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 frequently asked question from our readers and the question in last week’s episode was

IS INTENSIVE CARE AT HOME A GENUINE ALTERNATIVE TO ICU AND LTAC?

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 continue answering the next questions from one my clients Sharon who has her 64 year old mother transferred in the Intensive Care due to severe difficulty in breathing and alteration in mental state. Ultimately, her mother was diagnosed with liver failure and is on blood pressure medications and may subjected to dialysis due to renal failure.

My mom crashed and the ICU put her back on the breathing tube. Will dialysis help her to get fluids off the lungs?

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

PART 1

PART 2

PART 3

PART 4

PART 5

Sharon:  Well, it’s been going up and down. The doctor saw the kidneys not doing well last Saturday on her tests, and that’s when he wanted her to go to the hospital.

Patrik:  Okay. May I be sure….

Sharon:   … the liver.

Patrik:  Okay. That’s good information. That’s good information. Maybe. Yeah, sure. Then it might have been over the last few weeks. Could be. Could be, but again, with the kidneys failing, a lot of patients in intensive care with low blood pressure go into kidney failure eventually, and I should say temporary kidney failure. It’s temporary. The kidneys can recover. Again, most patients who need hemofiltration in ICU, they don’t need it eventually.

Sharon:  Okay. Okay, that’s good to know. What was the other question I wanted to ask you? And then, the other day … It’s just frustrating, because yesterday, literally when she was going into the ICU, they told us it’s all about her lungs and that she might have this ARDS (Lung Failure), and then today they were like, “No, she doesn’t have that.”

Patrik:  Look, it doesn’t … I haven’t seen the x-ray, but the reality is they have to think about those things, and the reality also of if there are fluids on the lungs the x-ray can look similar to an ARDS-type picture. So I can see why they would be suspicious. Again, they have to rule it out, and it’s just the lingo they’re using. I wouldn’t be too worried about it. It’s just again, from my experience, a test x-ray that has fluids on the lungs may look similar to an x-ray with ARDS (Lung Failure).

Sharon:  Right. Yeah. I mean, it’s just like she’s been this mystery. It seems like everything … They just can’t figure out what’s going on, and that’s very frustrating.

Patrik: Of course it is.

Sharon: She’s gotten sick. It’s starting to make me lose faith.

Find more information about positivity in the ICU:

• HOW TO STAY POSITIVE IF YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

Patrik:   Yeah, but at the same time, Sharon, anybody who presents in ICU with a complex picture, and your mother’s picture is complex, you can’t work out the details within 24 hours. It’s not going to get … It takes time. They need to do the blood tests.

Sharon:    Yeah, but they’ve been doing this for … They’ve been trying to work this out for a week.

Patrik:  Right, but they will be screening differently in ICU. They will be even more detailed in their screening, and you will need to give them some time to work through all the details. If people crash like your mother has, unfortunately, there needs to be a lot of testing. People crash for a reason, but you can’t often figure it out completely in the next 24 hours. The body, even though medicine has gone a long way, the body is still a mystery.

Sharon:  Right. She didn’t … The thing is she only crashed once they put that tube in. I mean, yes, she was definitely getting more delirious, and the pressure wasn’t as good, but it hadn’t gone below 100 or 110 even. So I don’t know. Does the tube do that sometimes?

Patrik:   It’s not so much the tube. It’s the sedation.

Sharon:  The sedative. Right.

Patrik:  It’s not so much the tube. It’s-

Sharon:  So how long would it take to … because this woman said to us today, she was like, “Usually we have to take a look if it recovers in two days, and then we’ll make more decisions,” almost being very ominous if it doesn’t recover completely in two days.

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• HOW LONG DOES IT TAKE TO COME OFF A VENTILATOR/ RESPIRATOR IN INTENSIVE CARE?

Patrik:   You see; this is the problem in ICU. They don’t want to give people time.

That’s the biggest problem, and that’s where we can help with as well. If they don’t want to give your mother time, we can help with that, help you position and help you advocate and all of that. But it’s-

Sharon:  Oh, you can?

Patrik: Oh yeah, absolutely. Absolutely. What we tend to do from our end …

We’re always happy to have a chat like we have now, and what we can do as bigger-picture-type thing, we’re also happy to talk to doctors, nurses, set up a three-way call with you and a doctor. We’re also very happy to come into family meetings with you, with the doctors. We do that over the phone, of course, and we can ask them all the questions, because they’re not telling you the bigger picture.

They’re not explaining things to you in detail. They’re keeping their cards very close to their chest because they always want to have the option to tell you, “Things are not improving. We got to, quote-unquote, ‘pull the plug’. That’s the option they always want to ask, but if you are not prepared to come in with the right questions, they will have … Most families don’t question. That’s the reality.

Recommended:

• THE 5 THINGS YOU NEED TO KNOW IF THE MEDICAL TEAM IN INTENSIVE CARE WANTS TO “LIMIT TREATMENT”WANTS TO “WITHDRAW TREATMENT”, “WITHDRAW LIFE SUPPORT” OR WANTS TO ISSUE A “DNR” (DO NOT RESUSCITATE) OR “NFR” (NOT FOR RESUSCITATION) ORDER FOR YOUR CRITICALLY ILL LOVED ONE!

Sharon: Oh, I question. I definitely want to question. I’ve been a little more reluctant … I questioned a lot more before the ICU. The ICU has been a little intimidating for me.

Patrik:  Yeah, of course.

Sharon:  And it’s just been very traumatic in general for me.

Patrik:  Absolutely.

Sharon: I’m an only child. My mother is young. I’m young. This is really hard.

Patrik:  Of course.

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Patrik: Yeah.

