8am
I just came back to intensive care after a few hours’ s sleep.
Simon has updated me on his 2nd half night shift. Hannah much as she was when I left earlier this morning.
Still quite tearful and very thirsty. Pain when she moves, despite the morphine clicker. Very sleepy but still woke a lot during the night.
Hannah said “I don’t like it here” and keeps asking when she’s going back on the ward.
We moved her into a ward bed around midnight with a plan to move back to the ward today.
Just had cardiac ward rounds while I was writing this…
Doctors very happy…chest drains going to be taken out (means nil by mouth until it’s done) and then back to the ward.
Just waiting for ICU ward round in case they have anything else to add.
She must be feeling better though….
When Simon was going to get a coffee, she asked if he could details her something….He joked “a juicy steak?” and she gave him one of her ‘looks’! Lol
She then complained of feeling cold (her fever is coming down but not gone yet so she has only a sheet on over her underwear and has a fan pointed at her…and her maintenance fluids are going into her veins at fridge temperature) and said
“it’s because I have a ‘temperature’ ” and did those inverted commas with one of her hands on the word ‘temperature’!
That’s my babychick!
When we told her the chest drains were going to be taken out today, Hannah’s response was “Let’s take them out then”
She also just took her nasal oxygen cannula off and said “I don’t need this”. She does, but she’s not overly impressed with anything at the moment. I wouldn’t be, either!
She’s barely conscious when she tries to (or succeeds) pull things off herself. It’s the after-effect of all the sedatives.
Oh, and she managed to pull one of her cannulas out of her hand last night. The one with the Heparin going into it….that bled somewhat!
11 am
Chest drains and central line are out. Arterial line coming out in a bit. Back to the ward this afternoon.
Got a bit scary when they gave her just a tiny bit of sedation (Propofol) for that:
She responded too well to it and was basically anaesthetised for a few seconds so stopped breathing. They ‘bagged‘ her and she started breathing again, but it was a tense/scary moment!
Very drowsy and a bit combative again from sedation for the drain removal but doing well (keeps yanking off the oxygen nasal prongs and she’s incredibly strong and determined with it!…she only needs that bit of support while she’s this drowsy) .
Every now and again, from being completely zonked/out of it, she suddenly flings herself up to sitting, tries to swing her legs off the side of the bed and get out. It takes quite a bit for us to hold her back! Then, just as suddenly, she flops back down onto the bed and is back in a deep sleep!
Nicola (Simon’s sister) is visiting in a bit, then Lodo and Jack (my sister and her husband) this afternoon. Something for Hannah to look forward to once she’s more alert 🙂
Physio came to see her earlier. No concern or need for further visits unless anything changes.
Chest looking better now so looks like definitely just water rather than anything else. Hannah needs to sit up loads. They want her to get into a chair today and walk around tomorrow. If pain is stopping her ask for more pain relief. Every hour / hour and a half she needs to take a few deep breaths in through the nose and out through the mouth. Cough when needs to.
11.30
Nicola arrived. Hannah woke herself up a bit to say hi and reached out for a hug and kiss. Smiled. Looked at the balloon Nic got her and smiled again.
No longer trying to pull out nasal cannula. When I tried to stop her hand reaching for her nose she said: “scratching my nose” and that’s all she did.
Sat up better in bed to guzzle her long-awaited saved-up water allowance.
Starting to see our Hanban re-emerge. 🙂
1.20pm
Waiting for Ward to come and get Hannah. Still very sleepy (though talks, follows instructions, asks questions, asks for drinks etc when awake, but only for v brief spells…often seconds rather than minutes. Not combative anymore now. Actively pushes nasal cannula back in if it slips etc – Definitely better than trying to pull it out!
She had another one of her escape artist episodes earlier:
She wanted to sit up. As we went to help her, she shot up into bolt upright sitting position, moved down the bed with her bum instead of up and started flinging her legs sideways and trying to get out of bed. The whole thing was really quick and she resisted our attempts to stop her quite vigorously. Then, just as suddenly, she flopped backwards onto the bed and went back to sleep. For a moment, I thought she’d fainted, but she hadn’t.
