The news tonight is only so-so. Emerson extubated to BiPAP yesterday afternoon (I said CPAP, but I was mistaken – she’s on BiPAP receiving 2-way pressure and rate of breathing support). She did okay overnight, but her work of breathing and oxygen requirements have been increasing all day. She’s at 5 liters now and still sating mostly in the low 90s.
Then there’s the psychosis… She hits me, pulls my hair, and tells me to go away. She says she only wants her mom and I don’t look like her mom. She thinks she’s still at the beach and talks about the ice cream she left in the freezer there. She got very upset at the nurse today for eating it. She talks to her brothers and her cousins. She tries to get out of bed to go to her bedroom. And more… She slept all day, popped up every 5-10 minutes, and then fell back over to sleep. All. Day. Long. They started IV Haldol this afternoon.
It leaves me wondering about her “episodes” while on the vent. We (myself included) attributed them to inadequate sedation. Based on the patterning of those events, though, & how similar they were to the events of today, I’m wondering if those were episodes of psychosis too.
No one is sure what’s causing all this, they only say “it happens”. They also don’t know how long it will last, only “not forever” – maybe a few days, weeks, or even months (to a lesser degree). As with everything, we’re on Eme’s time.
No improvement in urine output today; we continue to sit, support, and hope tomorrow her body starts to concentrate it. Until then, we’re left chasing electrolytes and trying to manage her fluid status. Same game, different day…