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 was

 

My Mother Had a Cardiac Arrest in the ICU Doing a Lot of Blinking Now. Will She Be More Awake Soon?

 

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 questions from one of my clients Stephanie as part of my 1:1 consulting and advocacy service! Stephanie’s mother is a post cardiac arrest patient in the ICU and she is asking about the plan of care for her mom’s congested lungs.

 

My Mother Had a Cardiac Arrest. Would it Be Possible that the Fluids in Her Lungs Will Lead to Infection?

 

PART 1

 

PART 2

 

PART 3

 

PART 4

 

PART 5

 

PART 6

 

PART 7

 

PART 8

 

PART 9

 

PART 10

 

PART 11

 

PART 12

 

PART 13 

 

PART 14

 

PART 15

 

PART 16

 

PART 17

 

PART 18

 

PART 19

 

PART 20

 

PART 21

 

PART 22

 

Miranda: If you don’t tell me, then you’re saying that you’re all going to do resuscitate, when you should’ve already done it, in the beginning. I had to keep asking. So, even the night shift is different from the day shift. Even, if they come at night, we need to contact them in the morning time.

 

Patrik: So, are you saying that they did a CT scan last night of the chest. Is that what you’re saying?

 

Miranda: Right. But, I’d already been asked them a couple times. Does this fall under my mother’s problem?

 

Patrik: Right. Did they give you-

 

Stephanie: About the swelling. About the swelling, you said a couple of times Miranda.

 

Miranda: Yeah, yeah. The night before.

 

Stephanie: Yeah, we did.

 

Eva: I can’t talk right know. We can do later.

 

Miranda: If that’s what you say.

 

Patrik: I argue-

 

Miranda: They said they’re dealing with a cardiac arrest downstairs. They said they’re going to do rounds later and we can talk to him then.

 

Patrik: So, they want to talk later? They don’t want to talk now. 

 

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Stephanie: Because they got a cardiac arrest downstairs that they’re attending to.

 

Patrik: I see, I see. Well, I’m sure we could get…it’s up to you Miranda. I’m sure we could get some information now from the bedside nurse. It really depends on how comfortable you are instigating that. We may not get…

 

Stephanie: If she’s right there then let’s speak to her then. Whatever she can’t answer, we’ll get from the doctor.

 

Miranda: Miss Eva, are you in the middle of something? My sister and my friend is on the phone, are you able to talk to them?

 

Eva: I don’t know anything at the moment.

 

Stephanie: Uh oh.

 

Miranda: No, they got general questions.

 

Eva: No, I know. But…It’s like….

 

Stephanie: She’s not going to do. I wouldn’t have asked her like that. Anything you can’t answer, we’ll ask the doctor, we just want to know.

 

Miranda: They didn’t have any whatever’s in the system, like about the blood, glucose…none of those questions.

 

Stephanie: We made a question to you. Well, so can you ask her what we want to know?

 

Patrik: Absolutely.

 

Stephanie: She don’t have to get on the phone.

 

Patrik: No.

 

Miranda: Is there any way I can ask you the questions?

 

Eva: I cannot do it.

 

Stephanie: Just ask the questions.

 

Miranda: because they’ve been saying. For example…

 

Eva: I’m busy but go ahead and ask…

 

Stephanie: She’s not a good one, she is not answering properly.

 

Patrik: Michelle…

 

Stephanie: She’s not cooperating. 

 

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Miranda: I’ll wait until you finish.

 

Eva: I cannot do it now. I’m starting to get meds.

 

Miranda: Okay, you can go ahead and do that.

 

Patrik: Michelle? Why don’t you ask, as a starting point, why don’t you ask them, why they can’t give Lasix. Why they can’t give the diuretics. That would be the most important question that I can see.

 

Miranda: I already answered that. Y’all I’m repeating myself. I talked to her about the diuretics earlier and she told me that they couldn’t, from her, I’m talking about the RN. Remind you, the doctor said last night, if we pretty much had questions and we need to talk the doctors on Monday.

