Dateline Oct 14th 2009: DR, we pitched the perfect game today!
The last 48 hours had pretty much been exhausting due to the acute level of care needed to get these patients through surgery. These young people are very sick and we all are worried someone is not going to make it. but today the tide was finally changing.
Our team was up and Adam as usual for the am bus ride to Cabral Hospital, all anxious to see how our patients were doing.
We left of last noc having somehow gotten Dr Crouch’s sick heart out of the OR, and to the ICU. He and the entire team busted ass to get that guy better and it paid off! Though still critical this morning on a balloon, he was awake, making urine and had stable vitals, incredible!
Chris and Betsy had done an awesome job, as we assessed the big picture, we needed to somehow get the last two cases extubated(off the ventilator) today so we could have breathing machines for the two heart surgery cases today. Limited resources greatly increases the chances of a rapid vent wean.
We had the early case today another sweet 48 yo woman with severe Aortic and Mitral valve stenosis from rheumatic fever. As Dr Juan walked her into the room we all gave her a big hug as she willingly put her life in the hands of these strangers.
This hospital is like a small community unto itself. All the 10 candidate patients stay the whole week in 3 rooms right outside the ICU.
So every time we go back and forth from OR to ICU we see our pre-op patients standing in the hallway watching intently as the drama unfolds. They all watch as we run by with Intra-aortic balloon pumps and 6 people hurrying the post-op patient down the hall out of the “tower of terror”. They all know what day it will be their turn.
We all know what they are thinking as they bravely smile and wave to us.
This woman is about to lay down on our table and have a double valve replacement and she hugs us all like we are her family, for today we are.
No doubt Monday and Tuesday we stressful days because the cases went long and hard. Fortunately everyone was doing ok, but for a little added good luck we whipped up the “Wheel of good Karma’ Everyone drew their picture on the cardboard pump tubing case and signed it. We then hung it on the heart lung machine.
With each spin of the wheel all of our positive energy would flow through the heart lung machine and into our patients. It may sound hokey, but I’ve used it before on tough cases. As I tell all my patients we will take everyone’s help in the OR, especially prayer.
Both our case and Dr Crouches case went without a hitch!, There was a little delay in ICU but it looked like we would have the two ventilators available for our post-op patients.
The routine when the surgery was done was to send one of the residents to secure the elevator and “test it” to see if it was running. As we sat in the OR waiting, Shyanne the resident(who refuse’s to ever ride in the elevator??) told us that the “tower of terror” was just being fixed after trapping one of our patients from yesterday in it for an hour, on her way down for an xray! oh boy.
Also we had no more EKG or transport monitors available, so we would only have O2 sat monitor for transport. Moving a fresh post op heart patient is always an anxious situation, at any hospital. Here it is another ride at Six Flags.
We finally got the go ahead from Shyanne, scrambled on the elevator and promptly went no where. After 4 minutes and a lot of yelling up the shaft by Manny (the main elevator operator) we then descended to the first floor lobby. I was monitoring blood pressure by pulse, If you can feel it, It’s probably at least 80. After about 8 agonizing minutes and 3 trips to the first floor, we finally went up to the 6th floor, hallelujah.
Our Lady did great, without turning a hair. In the ICU we saw that everyone, including the really sick guy from last night was doing better. He was extubated and the Balloon pump coming out. The ICU team of our Nurses and the resident Doctors where all fired up.
Our young patient from yesterday looked great and we were all hoping to get back to the hotel possibly before 6 pm for some R and R.
Our young man from yesterday looked good. Thursday we have another 2 cases, Dr Crouch has a difficult Mitral valve repair on a 23 yo student and I have the other CABG case on these notoriously small coronary patients.
There’s gonna be a lot of wheel spinning tomorrow!
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