still at same place, things happening, lots still up in the air... ups, but also downs that I didn't want to drag everybody through with me
weaning progressing, after three days I passed the first hurdle, on "spontaneous" only on the vent for those three days i then had a blood gas CO2 level of ?( 0.70) down from ?( 0.76) at admission, thus earning me lengthening sessions off the vent but still on 0.5 O2 which is a blend of room air and pure oxygen. normal air is .19 O2 ( 19 %O2, 80 % nitrogen, 1% other gasses )
I have stood up twice clinging desperately to the walker heavily for 10 seconds which enabled them to first zero the built in bed scale and weigh me at ( barely ) under 500 # and then the second time screw up the bed scale's zero...
on the minus side I am developing a red patch with a blister on my foot...
now I'll try to leverage the foot's condition to stave off a move.
Well, if I may comment, it sounds like you're still fighting respiratory failure complicated by atrial fibrillation and the effects of the weight you're carrying around. From the picture I saw, it looks like the decision was made to provide you with a tracheotomy, which will be the most efficient to get you off the vent. Unfortunately while it's in use, you won't be able to speak. As you progress, you should be able to start using a vocalizing plug to divert the air flow back up through your vocal cords and normal airway passages, allowing you to speak essentially normally. One you get out of the hospital and really get going, the tracheostomy tube can be removed, and the stoma allowed to heal over. Unfortunately, as I'm sure you're aware, there's a long way to go. Just a 4 or 5 day period of lying flat on your back starts the process of muscle and strength loss.
The CO2 retention is another issue that the trach will help. A normal CO2 level is about 40 mm HG or torr. A CO2 in the 70s range means that more than likely, your physicians will try and work on physical and lifestyle changes to address the issues causing the problem. Just so you know, when CO2 levels reach 100 mm Hg, the CO2 itself acts as an anesthetic, let along any other depressive drugs that might be in your system.
The atrial fibrillation, or A-Fib is treatable via either a procedure or via drugs. Essentially it's due to a derangement of the normal spontaneously discharging electrical focus in your atria, or the upper chambers of your heart. Think of it as a small capacitor that once discharges, follows a prescribed wiring pattern that also causes additional caps to discharge along the electrical wave.
Typically there's one of two issues. Either your Sinoatrial (SA) node is sick, which causes other areas in your atrium to discharge spontaneously, a role which they were not meant for, or you have additional, so-called ectopic foci or areas that have aberrantly decided to start spontaneously discharging.
The first cause is typically either treated with drugs, or sometimes with a "reset button", otherwise called a cardioversion, where a small shock is administered to try and get things to reset. The second cause typically gets treated with an ablation, where a team of cardiologists goes, and tries to find the aberrant foci and eliminate them. The bad thing about A-Fib is that one, it reduces the amount of blood your heart pumps by about 10%. The second is that it makes you prone to developing blood clots in your Atria, which can then get thrown to your lungs, called a pulmonary embolism, or elsewhere in your body, causing an infarction or area of dead tissue. Not good when it goes to your brain. Therefore, you may wind up on blood thinners to prevent this from happening.
Lastly, if you really are up around 500 lbs, once you have recovered, you should seriously talk to your doctors about Bariatric surgery. Once known as stomach stapling, there are now other less invasive ways of achieving the same results, which would greatly aid you in not only losing the extra weight, but it reversing some of the problems you're facing. I'm guessing you've also either developed adult onset diabetes, or will develop it, which is another really bad thing that you want to avoid.
Concentrate on your immediate recovery, and then deal with the root sources. One step at a time. If you have any medical questions that you want to run by me, feel free to PM me. Fair trade for at least a few audio questions I've run by you. If I can't answer them, one of my best friends runs the Adult ICU at Duke Medical Center, so I can always get a consult from him if necessary.
Speedy recovery my friend. set your sights on your long term goals, but concentrate on one day at a time.
Robie, please PM me with your PayPal addy.....:thmbsp: