: I appreciate that.

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Amanda:  You could always call back and speak to me later, once the doctors have spoken to the family. Once the family has been updated, I’m more than happy to talk to you as well.

Patrik:  Yeah, OK.

Amanda:  The family has just got here.

Patrik:  No, I understand.

Amanda:  If you want to call back later, I can definitely explain.

Patrik: Sure and if I may just ask, how did the deterioration drop? Were her pupils fixed to light?

Amanda: Yeah.

Patrik:  Right.

Amanda:  Yeah, fixed and dilated, yeah.

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Patrik:  Right, okay.

Amanda:   Yeah, yeah and she had a CT scan about two hours ago.

Patrik:  Yeah.

Amanda: Yeah, the doctors are going to come in now and speak to the family with the results of the CT scan.

Patrik: Of course, I guess that is the missing link what triggered for her to have the CT scan. Okay, thank you so much.

Amanda: Yeah and if it helps, I’m more than happy to speak to you again once the family has spoken to the doctors.

Patrik:  Yes, it would help. It would help.

Amanda: Yeah, no problem. My name’s Amanda. If you want to call back, say, in a couple of hours, late morning, I can speak to you and let you know what’s happening.

Patrik: No, that’s great. My name is Patrik. Thank you so much Amanda.

Amanda:  Yeah, no problem. Your welcome. I’ll just pass you back over to the family.

Patrik: Thank you. Yeah, thank you. Bye bye.

Andrea:  Patrik?

Patrik: Yes.

Andrea: Are you there?

Patrik: Yes, I’m here, I’m here. So, I just wanted to confirm with them what I suspected because as I said to you this morning, I can’t possibly see how they would know the pressure’s in the brain are high and the only indication they would have is that the pupils are not reacting to light which is exactly what she confirmed with me.

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Andrea: Well, she’s done that the whole week. There’s no reaction to the light at all.

Patrik:  Right, right. What she’s saying is that the pupils have apparently dilated, which, if they were small prior to that, then that would have been the difference.

Andrea:  Right.

Patrik: But you are certain that there was no reaction to light all week.

Andrea: I know because I saw her and there was no reaction to light and it broke my heart because I saw it and I had to turn my head because I saw her, it’s just quite scary for me. I mean, the doctors are doing their rounds which I find really unethical and now we have to wait for them to do their rounds.

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Patrik: Yeah, yeah, yeah, yeah, yeah.

Andrea:  They said that she’s really deteriorated and I said, “Of course, she’s deteriorated. You’ve not given enough blood.” How is a person not going to deteriorate when they’ve got no blood in them?

Patrik:  Exactly, exactly.

Andrea:  They’ve killed her and I’m not finished with them. It’s malpractice.

Patrik: It is malpractice.

Andrea: It is malpractice and God knows how many other families they’ve killed.

Patrik: Ah, it happens every single day.

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Andrea: Yeah.

Patrik: Okay, I think, so, what have they mapped out … So, Amanda told me now, that apparently the doctors are going to talk to you but she hasn’t given me a timeline. I would imagine, given that the CT scan just happened in the last hour or so, there won’t be a formal report for another couple of hours most likely. So, knowing this from experience, I can pretty much map out what’s going to happen from now on.

Patrik:  They will be waiting for the formal report from radiology, right. That will take probably a couple of hours. Then they will have a look at this report and then they will talk to you. It wouldn’t surprise me if they won’t talk to you before lunchtime. It wouldn’t surprise me at all.

Andrea:  Is that right?

Patrik:  I’m not saying, hopefully it’s not going to be like that but just from experience, it wouldn’t surprise me if you don’t hear a single word until lunchtime.

Andrea:  Okay. They’ve moved her in a room by herself.

Patrik:  Okay. Is that because she’s neutropenic?

Andrea: No, because I think she’s dying.

Patrik:  Okay.

Andrea: That’s what I think.

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Patrik:   Right.

Andrea: Sorry…

Patrik: Now have you clarified that she’s definitely not neutropenic and that’s why they moved her into a side room?

Andrea:  No, I haven’t clarified that.

Patrik: I think that would be your first question. Is she neutropenic and is that why you’ve moved her into a side room?

Andrea:  Here’s Amanda. Is she neutropenic?

Amanda:  No, she’s thrombocytopenic.

Andrea:  Thrombocytopenic, whatever that means.

Patrik: Mm-hmm (affirming).

Andrea:  She’s got no platelets because they refused to give her blood.

Amanda:  No, no. Not because he refused platelets… Her Platelets are 6…

Andrea:  Sorry, can you just repeat that?

Amanda:  Can I speak to him?

Andrea:  Yeah.

Amanda: So what I was just saying is she’s from thrombocytopenic, she’s got platelets of 6.

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Patrik:   Yeah, yeah, yeah.

Amanda:  Because of the advanced stages of her cancer, even if we gave her two bags of platelets, they would be gone again in two days, right. The platelets are not going to save her life, a blood transfusion’s not going to save her life. The platelets would just go. If we give her a bag of platelets right now, she’s not going to wake up tomorrow because we’ve given her platelets.

Patrik: Why is she in a side room is she neutropenic now or is this because it’s end of life care?

Amanda: Exactly, you said it, yeah, yeah.

Patrik: Okay. Is she on inotropes (vasopressors)? Is she on noradrenaline?

Amanda: She’s on noradrenaline, yeah.

Patrik: Right, right. Okay.

Amanda:  She’s hyperdynamic (erratic). Her blood pressure is 200 one minute and then it’s 90 the next.

Patrik: I see.

Amanda: It’s the whole neurological response. So, sometimes the Noradrenaline is at 20 and then five minutes later the Noradrenaline is at two.

Patrik:  Sure.

Amanda: Her blood pressure’s swinging all over the place.

Patrik:  Okay, okay.

Amanda: I’m so terribly sorry about this. It’s just a horrible situation for everybody.

Patrik:  Look, it is, it is. I’m not telling you what to do. I’m just asking, it’s difficult for you to be stuck in a side room with a patient who may die.

Amanda:  No, don’t worry about me. This is what I’m here for. The doctors have just arrived so I’ll just say goodbye.

Patrik:  Yeah, yeah, yeah, yeah, yeah.

Amanda:  If you call back later, I can speak to you.

Patrik: Yeah. Thank you so much for your help.

Amanda: Thank you.

Patrik: Thank you. Bye bye.

Amanda:  Bye.

“Look out for next week’s episode of YOUR QUESTIONS ANSWERED where I continue to help Andrea with this challenge of having her 34-year-old sister in ICU!”

Kind Regards

Patrik