ICU

The ICU's at WFBMC are only 10 beds large.  In Ernie's ICU, only 6 of the beds are occupied.  That turned out to be a blessing, as he developed lots of issues last night that required his nurses attention.  Early in the evening, his head suddenly swelled and, along with it, his blood pressure spiked.  They gave steroids for the head and BP medicine to get his pressure down.  His blood pressure gradually dropped to normal but then kept going down more!  Finally, they gave him IV liquids to get it back to normal.  He also needed a catheter.  By about 2 AM, things were under control and he slept fitfully until rounds started at 6 AM. 

It is now up to the ICU docs and ENT docs to convene and decide whether Ernie can move back to intermediate care in the Cancer Center.  The ENT group has no idea why his head swelled and thinks he should be off the steroids the other docs gave him.   From their perspective, he is doing better than most trach patients.  Ernie is worried about his swollen head, a scleroderma renal crisis (high blood pressure can be a sign of that) and getting the attention he needs when the trach gets clogged and he needs suction.  So, he is working on the docs to let him stay in ICU another day. 

One of the most difficult parts of all this for Ernie is the temporary loss of his voice.  Although he has been writing copious notes to the docs, it is sometimes difficult for him to get the attention he needs.  The family has decided that one of us will be with him 24/7 until he can talk again.  I will be the night shift, my sister will take the morning and Ernie's brother the afternoons.  Hopefully, by Friday they will give him his permanent trach tube and he will be able to advocate for himself.