Day 8, morningThe Doppler reading this morning again

Day 8, morning

The Doppler reading this morning again showed no signs of vessels misbehaving. Still, they’re pretty sure the vaso spasms will occur, and likely sometime in the next few days. Nothing showing to indicate that, except possibly some increased urine outflow, but that’s more a possible precursor than a predictor. The reason they expect it to happen is that, with a subarachnoid hemorrhage such as Kathy’s, the incidence of the spasms is exceedingly high. Usually they occur sometime between day 3 and day 15. If spasms don’t appear in that window, and no other signs prevent it, they’ll consider the very slow and critical process of awakening her. We’ll mark that anniversary on our calendar for special annual celebration.

Kathy is very high maintenance, just because of the seriousness of her stroke type, the extent of the hemorrhaging, and the heightened risk of pneumonia. But even more so because of an unusual fluctuation of her blood pressure and TCP’s.  Usually, when a patient’s BP increases so does the TCP, and vice versa. With Kathy, they’re acting inversely with each other. So regulating the balance is, literally, a minute-to-minute project. Or, really, from my observation, it’s an every 3-4 minute adjustment (not always, but much of the time). Keeping one in line throws the other out of kilter. Nursing is hard.

The pulmonary ICU doctor was in while I was there this morning, along with the ICU micrologist (?) doctor, discussing the plan for addressing fluid buildup in Kathy’s lungs. The might go in today or tomorrow and suck some of it out, a highly useful procedure but one that puts extra strain on BP. They’re going to schedule it for shortly after she gets her 1:00 pm BP meds. The discussion of alternatives took about 20 minutes. Doctoring is hard too.

Kathy loves dancing. When I went into her room today she was doing the shimmy. They had her bed vibrating her upper torso to loosen some of the fluid in her lungs. Then they put the whole bed on vibrate. People who know Kathy when we go out to hear music (Back Bay Betty! neuorology specialists kickass blues band) know that when she dances she exudes serenity. Some call it “doin’ the Kathy.” Jessica, today’s attending nurse, says that, curiously, when the bed goes on vibrate her BP goes down. I’m no medical authority but I could have told her that.

Come on, Kathy.