 

Patrik: I see, I see. Okay and that’s why…

 

Miranda: We said that last night. I don’t understand. You know a little frustrated but what I’m saying is since I talked to her, she’s going to say to the doctor what she believes according to her knowledge and her understand. The doctors going to say something else. I don’t feel like going through that because that cause me anxiety.

 

Patrik: I don’t think they’re telling you. I think they’re hiding something there.

 

Miranda: The doctors said, if you can’t do the diuretics. When I talked to her earlier, I just told y’all what she said. She said, I asked about the fluids and she said, “If it was so important, they would act accordingly.”

 

Stephanie: That’s not an answer. If it was real important.

 

Patrik: I would- You see…

 

Stephanie: My mother has other things, other concerns, you know- ahead of that.

 

Patrik: Sure. 

 

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Stephanie: So what is the reason then? They’re still not giving…that’s not a reason.

 

Patrik: That’s right.

 

Stephanie: That’s not a reason.

 

Patrik: Miranda, if you can get the nurse on the phone. I will get it out of her because other…

 

Miranda: She doesn’t want to talk.

 

Patrik: He or she doesn’t want to…

 

Miranda: They don’t want to talk to y’all.

 

Stephanie: Yeah. But she’s been saying that since last night.

 

Miranda: I had medicine at 9 o’clock. She said that we as a family know what’s going on. I don’t… either way, if we don’t…

 

Stephanie: She said that to you?

 

Miranda: We know what’s going on.

 

Stephanie: She said the family knows what’s going on?

 

Miranda: She said, “We already know what’s going on. Ain’t nothing really changed?” And I said, “No, that’s not true because we just found out…”

 

Stephanie: Oh my! She’s not cooperative.

 

Miranda: I think…

 

Stephanie: We’ll just call at seven o’clock in the morning.

 

Patrik: All right, let’s do that.

 

Stephanie: Yeah, just leave it.

 

Miranda: The doctor will be contacting us.

 

Stephanie: Okay. If that’s the case, we can call to the doctor.

 

Miranda: Are you able to speak to Patrik? 

 

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Stephanie: Anytime, yeah. He said anytime. So, when the doctor comes, you just call.

 

Miranda: Here comes the doctor on rounds. She’s a liar.

 

Hey mommy. It’s your daughter.

 

Yeah but I’m just being honest with you. I don’t feel comfortable with this doctor at all. I’ve seen him. I seen how he look at me. Looking at me with a belittling look.

 

Stephanie: Listen to Patrik.

 

Patrik: Doesn’t matter. Doesn’t matter. Don’t worry about that.

 

Miranda: But, he’s not going to get on the phone.

 

Patrik: Why not?

 

Miranda: He’s going to say he’s doing rounds.

 

Stephanie: Really? Oh, until he finishes his rounds.

 

Miranda: Most likely will say, until he’s finished his round then we can talk.

 

Patrik: Okay, okay.

 

Stephanie: If you’re one of his rounds, why can’t he talk? Is it a whole group of them?

 

Miranda: Yeah.

 

Stephanie: If he’s doing his rounds and he’s at her bedside, why can’t he talk about her? That’s the time to talk. If he’s at her bed. If he has a whole team with him…does he have a team with him or not? Have you noticed? 

 

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Stephanie: Okay, yeah. Okay well we’ll play it by ear Miranda.

 

Patrik: Well, I’m very happy to talk to them. When they come back and when he has time to call. When he has time to talk.

 

Miranda: They coming down the hall right now. This is what I’m going to say. I’m going to ask him if he able to talk to my sister at this present moment.

 

Stephanie: There you go.

 

Miranda: If he says no, then I’m going to say I’m requesting for you to provide us a call tonight because I’m not gonna be. And then when he calls me, we can hurry up and do this three way thing.

 

Patrik: Yes.