Sharon:   Yeah. I don’t really use it, but okay. Yeah.

Sharon:  And then, where did you … If you don’t mind me asking, which ICU did you work in?

Patrik:  I’m based in Melbourne, Australia, I worked in a few ICU’s there but also in the UK and Germany. I’m telling you we do most of our work … Most of our work we do in the US.

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Sharon:  Okay. Yeah, my mother is at Mt. Sinai in New York.

Patrik:  Oh, yeah. Yeah, I know Mt. Sinai. I’ve had clients there before. They seem to be a reasonably good hospital, but I also know the pressures they are under.

Sharon: Yeah. I mean, I think they’re … I think they’re one of the number one liver transplant hospitals in the world.

Patrik:  Yeah, they’ve got a good reputation.

Sharon:  Yeah, so I do hope they’re doing all the right things, and you seem to think that they’re doing what they can, but I….

Patrik: So far.

Sharon:  … like to have-

Patrik:  So far.

Sharon:  I like to have these explanations.

Patrik:  Yeah, absolutely, and you need to be able to ask all the right questions.

As a person who’s not medically trained, you don’t know where to start.

Sharon:  Right. No, I have no idea, and every day it just seems like it’s getting worse and worse, and they’re doing … and it’s just very discouraging, and it’s very hard on my family. I sometimes just ask them for, “Is there hope?” And they won’t even answer that question.

Patrik:  No, they won’t. They won’t, because they want to keep their options open. It’s so important that you read between the lines. Very important.

Sharon:  Okay. All right. This is all really helpful and good to know. I want to push back where I feel like they’re not doing everything that they can.

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Patrik:  With the 7 day 1:1 consulting and advocacy option you purchased you have 24/7 access to me!

Sharon: Okay, yes that’s what I wanted! This has been very, very helpful and encouraging. I do have more questions for you. Obviously, my mother’s ultimately going to need a transplant. Can somebody who’s gone through this kind of trauma even qualify for a transplant on anything?

Patrik:  As a rule of thumb, yes. It often comes down to, number one, availability of organs, and general condition of course. As a rule of thumb, yes. What might be an issue for your mom … There is often a cut off for organ transplants, and it doesn’t matter whether it’s liver, lungs, or heart. There is often a cut off at 65 years of age. It’s not written in stone, but some people might argue around an age cut off, if you will.

Sharon:  Yeah, they didn’t say anything about … They even encouraged us to put her on the transplant list-

Patrik:   I think you should-

Sharon:  … but they didn’t say anything about age.

Patrik:   Good. Good. I think you should definitely try. I think it’s worthwhile trying, and it also … In some states, it comes down to state laws, I understand, and because we’re doing about 70% of our work in the US, I have come across some states having different policies, procedures, whatever you want to call it, even legislation around when people can have a transplant or not. So just be mindful of that, but if they have encouraged you already, I see that as a good sign.

Sharon:   Well, that was before all of this happened.

Patrik:  Yeah. Look, I can tell you that anybody needing a transplant, whether that’s a heart transplant or a lung transplant, they often crash. They often spend time in ICU before they even get on the transplant list. That’s how they often end up on a transplant list, because they do need ICU.

Sharon:  Right. Well, I’m O negative, so she can have part of mine.

Patrik:  Well, I understand how frustrating this is for you. I understand that, but try and stay positive. Try and stay positive.

Related information:

• HOW LONG DO YOU NEED TO BE ON A VENTILATOR AFTER A LUNG TRANSPLANT?

Sharon:  Yeah. I mean, it’s just … This has just … It’s been this ridiculous roller coaster where, yes, my mother was in terrible shape when we brought her in, but she was talking and eating a little bit and whatever, and now she has a breathing tube and low blood pressure again after a week of not having that, and I’m just confused with … They’ve done multiple tests, and everything they thought it was is not what it is, and I’m just confused.

Patrik:  Yeah, and look, that … Again, it might take some time for them to get to the bottom of things. It’s only 24 hours ICU. You got to be … and the other thing that I’d like to mention is recover in ICU is often a marathon. It’s not a sprint.

People are impatient, and I get that. I would be impatient too, but it’s not a sprint. It’s a marathon.

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Sharon:  And I totally get that. It’s more like the ups and the drastic downs … We haven’t had good news in days.

Patrik:  Yeah. Two steps forward, one step back, and often two steps forward and two steps back. Just part of the package.

Sharon:  Yeah, and so my mom … I don’t know if I mentioned this, but my mom’s ventilator  is at 50, and they were even going to bring that down, so I don’t think she’s requiring that much oxygen. So we keep saying, “Is that good news?” And they wouldn’t even say yes or no.

Patrik:  I think once they start the hemofiltration (Haemodialysis) and take fluids off, there’s a good chance they will bring the oxygen, because fluids on the lungs will reduce. Does that make sense?

Sharon:  Right. Yeah. I mean, they started it, but they said that’s a slow process.

Patrik: Yeah, and it can be, but if they reduce fluids, her oxygen level hopefully will come down.

Sharon: Right.

Patrik:  All right, Sharon. I’ve got to run.

Sharon:  Okay. Perfect.

Patrik:  And you know where I am.

Sharon:   Okay. Thank you so much. Yes, please send it to me, and I appreciate your help.

Patrik:  Your welcome.

Sharon:   It was definitely a good conversation.

Patrik:  You’re most welcome. Take care.

Sharon:  All right. Bye-bye.

Patrik:  Bye-bye.

“Thank you very much for being a part of the previous series of 1:1 consulting and advocacy sessions . We hope you will find these new upcoming episodes informative and empowering.

Kind Regards

Patrik