We
now confronted some new hurdles. Under
life support protocols, after two weeks a tracheotomy replaces the mouth
breathing tube to reduce the risk of infection and further damage to the throat. An ICU consultant was the designated expert
in this field.
However, these procedures
happen during week day mornings to ensure full backup in the case of mishap. It
was often the time angiograms and CT scans were scheduled. It took almost three weeks to align all the
actors for a tracheotomy.
Carolie
now breathed through a tube in her lower throat, cleared regularly by a nurse
using a reverse suction mechanism attached to the tube. This was an alarming exercise as it triggered
a violent coughing spasm each time. The
nurses were pleased with this response as it signalled her cough and clearing
mechanisms were working.
One
down side of a tracheostomy is higher risk of pneumonia. I signed Carolie up for a study of pneumonia
incidence in tracheotomy recipients.
Several approaches came from study teams trialling new techniques and
reviewing existing management protocols.
I agreed to all of them. One of
the by-products of large teaching hospitals is research to improve treatments
and enhance the knowledge base. I
welcomed the opportunity to contribute, although vicariously on Carolie’s
behalf.
New technologies, methodologies,
treatments and pharmaceuticals are trialled regularly in hospitals offering a
full suite of treatments; often funded by companies with a commercial interest
in new developments. Unfortunately, I
did not see similar enthusiasm for holistic healing horizons, although the new
‘life house’ could be a catalyst to better integrate treatment, recovery and
healing.
We
remained locked in ‘treatment’ mode.
Carolie’s other responses were not encouraging. She did not respond to basic commands. Her reflex points were sluggish. She succumbed to mild pneumonia, for which
she received additional antibiotics. Ongoing oedema increased the risk of deep
vein thrombosis.
To detect possible
clots nurses used Doppler ultrasound to locate various lower limb pulses. Swelling disfigured her feet and legs and she
shed all her skin from the calf muscle down.
Various preventative measures mitigated the worst effects, including
foot elevation and a sleeve-like device to compress her legs and keep blood
flowing through her veins. Orthopaedic
shoe splints manipulated feet, ankle and shin.
Therapists and nurses occasionally performed leg lifts and gentle foot
and ankle exercises. I responded
diligently to a green light to apply gentle massage to arms, lower legs and
feet – I was relieved to be doing something.
To be continued....
No comments:
Post a Comment