 

Stephanie: He what? He don’t have to know, shoot.

 

Patrik: Don’t over-complicate it. Don’t over-complicate it.

 

Stephanie: Right.

 

Miranda: They think he overcomplicated stuff. Like the rudeness.

 

Stephanie: Yeah. Ignore it.

 

Patrik: Ignore. You gotta ignore. We got to get an outcome. We can’t take this personal Miranda. You can’t take it personal.

 

Miranda: Even as lady say, he said, even something, I think what they’re saying is that there are an infection somewhere but they haven’t been able to find out where it’s coming from.

 

Stephanie: Just treat it, okay? Just treat it. God may help the medicine, okay. If you want to go that route. Just treat it. They have people Miranda that have way, way more complications than Mommy has had. All kinds of sepsis . All kinds of everything. Right, Patrik? 

 

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Patrik: Oh, absolutely. Carmen is in a different situation but people have come through this. She’s not dying at the moment. We don’t know the outcome but…

 

Miranda: Hey Mommy.

 

Stephanie: Hey Mommy.

 

Michelle: I love you Mommy. I love you Mommy.

 

Stephanie: You want to put me through the phone, so she can hear my voice?

 

Miranda: I’ll put you on the speaker phone.

 

Stephanie: Let me know when.

 

Hey Mommy! How are you? I heard you were listening to Luther Van Jones today. Heard some good music, huh? Oh yeah. Yes. You could sing pretty well in your early days. You could shoot a little basketball too. You were better than me. You keep on. I want to play you one on one. I wanna get on that court. The only reason I beat Rebecca because I was taller. You took me off of speaker?

 

Miranda: Yeah. I thought you was done.

 

Stephanie: It’s okay.

 

Miranda: Sorry.

 

Patrik: What do you want to do next? Do you want to call back, Miranda? When the doctors can talk. What do you want to do next?

 

Miranda: Well, they’re doing… Miss Eva, you said they’re doing their rounds, right?

 

Eva: They’re going around right now.

 

Miranda: So, then when they do their rounds…

 

Stephanie: About how long?

 

Miranda: You said when he’s in his rounds or after the round?

 

Eva: I’m not quite sure.

 

Miranda: Yes ma’am. 

 

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Eva: You can bring that up to him and ask him all the questions.

 

Miranda: Okay.

 

Eva: I told him you’ll ask him questions.

 

Miranda: Hello?

 

Stephanie: Yeah.

 

Miranda: Hello? Is the doctor coming tonight?

 

Stephanie: Yes. She says she’s trying to come at nine o’clock so she won’t have to, after 9:15, won’t have to pay. I think that’s what she’s saying. I know baby.

 

Miranda: I’m starting to get overwhelmed.

 

Stephanie: Well you get a break tomorrow. Don’t worry about it. She should be coming soon.

 

Miranda: I’m telling you now, this doctor, I don’t care for at all. So, what am I asking him? Oh, I’m asking can…you know what? When can I speak to him? Me and my sister need to speak to him.

 

Stephanie: When’s a good time? Go ahead Miranda, I’m sorry I cut you off.

 

Miranda: No, that’s it.

 

Stephanie: Repeat it because I didn’t catch it. Repeat it please.

 

Miranda: I’m just going to ask him, when we can speak to him because I have questions.

 

Stephanie: Because you have some concerns. You had some concerns. Yeah. Just briefly. Tell him briefly.

 

Miranda: He’s not going to want to answer any questions.

 

Stephanie: You want to ask him questions that the meds or nurses not…not able to ask. He will tell it to you or whatever.

 

Patrik: Yeah. 

 

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Miranda: Well, we got two people in front of us.

 

Stephanie: You don’t even have to tell him that it’s your sister. You just say one of my family members. Okay?

 

Patrik: No, you don’t have to tell them. You just ask them, when we can talk to you with my family on the phone. Keep it simple.

