Day 8 - December 29, 2012

Today we were so hopeful and expecting an exciting day!  We have been waiting (I wish I could say waiting patiently but that might not be true) the past few days in hopes of bringing down Dad's sedation to see where he is at and find our baseline.  If we can know where his mind is, separate from any effects of sedation or other major pain medications, then we will know where we start and move forward.  After the tracheostomy, we understood that he needed to be very still for 24 hours.  But today, our 24 hours were going to be over and we should be able to wake him up. 

We were all feeling optimistic, but when we get to the hospital, Dad was more sedated than ever before (50 propofal and 125 fentanyl) and was completely and totally out...snoring...back on the vent because he was so sedated that his respiration rate fell.  There were more than a few of us fired up!  After a few minutes of family pow-wow and a talk with the doctor, we were back in agreement that at the 24 hour mark we would get to reduce or remove the sedation and wake him up.

At around 3pm, they cut back on his sedation and he began to wake.  As he continued to gain consciousness, he became very agitated.  He tried to sit up in the bed.  He pumped his legs in the air.  His heart rate began to increase.  His blood pressure began to increase.  Overall, he got to a point where he was just too agitated and his stats got bad and we needed to get him relaxed.  After about 1.5 hours of trying to get him to calm down, he went back onto the sedation.

Afterwards, we all just felt so defeated.  We had anticipated a much different result.  We had a big family meeting with the doctor involved and thankfully, he helped calm us and laid out his plan for the next thing to try.  He is starting dad on some different medications in an effort to reduce his anxiety so that we can minimize sedation and have him in more of an awake state.  He is now on Ativan and Zyprexa to help control his agitation.  He also switched his sedation from Propofal, which would put him completely under, to Versed in an effort to keep him somewhat more awake.  In addition, there are certain side-effects to long-term use of Propofal which probably also played a role in changing over to the Versed.

So, all in all, a pretty discouraging day.  We are all having a difficult time with our patience.  We just want to see forward movement, and when I really stop to think about it, it is there in some ways....its just such slow progress.