Wednesday, December 9

Breaking off long-term, co-dependent relationships is always a difficult thing to do.  Even the fact that one part of that relationship is a cold, unfeeling, medical device does not make it any easier.  Ventilator weaning has gone to the next level and boy is it a tough level!  When I went in this morning, Bill had just started a breathing trial.  To do this they unhook the ventilator from his trach (the plastic hardware in his neck and windpipe stay in place) and then fasten a loose plastic shield over his throat through which flows oxygen-enriched air.  So- Bill is doing all the breathing and all the work himself.  It's great- a huge step and he did really well.  Unfortunately the whole thing was terrifying for him and he had one giant panic attack the whole time.  He wanted me to watch him to be sure he was breathing, to read him his vital stats from the monitor every 30 seconds or so, and to not let go of his hand.  I just can't imagine how difficult and frightening this was for him.  The fact that he did well and impressed everyone does not matter much.  Apparently most people only last a few minutes on their first breathing trial and he went for two hours!  It was hard and he did it.  I hope that he will soon be able to acknowledge his accomplishments for the accomplishments that they are.  We tried another breathing trial this evening and he had a bradycardic episode so he went right back on the ventilator.  His heart rate does not really drop anymore because of the pacemaker, but his blood pressure plummeted and he passed out.  This is the first time I had actually seen this happen and it gives me a new respect for his panic and anxiety.  It is valid.  I think that they will probably try another breathing trial again tomorrow.