Thursday, 31 March 2011

In The Cardiac ICU: A Family Member's Perspective

Welcome to our first ever guest post. And it's a doozie.

Due to circumstances beyond our control, Terry was unable to be with me while I woke up from surgery. I woke up way past the kids' bedtimes and they were both unfamiliar with my family and unwilling to let someone watch them so Terry could stay with me. My brother bravely volunteered.

This is his account of his experience in the Cardiac ICU.

Warning: The following is not safe for work. It contains graphic language and situations.

I left the entire text unedited because it displays my brother's shocked and overwhelmed mind perfectly.

*******

in the cardiovascular icu… how to describe it. it is futuristic. mostly white and glass. white walls, white floor, white ceiling. big sliding glass doors, all wide open. outside of the room is a desk with a bunch of screens. some are touch screens. others just computer terminals with keyboards. There are a few of these rooms arranged in an arc, like pods, organized around a few of these desks.


inside the room. there is a sink on a small surface. some drawers. the male nurse has a sliding silver tray, on wheels, chest height. he's mostly flipping through and writing on papers. it's somewhat dark; the lights are turned down but everything still looks white.


My sister is lying on this crazy, futuristic looking bed with all types of controls and buttons and i swear i remember there is a joystick built into it as well. it's white. there are adjustable railings on the side with many buttons.


to the left there is a hanging stack of these module things… taller than longer. I think there is six or maybe eight of them. digital readouts on them all displaying something i don't recall. all of them connected to small diameter transparent tubes leading off to somewhere in the grand circus of small diameter transparent tubes in that room.


small diameter transparent hoses running all over like spaghetti heaped on a plate. they would run into several T-junctions with little adjustable knobs and attachments and branch off into other directions going every which way.


to the right of the bed is the freaking big-screen heart monitor output. geez this thing is touchscreen and it must be like 19 or maybe 22 diagonal inches big. it outputs her heart beat in four different ways, all with funky graphs. holy crap it's a badass screen. i don't really comprehend anything it is displaying.


i have to admit i really don't know the bio and science knowledge necessary to deceipher or even comprehend the things i saw in that room.


also to the right is the ventilator. this is the mother-fucker. this is the badass son of a bitch that you never want to meet in a dark alley in the middle of the night. don't fuck with this fucker.


the ventilator is whats breathing for my sister. it is programmed to keep a certain pace and i'll never forger seeing what it was like to watch my sister's forced breathing, mimicking what the screen is showing, again in graph form. those line graphs where she's breathing in and the line is slowly ascending… then she exhales and the line quickly drops and the pattern repeats and is obviously forced. it's breathing for my sister.


this ventilator has its own lcd screen, showing three different line graphs representing her breathing in some way. the nurse explained, as she comes out of the sedation, they reprogram the son of a bitch to allow my sister to breath overtop of it, and that's how they leave it until it's ready to come out.


the process of getting the fucker out of my sister... shit. all i want is to get the mother fucker out of my sister. when she came out of sedation, she came out quick. i think it caught them off guard.


let's back up a bit, i'm going to make a novel out of this while i still remember.


dad and i, and terry and the kids got there, and in the hallway outside the family waiting room you had to hit an airphone intercom system to be buzzed into icu. terry had the kids and they were a handful so dad and i went in first. tawny was completely in sedation, the male nurse never really left the room. he mostly had some clipboard action going on and occasionally would adjust some of the hose thingys and buttons on the… the hanging stack of module thingys… i should have given them a name when i introduced them earlier.


machines in the room would start beeping. the nurse would adjust buttons and knobs. the beeping would stop. other things would start beeping. the nurse would adjust other buttons and the beeping would stop. the nurse explained there are walking beeps, and running beeps.


when she stirred a little bit i held her hand. she instinctively was trying to lift her arms to her face to swat at the breathing tubes. because she called it. just the previous day she said she would do that, and she said the aenesthasa ...as if i can spell that... would make her nauseous.


the nurse is on it and asked tawny to squeeze his hand and she does. then she kinda settles back down and the thing stops beeping that i had just noticed had started beeping at some point.


the nurse gets restraints put on my sisters arms upon hearing the news that she has a history of this and is going to be swatting at the breathing tube. it seems cruel at the time but obviously necessary. and these aren't any kind of barbaric restraints or anything. he also doses her with something into one of the transparent tubes to help with the naseau. but it isn't gravol because he says gravol would put her back to sleep, we want her to wake up.


the male nurse says she's almost ready for some final tests and they will clean up and wipe off some of the surgical fluid, i'm assuming, iodine or some modern new anti whatever stuff… she seems to be right back to deep sedation.


dad and i go out to the waiting room so the nurse can do these tests. we hang out on the weird high-arm furniture and watch tv and play angry birds and watch tv and dad reads the paper and logan jumps around and rolls around on the furniture on the other side of the room and lane wants to be in terry's arms and gives everyone the "i'm on to you!" eyeball.


i think dad was pretty upset by it all, i was upset by it all, and lane seemed to be showing signs of sickness, and all of this being so much of a shock to them. and above all i think none of us where prepared to see tawny like this. terry had to get the kids back to the hotel it was getting pretty late, this must have been approaching ten o'clock, i can probably verify by the text message updates i had been sending to terry throughout the night and i said dad should go too and i'm going to stay with her. i went back into the room after the nurse dude came and got me saying the tests were finished.


