--Everly Brothers, "Wake Up Little Susie"
Last night was another quiet night for Jay. The docs are working to decrease the support he gets from the ventilator and his medications, but they are taking things very slow with him. In rounds this morning, his doc described the changes not as weaning his meds, but very slowly "tweaking" them down. So far he is off two meds, and only has 438 to go (okay really only about 12 more).
In the meds department, one thing I think is very interesting is that there is a pharmacist on rounds each morning. He is there to make sure that all meds are working together and that dosage changes (er, tweaks) are appropriate. Rounds usually include the attending ICU doc, a doc from heart failure team, nurse practitioner, respiratory therapist, 2-3 fellows, his nurse, pharmacist - thankfully ECMO specialist is no longer on that list. And us. That is one thing that is really cool: they let us stand right there with them and hear the discussion, ask questions. It's a very open process, and I am really grateful for it.
They are allowing him to wake up, which is great to see that he can open his eyes, look around, move his hands and feet, and even grab at his tube and lines. The down side is that he is quite agitated when he does wake up. He will grimace, open his mouth to talk, and sometimes sheds a little tear. It's absolutely heartbreaking to see him so upset. He's trying so hard to communicate with us - he's pointing at things and trying to talk. We are trying to be reassuring and comforting, and the docs and nurses are trying hard to give him additional drugs to help him relax.
He's apparently immune to morphine ... guess all those years of giving it to him at night to get him to sleep gave him some serious tolerance. I'm kidding, folks! No need to report me to social services. (See, I must be doing okay - still making pitiful attempts at corny jokes!) But seriously, they have had to give him more and more rescue doses, and each seems to have almost no effect. Last night, they finally went to pentobarb, and just after midnight he finally relaxed and went to sleepy-land. So we finally decided the nurses could watch a sleeping baby and we did the same.
Thanks to all of you for your continued prayers. Your comments and notes keep us going through the long days.