Cindy had a difficult day on Thursday November 8th. Her blood pressure fluctuated a good part of the day. She also wasn’t getting enough oxygen and was not breathing on her own at all. While she was on dialysis, her blood pressure, and dialysis was canceled for the day.
A PICC (periphally inserted central catheter) is an IV that can be used for a long period of time. Cindy had one inserted today. It can be used for medications or for total parenteral nutrition (TPN).
The doctor tried to insert a feeding down her nasal passage. Unfortunately, the tube went into the hernia and curled in there. The doctor is hoping it will ‘snake’ it’s way out. The radiology team is going to try to put the tube where it needs to be. If that is unsuccessful, they will probably use the PICC line for feeding.
Rita called the ICU this morning to get an update on Cindy. They told her they couldn’t find her and asked if she was a patient. Then there was an “oh here she is”. Talk about freaking out!!! When they did find her, this morning’s status is ‘slight improvement’.
Can you spot Cindy in this picture? No cheating, Fran Pandolfo (that’s who you were then).
If you have a favorite picture or story of Cindy, please send it to me (or Rita) so we can all enjoy it.
Cindy went to the emergency room on October 31, 2013. She was having difficulty breathing, couldn’t walk well, and was retaining fluids. Her whole body was very swollen. They admitted her that night. They determined that she was in heart and renal failure. The right side of her heart wasn’t strong enough pump blood to her kidneys. Her kidneys weren’t working. That caused the fluid buildup. They tried giving her diuretics, but that didn’t do anything.
The first thing they needed to do was to remove the fluid that was on and in her organs. The total amount of extra fluid in her body was about 50 – 60 pounds. The fluid had to be removed using dialysis. A triple lumen catheter was inserted into her neck on Friday to minimize the amount of poking they would have to do her veins. Each of the three catheters is a hollow tube where the staff can draw blood, administer medications or fluids and, in Cindy’s case, do the dialysis. Inserting the catheter was complicated due to the fluid in her system.
Most of her labs were good on Friday. Her blood pressure kept dropping, so they had to give her dopamine for that. Dopamine can only be administered in ICU, so she was scheduled to be transferred there. Dialysis was due to start on Saturday.
Early Saturday morning Cindy went into respiratory failure. That means that not enough oxygen was able to pass from her lungs to her blood nor could her lungs couldn’t properly remove carbon dioxide. She had a tube inserted into her trachea to help her breathe. She was also sedated with Propofol (the Michael Jackson recreational drug of choice).
As of today, Cindy still cannot breathe on her own. The ventilator is breathing for her. She is being given medication to keep her lungs open and keep her blood pressure at a safe level. She remains sedated, occasionally opening her eyes when the sedation is reduced. She recognizes the people around her and can hear what we say. Because the tube is in her throat, she cannot speak but nods her head in response to questions.Dialysis started Sunday morning is being performed every day until the liquid has been removed. Between Sunday and Thursday, approximately 35 pounds of fluid was removed. A lot of her swelling has gone down, and she looks much better..Her kidneys are also working, and she is able to urinate via a foley catheter.
One of the complications that Cindy faces is that she has an inverted stomach that is lodged under her right breast (it should be on the left side below the rib cage) and a hiatal hernia at the bottom of her esophagus. .This has made it difficult to insert a feeding tube for her to receive nutrition. Today, she will be going to radiology (so they can see where the stomach and hernia are) to get a feeding inserted tube through her nose.
If you want to send her cards or well wishes in any format, we will make sure she gets it.If anyone has any questions, you can leave a question/comment here, or you can contact me or her partner, Rita, directly.
