Monthly Archives: June 2014

Day 221 – Pulmonary Artery Catheterization

Pulmonary Hypertension

Pulmonary Artery Catheterization

Cindy continues to be stable.  However, the doctors are not sure that they are medically treating her correctly due to all her complications.  Today they decided to do a procedure called Pulmonary Artery Catheterization (also called Swan-Ganz).  The procedure consists of a catheter that is inserted into the groin and “pushed” up to the heart.  An x-ray is used to watch the catheter  ensures it is in place correctly.  The purpose of the test is to monitor her heart’s pressure.  This will help them determine if Cindy is having heart failure pulmonary hypertension or valvular disease.  It will also measure volume status.  Both a Cardiologist and a Pulmonologist with be doing the procedure and monitoring the results.
Pulmonary Artery Catheterization
Pulmonary Artery Catheterization
The benefit of this procedure is to be able to make good treatment decisions.  The doctors will be collecting information from the pulmonary artery catheter so they can determine the best form of therapy for Cindy.
One of the biggest challenges the staff will face is transporting her to where the procedure will take place.  Cindy is hooked up to so many tubes and monitors and has to be transferred to a guerney from her bed.  Below is a picture of what was following Cindy as she went down for the procedure.

The procedure went well, but the doctors never came to tell us anything.  Updates on her condition later.

Answer to yesterday’s quiz.

Intubate means to insert a tube for the purpose of mechanical ventilation (helping someone breath).

Day 220 – A New Beginning

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Hi folks,

Cindy had a fall last week and cut her shin.  After a couple of days, the cut started to look infected.  Debbie took her to the doctor.  He prescribed an antibiotic.  The antibiotic seemed to have cleared up the infection, but this past Thursday, the infection started to look pretty bad.  Debbie took her back to the doctor.  There were other issues going on for her, too.  She was having a difficult time with her breathing, walking, and she had been retaining a lot of fluids since February.  She was taking a high dosage of diuretics (Lasix) and another medication to “boost” the diuretics.  Nothing was working.  The doctor suggested she go to the emergency room.  

During triage (where they first do a medical intake to see how “bad off” you are) they found that her oxygen saturation level (how much oxygen you’re getting when you breath) was low.  Her blood pressure was also low.  They put her in a room in the ER and started giving her fluids, oxygen, and a tetnus shot (because of the fall.  You should have one every 10 years and her last one was more than 10 years ago).  They also took x-Rays, an EEG and checked her for clots.  

Debbie and Cindy were talking about old times when Cindy went into respiratory or heart failure.  Thankfully, there was a doctor in the room (and REALLY thankfully – we were at the ER) and he and a team of doctors, nurses, and technicians were able to revive her.    They had to intubate her (QUIZ– what does intubate mean?  Answer to quiz tomorrow or you can check out previous posts from last year).  So here we are again!!!

                            Deja Vu

Yesterday (Friday), Cindy was seen by a cardiologist, renal specialist, pulmonary specialist and hospitalist (doctor from the hospital).    The hospitalist told us the following:

1.  The Cardiologist found that the right side of her heart was struggling and the left side was working harder.  Her blood pressure is too low.  She is now on a medication that helps raise her blood pressure.

2.  The Renal Doctor found that one of the medications she was taking for her diabetes was interfering with the Lasix which was why she was retaining fluids.  That medication was also damaging her kidneys.  

3.  The pulmonary specialist was concerned about a possible clot in her lungs.  The test for a lung clot is a Cat Scan that requires a dye.  Because her kidneys are compromised, the dye couldn’t be administered and the test could not be given.  They started her on blood thinners to treat the clot just in case it is there.  

4.  The main goal is to get her vital signs stabilized; blood pressure and oxygen saturation levels need to go up.

Today, a machine that blows Nitric Oxide into Cindy’s left ventricle was attached to the breathing tube.  It acts as a muscle relaxer that works on her heart and will open her arteries so the doctors can see what’s going on.
Cindy will be in the hospital for a while – we don’t know how long.  She is in the ICU, next door to where she was last November.  The nurses and technicians all remember her (and Debbie, Rita and Mary).  She is getting great care.  
There will be daily posts as long as Cindy is in the hospital – or she tells me to stop.