ICU Day 4

Today has been a difficult day for my husband. Andre had a V-tach episode at around 8:30 AM this morning. It took the docs about half-an-hour to get it under control with Versed being the one that worked. The Versed was supposed to be a pre-medication prior to using a defibrillator because they thought they had to shock him to get his heart to slow down; good thing they never did. The docs think that the V-tach is likely a stress response of the heart due to surgery and pain, and not due to other potential sources (e.g., an infection or an underlying heart problem). They've made changes to his sedation cocktail (taking out Propofol and Haldol, and sticking with just Versed and Fentanyl). They've also taken away some of the drugs that they suspect might be suppressing his bone marrow's white blood cell production. They need the marrow to start up so that he can better fight the lung infection that he has (fungal, bacterial, and CMV), and also to help heal the wounds from surgery. Another reason they've change some of his medication is that his kidney function is not as good as before the surgery.

Andre's lung does have a significant volume of dead space (basically air goes into his lung, but no gas exchange happens because the blood vessels are not "contacting" with the lung's alveoli). A potential cause is a blood clot in his lung which they can't confirm by imaging because a CT scan of the lung will require a contrast reagent that is bad for the kidneys. They'll do some imaging of his legs tomorrow to see if there are clots, and if there are, they can put a filter in him to make sure that these don't make his already precarious situation worse.

I asked the doctor directly if he thinks it's time to call in his family. He said "no", and then assured me that he'll be forthright about it when it's time.

Andre is still sedated and sleeping. I hope he's having some wonderful dreams--maybe of him riding his motorcycle, and maybe of me.