He said the tests went great and couldn't have been better. He said he just stopped the flow of the sedation drip thingy controlled by the… dammit... the hanging stack of module thingys.


i stayed in the room. i sat on the chair. the nurse did hose thingys and button thingys and clipboard action.


what seemed like hours but couldn't have been more than twenty minutes, the nurse was clipboarding with another nurse and my sister kicked and kinda shot her head up a little bit and i could see her left eye open a tiny little bit then close and she settled back down in the pillow. she was awake. the nurses bolted to action.


---------- ---------

she's clearly choking and gaging. and it seems so horrible i can't even describe. her eyes fluctuate quickly from open to close, never fully open, and always darting in different directions. i hold her hand. the nurse on the other side of the futuristic bed holds her head down and says "relax" and says "don't move your tounge, keep your tounge flat, it will help" ...why don't i know how to spell tounge?


she kinda settles on it a bit more and i worry about the ventilator mother fucker. from my primitive comprehension i'm thinking we need to adjust that mother fucker now that she's awake but that doesn't seem to be a priority right now.


the nurse says "open your eyes" and she does. she looks at him. she's uncomfortable. she's clenching her fists and sometimes pounds on the bed in her restraints. he says "squeeze my hand" and she does. she looks like she's starting to comprehend what is going on. he says "hi tawny, you're here in the icu you are doing great and everything went well, just try to relax, my name is Darren i'm going to take care of you. your brother is here" …she looks at me… he continues, "you're doing so great just try to relax". she looks back at him, she squeezes my hand she is uncomfortable, she is naseous and dry heaving… i will never ever forget these moments.


as seconds or maybe minutes pass, i don't know it seemed like forever… she slowly starts to settle in on it and is still clearly uncomfortable but not so much choking anymore. they still haven't done anything with the mother fucker. the nurse explains what's going to happen. he says she has to pass some physical tests, and a blood test, before they can remove the ventilator. i didn't really comprehend much of it. i consider myself smart but this was over my head. in summation it had to do with making sure she could breathe for herself, she was fully awake and aware, her lungs were working properly, her blood pressure remained at a certain level for a certain period of time, i don't know it's was all so overwhelming seeing her like that.


the nurse takes the blood for the blood test and another green-suited person comes along and fucks with the mother fucker. i get the explanation that she is now breathing on her own completely unassisted, and based on the outcome of the blood tests and physical test, they will be able to take out the breathing tubes. i just want them to get that mother fucker out of my sister.


the physical tests involved getting her to lift her head off the pillow, and breathe into some apparatus. the green suited person, this time a shorter blonde woman, unpacks this big gauge thing that looks like a compression test for vehicles engines. she unplugs my sisters breathing tube from the mother fucker and plugs into the gauge and has my sister breathe in and out as hard as she can. and then she takes it off and reconnects the breathing tube to the mother fucker. also there is this bubble thing in her throat that they deflate at the start of this test, and reinflate at the end.


they say all the test are back and are great and they can pull the tubes and i back away as other apparatus comes in and two more green suits and they are doing stuff and i need to sit down. i'm so scared but so happy the breathing tube is finally coming out. i don't see much of it but at the last second i see one of the smaller tubes coming up and out and then into a bag-lined bucket. and i see the big clear one coming up but i look away before its all the way out and it goes into a bag-lined bucket.


and once they are all out, two suits leave and i stand up i go to the bed and my sister tilts her head and looks over to me and says "how was work today?" i look at her and laugh and smile and i'm so fucking relieved and i want to cry but i'm being a rock and say to her "work? what are you asking me about work for? look at you, you're doing great and everything went great and they couldn't have been happier and you're going to be fine you're going to be great…" and i just kept going on and on because i know she probably hasn't comprehended any of this yet as she just woke up and i don't even know if she's going to remember. and i hold her hand and i think i even petted her head and i tell her "dad was here and terry and the kids were here and they love you and they miss you and tanj and mark and chels will be here tomorrow and you're doing so great and i love you".


and i stayed in the white-not-bright room and she teased me about working and asked about tanj again and she told me about lane and a ball pit and logan driving boats at the west edmonton mall.


and she drifts in and out between brother-sister banter and she's occasionally quite nauseous and dry heaving and they finally give her gravol which makes her sleepy and i say she should sleep and i tell her i love her. she seems out like a light and i ask the nurse what happens next and he explains.


he is going to stay with her all night. she'll likely sleep through the entire night and they will wake her around 8am in the morning if she doesn't wake herself. he says around 11am they will be able to move her out of icu, of course pending some tests. i thank him and i thank him and he's a great person and is doing some clipboard action as i leave my sister to sleep.


- Written by my brother Davan

*************


I thank my brother with all my heart for staying with me during these hours. I don't remember much, but I do remember him squeezing my hand and saying that everything was going to be OK, sis.

The whole experience is terrifying for both patient and family members, but if you read a little deeper into this story you'll see a few striking things.

1) Was I gonna let a little anaesthesia knock me out for long? HELL NO! I was gonna wake up early and with a fight.

2) Was I gonna let some machine do my breathing for me? HELL NO! Get that mother fucker out now!

3) Did I just score a sponge bath from a hot male nurse? BOOYA!

4) I have the best family in the entire world. :)


4 comments:

Mandy said...

That was incredible. I love the way he describes everything. It was like I was sitting their in that room seeing it all. That was so great of your brother to write this all down. And I am so happy that you are doing so great!

Jennie said...

Your family kick arse. And you kick ICU arse!

Periwinkle Dzyns said...

you rock!

sounds like it's hereditary :)

Steph said...

Oh. Wow. Your bro rules. You rule. You guys sure have a lot of strength.