My Dad’s been in ICU 2 months with Tracheostomy,now he’s got a stomach bleed&he’s on 100% Oxygen!Can he survive?

Published: Fri, 06/10/16

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 29 year old husband is in Intensive Care with a brain injury and fractured legs! He’s been in an induced coma for four weeks and he has been septic! Will he be OK?

You can check out the answer to last week’s question by clicking on the link here.

In this week’s episode of “YOUR QUESTIONS ANSWERED” I want to answer question from one of our readers and the question this week is

My Dad’s been in ICU for 2 months with Tracheostomy and now he’s got a stomach bleed and he’s on 100% Oxygen. Can he survive?

This question from Christen formed part of a phone consulting/counselling session with me.

Christen shares her Dad’s situation in Intensive Care as follows

Hi Patrik,

my 66 year old Dad has been admitted to Hospital on the 30^th March with breathing issues.

I took him to the emergency room that night and he ended up in Intensive Care over the next couple of days as he had developed severe Pneumonia.

He ended up on a ventilator and he has been ventilated since.

My Dad has been treated for ulcerative colitis over the years and it was managed well generally.

This time, while he was in ICU my Dad’s ulcerative colitis blew up and he had to have surgery for it and they removed parts of his bowels in mid April.

After he’s had surgery, he developed a severe infection and he became septic to the point where he was unable to be weaned off the ventilator.

They performed a tracheostomy and by now it’s been nearly two months since he first got admitted to the Intensive Care Unit.

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Since he has had the bowel surgery and the tracheostomy he hasn’t woken up, besides him not having any sedatives.

I don’t know what to do and I am coming to the point where I am extremely frustrated and I’m losing hope!

They have done CT’s of his brain and they are saying that brain function is there and that there is no apparent brain damage!

I feel extremely stressed and vulnerable, I spend as much time in the ICU as I possibly can and I am getting extremely tired and exhausted.

I obviously want to be there for my Dad during this massive challenge, but it looks like he’s not improving, if anything he’s going backwards.

To make matters worse, last week my Dad developed a bleed on his stomach and he ended up having quite a few blood transfusions and they also started pressors(Inotropes) for his low blood pressure.

He hasn’t had any pressors/inotropes for a while, not since he had the infection last month anyway and he seems to be over the infection now.

My biggest concern now is that he’s had the stomach bleed and today they also put him on 100% of oxygen on the ventilator and he’s on 30 mcg Noradrenaline.

I have never given up hope but now I feel he’s reached the point of no return and I am extremely worried that he may not survive.

What do you think are the best courses of action and do you think my Dad has a chance to survive his ordeal?

I'm looking forward to speak to you on the phone soon, so we can discuss what I should be doing.

Thanks

Christen

Hi Christen,

thank you for sharing your story and your pain.

I can only imagine how you must feel after two months of ups and downs with your Dad being in Intensive Care.

It’s good that you’ve chosen to use my phone/ Skype counselling/ consulting service and here I can dive deep into what’s happening with your Dad and how you can move forward.

Here’s what’s been happening from a bigger picture perspective Christen.

Your Dad’s come to Intensive Care with a Pneumonia and he’s been generally unwell. Many Patients with Pneumonia in Intensive Care end up being ventilated for short periods of time.

Given that your Dad has Ulcerative Colitis he would have been at high risk of bleeding from the start. Please keep in mind that most Patients in Intensive Care are at higher risk of a gastric/ stomach bleed as an admission to Intensive Care is very stressful and the body often reacts with a bleed in the stomach to the stress.

Health professionals in Intensive Care know that and generally take precautions to prevent stomach/ gastric bleeds by feeding early via a Nasogastric tube and by giving other medications such as Pantoprazole, Rantidine or Nexium.

In your Dad’s case with the Ulcerative Colitis, he was even at a bigger risk of bleeding. It’s also no surprise that your Dad’s Ulcerative Colitis “blew up” since he’s been in ICU due to the reasons that I just mentioned.

Another huge risk factor is your Dad’s prolonged stay in Intensive Care, as anything above three weeks in ICU is considered a long-term stay in ICU.

Therefore, the longer your Dad- or any Patient for that matter- stays in Intensive Care the higher the risk for an infection or Sepsis to occur.

I’m sure you’d appreciate that the body gets weaker and weaker after or during an induced coma and ventilation. You also need to keep in mind that there are lots of bugs floating around in Intensive Care from all the other sick and infected Patients. This happens in spite of all the precautions taken for infection control, therefore your Dad might have just caught an infection from another Patient.

Your Dad would have also been on Steroids for his Ulcerative Colitis and therefore the Steroids would have lowered his immune system and hence would have put him at a higher risk for infection.