 

Stephanie: There you go. Because see men don’t respect women. Okay, this many times. You say woman and he’s like, okay forget it. When can we speak with you with my family on the phone? That’s it.

 

Patrik: That’s right. That’s all you got to say.

 

Stephanie: Yeah. You don’t make yourself supplier to them. That’s what they want. That’s how they look at you as it is. They assume we’re not in their field.

 

Miranda: I don’t know what type of questions you got.

 

Stephanie: You don’t have to worry about that. Did you turn on for Mommy?

 

Miranda: Yeah. The young lady helped me really good to put on some music for her. It played like three songs then it just clunked out.

 

Stephanie: The nurse here or the earlier one?

 

Miranda: Miss Eva. She was nice to help me out.

 

Stephanie: Oh, who’s Miss Eva? The tech?

 

Miranda: No. My sister asked me about the music. I said you helped me out. You know Pandora do that. It play a couple…

 

Eva: I have the songs, I played that.

 

Miranda: Oh, here we go. Hello, hey. Dr. Brendon.

 

Dr. Brendon: Hello. 

 

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Miranda: No problem at all. One second.

 

Stephanie: Mm-hmm (affirmative).

 

Miranda: No more hematuria?

 

Dr. Brendon: Urine output?

 

Patrik: Ask them why they can’t give Furosemide. Why they can’t give Lasix. Ask them.

 

Dr. Brendon: Urea? Creatinine?

 

Stephanie: We just want to get on the phone with you, I think.

 

Patrik: Yes. If he doesn’t want to talk to me, ask him what he’s got to hide. Ask him what he has to hide.

 

Stephanie: That’s right. We’re family. We’re making decisions together.

 

Miranda: With the plus three edoema? Okay I know what that is.

 

Stephanie: Swelling.

 

Miranda: Her GCS is three.

 

Patrik: Get him on the phone. Get him on the phone. If he doesn’t want to get on the phone. Ask him what he has to hide.

 

Stephanie: Right.

 

Eva: The nurse today wasn’t involved-

 

Stephanie: With all due respect, what do you have to hide?

 

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Miranda: What did I want to ask?

 

Patrik: Lasix.

 

Miranda: I’m sorry, I just wanted to know about Lasix. With her lungs. The issue with her lungs.

 

Dr. Brendon: I’m not sure what you’re asking me.

 

Stephanie: Say here, here’s my family. Give him the phone.

 

Miranda: Of course you do. That’s what they told us. Let me ask you, is there any way you can talk to my sister Stephanie and my friend? Hold on, I’ll let you two talk.

 

Dr. Brendon: Hello? It’s Dr. Brendon.

 

Patrik: Hi Dr. Brendon. My name is Patrik. I’m a family friend. So, we’re just trying to get an update on Carmen. How is she been doing. I understand she has been fluid overloaded on her lungs. But, Lasix can’t be given. Can you just explain a bit more about why Lasix can’t be given? If she’s fluid overloaded.

 

Dr. Brendon: This is the first I’m hearing with this. I’m going to have to talk with the rest of my team. Do you know why? Is she fluid overloaded and why she can’t get Lasix? We’re not aware of her being fluid overloaded and needing Lasix. 

 

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Patrik: Okay. Right. Because we were talking about the family meeting this morning. The family had been informed at the time that she was fluid overloaded but Lasix can’t be given. You’re not aware of that?

 

Dr. Brendon: I’m not aware of that.

 

Patrik: Right. Maybe that was misinformation then. Sounds like it.

 

Dr. Brendon: I’m looking at the notes from today, from the doctors. Hold on one second here. Nobody’s really written about fluid overload or needing Lasix.

 

Patrik: Right.

 

Dr. Brendon: I’m not seeing that anywhere.

 

Patrik: Maybe we heard…

 

The 1:1 consulting session will continue in next week’s episode.

 

• Email counselling/consulting with Patrik
   

• One on One phone/ Skype counselling/consulting with Patrik