Hurray for the Grimace

I'm back home now after a long night of flying and a day of teaching. But I called the hospital and got some good news. Let me set the stage. When dad first came out of surgery he was fairly responsive. He would open his eyes on command, he would squeeze a hand, he would even nod. But as the days dragged on he was increasingly sleepier and sleepier. He stopped squeezing hands or opening his eyes. As time went on he stopped responding to pain stimuai in his upper body. They put the dialysis line in his neck with out anesthetic, he did make a move. He still would move his legs and even respond to pressure, but not on top. This worried everyone and eventually is why they made the move to dialysis.

Today I'm told that things are continuing to look better. His BUN is down to the upper 30's. His creatinine level is even lower than before his surgery. And today they did an EEG which showed he had brain activity and there was no sign of seizure. So whatever else is going on, he's clearly not brain dead.

All good news, but what about responsiveness. There I'm told he is continuing to make steady if slow progress. He still won't squeeze hands on commands, but the nurse tells me he is opening his eyes just a bit and is now responding to pain stimulai in his upper extremeties. This means when they put some pressure on his hand (squeeze a finger) he will make a face. This seems a big improvement from where he was. At the very least he is really moving in the right direction.

Plans are formulating to start with drawing the support of the machines. They will take the dialysis machine away, perhaps as soon as tomorrow and see how he does on his own. They say he is now processing waste in his urine, no longer just excreting water. And they may start drawing down the RVAD as well. Apparently they can adjust it to see if the heart will support pumping independently without risking a total failure. And they have now stopped all heart medications and his blood pressure continues to do well and be stable. They will probably return the meds when they take the rvad out, but in the meantime this shows a strengthening of the the right side. All this is good news.