Moving to Medical ICU

Yesterday afternoon the medical team(s) started discussing moving Jerry upstairs to a floor with a higher level of care (MICU-Medical Intensive Care Unit) from the Cardiac Care Unit. That move is happening today. Medically, he is more needy.

It seems that most of his needs are pulmonary. There was a mechanical episode with the vent morning that has set him back further. He had been off blood pressure medication, but is now back on.

They suspect that he has more pneumonia. He will have another bronchoscopy today to 1) determine if he does have pneumonia, 2) determine if he has acquired ARDS, and 3) to assess bleeding in the lungs.

Today marks 4 weeks on this journey. Being on the vent for that length of time can introduce new issues with tissue breakdown, infection suceptibility, etc. His vent needs are going to be more long-term than short-term, so they will be performing in a tracheotomy. It will happen as soon as he can tolerate the procedure as it requires a trip to the operating room. That could be today, but most likely tomorrow or sometime this next week.

His sedation levels are increased because they have made some changes on the vent due to his needs and the morning episode.

Nutritionally he can't tolerate OG feedings (nutrition going directly into the stomach). They will reassess and may try NG feedings that will go directly into the small intestine. His nutritional needs are a continued source of concern.

An echo will be done today to check on his cardiac status. We're hoping that this will show that his heart is holding up under the new stresses.

We are thankful for the things that are holding up. His hemoglobin levels are a little better. They are still not great, but the are better. Dialysis seems to be working and his edema is marginally better. Dialysis continues.

Debbie is continuing to receive cautious reassurance that all of this is productive. She prays that all of the decisions about his care continue to be obvious. She is re-framing how she is dealing with things as this journey starts it's second month.

The move today is also creating more anxiety and stress for her. There are a whole new set of day to day caregivers to get to know. She is very comfortable with the quality of care he is and will be receiving, but this move will change the dynamics somewhat. The patients in Medical ICU are very critically ill and there is a higher level of intensity than the floor they are on now.

Specific Prayer Requests

1. Jerry gets better.
2. We have an informative bronchoscopy.
3. The echo results are good.
4. Strength and wisdom for Debbie.