I’m glad to hear that they’ve given him blood products and pressors/inotropes for his gastric bleed. That most likely saved his life for now. 30 mcg of Noradrenaline is a fair bit and it needs to come down before there will be any significant improvement!

It’s also good to know that he’s got no brain injury and that they’ve ruled out brain damage. That’s great news!

It’s good that you’ve never given up hope and that’s admirable!

Most families in Intensive Care give up hope way too quickly and the often get dragged down by the negativity of the Intensive Care team! Don’t let anything or anyone drag you down no matter the situation and no matter the challenges!

Because here is the thing! No matter the outcome of the situation, it’s much better to stay positive anyway because you are not doing yourself or your Dad any favour if you become negative!

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You have also mentioned that you are spending a lot of time in Intensive Care to be with your Dad. Again that’s commendable and you’re doing a great job, however you also need to look after yourself, because only when you are feeling strong, rested and rejuvenated you can feel positive!

When you are feeling well rested, rejuvenated, strong and positive you will bring good positive energy with you and your Dad and the Intensive Care team can feel that!

It’s OK to be a bit selfish to be at your best!

Related article/ videos:

BE MORE SELFISH IF YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!

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

Moving forward from here Christen, two months in Intensive Care is a long time and I know it must feel like an eternity to you.

From an Intensive Care perspective having a Patient critically ill in Intensive Care for two months with ventilation, sepsis/infection, induced coma, tracheostomy, stomach/gastric bleed etc… is not at all uncommon.

Whilst most Patients in Intensive Care are there for short periods of time, all health professionals in Intensive Care have seen Patients like your Dad over and over again!

And here’s the most important thing Christen, besides you feeling positive, hopeful, rejuvenated, optimistic and strong, you must never give up and you must be patient.

I know I hear you say, I can’t be anymore patient after two months in ICU, I’ve had enough of this.

Ok, I get it. But again, Intensive Care is an extremely volatile and unpredictable environment and therefore anything is possible.

Your Dad might improve and recover or he might not. I can’t predict the future. I have seen both in more than 15 years Intensive Care nursing in three different countries where I literally worked with thousands of critically ill Patients and their families and where I also worked for more than 5 years as a Nurse Unit Manager in Intensive Care!

But the reality is that whilst you are trying to look into the future, take day by day, hour by hour and see what happens.

66 years is not very old and your Dad should be given any chance to live and to get out of Intensive Care alive.

Furthermore, you have mentioned that your Dad has been in an induced coma initially and now he’s not waking up despite being off sedation.

From my experience, this is nothing to be too worried about, it just means your Dad is not quite ready to wake up as yet.

Imagine your Dad has been in ICU for two months and most of the time he’s been in the induced coma, he had the tracheostomy, he had the Pneumonia, he had the Sepsis, he had the gastric/ stomach bleed on top of his ulcerative colitis.

That’s a lot to deal and cope with as far as anyone is concerned. Your Dad is simply exhausted and he simply needs time and you’ve got to give him the time.

Given that he has no brain damage, you simply have to give him the time to “wake up”!

On top of that you’ve mentioned that your Dad is now on 100% of oxygen and he still has the tracheostomy.

As long as your Dad is not waking up it’ll be difficult for him to start breathing by himself and wean him off the ventilator.

Again this is nothing unusual given how sick your Dad was and still is.

Let the Intensive Care team wean your Dad off the 100% of oxygen first. Once they can wean him off the oxygen then other steps can follow.

Related article/ video:

TRACHEOSTOMY AND WEANING OFF THE VENTILATOR IN INTENSIVE CARE, HOW LONG CAN IT TAKE?

Even if your Dad can't be weaned off the ventilator and tracheostomy, he may still be able to leave Intensive Care. In this day and age there are specialized Intensive Home Care nursing services that provide a genuine alternative to a long-term stay in Intensive Care for ventilator dependent Patients. Check out INTENSIVE CARE AT HOME of more information.

Intensive Care is often two steps forward and one step back. Sometimes it’s one step forward and one step back.

You’ve got to be patient, stay positive and keep your sanity! This is extremely important Christen! And that’s why you shouldn’t spend day and night in Intensive Care, it’s actually the worst any family member can do, because they get exhausted way too quickly.

But what you also need is a plan from the Intensive Care team. You haven't mentioned any of it. They must really discuss and outline a plan for your Dad to move forward.

As you probably know by now, most Intensive Care teams are not great communicators and they often discuss things when you are not around.

Sit down with them. Ask for a meeting and find out what they are planning for your Dad and then hold them accountable to that plan! It doesn't have to complicated!

Kind Regards

Patrik

Check out my counselling/ consulting options via phone/skype or email