2pm
Moved to ward. She has a room by herself. It’s much quieter than the main high dependency bit or the main ward bit. And there’s a very comfy armchair I can use until she starts needing it! Her nurse is Kelly, one of the sisters. She’s been here 12 years and couldn’t believe how grown up Hannah is now.
Got pain team back in to adjust Hannah’s Morphine. She’s way too sleepy. She took a lot of top ups around midnight last night when we were moving her to the ward bed and combined with this morning’s sedative, she’s zonked.
They’ve reduced the constant dose and have put more of a limit on how much and how often she can have with her clicker.
All observations good at the moment. Just needs to wake up a bit more but at least she’s not agitated and in pain.
7.30pm
The post-heart surgery battle over the limited water allowance took on a new dimension earlier.
Hannah is still zonked out on morphine, but every time she wakes she desperately wants water and I have to keep telling her she’s not allowed yet because of getting the fluid balance right. She’s allowed very specific (and quite limited) amounts. The joys of post-surgery recovery!
To make it even more interesting, she’s also got really ‘dry’ blood at the moment, so while they have to watch the balance and make sure she doesn’t take in too many fluids until she’s up & walking etc and her body can handle them and dispose of any excess, she also needs more water than usual to make up for the dehydration in her blood! Luckily for her that means she gets to drink more than she would otherwise.
Lodo (my sister) asked about why she wasn’t allowed drink, and Hannah pointed a sleepy finger at me accusingly and said “I AM allowed, but SHE won’t let me!”
Made me laugh. A lot! Shades of Karen in “Outnumbered” 🙂
Midnight
I’m just finishing up with the catch-up on my blogging while mostly watching Hannah sleep. Occasionally she shifts her position, sometimes she coughs.
She’s doing well, but there’s still a lot of work to do.
The nurse and I gave her a bed bath earlier, got her onto the commode in the hope she’d have a wee (but due to the morphine, even though she feels the need to, nothing happens…and they took out the urinary catheter in ICU when they took out her drains! The nurse was NOT happy about that!). We got her into clean underwear, got crisp clean bedding onto her bed and then got her back into bed.
While she sat upright on the commode, her O2 Sats rose back into mid-high 90s, where they should be. The rest of the time, even with the nasal prong oxygen, her Sats are too low. In the past I used to get very hung up on and frustrated by these ‘setbacks’, but actually if she needs a bit more oxygen support initially, it doesn’t matter.
As the evening has gone one and she’s more and more tired (and has thrown up 3 times due to the Morphine), she’s struggling to keep her O2 Sats up. She has finally agreed to have an oxygen face mask on and not pull it off and seems settled with it on for now. Her Sats are nicely at 99.
She’s still really guzzling water when we give it to her but she’s not waking up as often just demanding water and getting really upset.
The Morphine seems to be reducing in her system as she’s had something more like a proper conversation with me – and gave me a half smile / half chuckle at something she’d found funny, while also raising her eyebrows disapprovingly!
I’d got all excited earlier about getting to sleep in a fabulous recliner chair next to Hannah – more comfortable than the fold-up beds! But unfortunately it’s electrical and needs an adapter to plug into and the adapter has gone missing, so I’m back to the fold-up bed. Oh well. Not the end of the world and at least it’s nice and quiet in this room.
Hannah devoured a couple of pots of jelly when she first got up here to the ward and then had a few juicy grapes earlier. Hopefully her appetite will start to come back and eating juicy fruit will also help quench her thirst.
The photo at the top of this post was taken when we first got to the ward and I wanted her to have her PJ top on rather than just her bra for varioius visitors coming – to preserve her dignity. The nurse suggested putting on one of the fab ‘Dignity Suits‘ that Birmingham Children’s Hospital have. She looked fab and as though she was already in surgical scrubs, ready for her chosen career! 🙂
Now I’m going to try and get some sleep. I hope that, with the oxygen mask on and nice high O2 Saturations, Hannah can have a good and restful night’s sleep to emerge even stronger tomorrow!
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