Well, we weren't at the hospital when Dr. Watts did his rounds, so he was gone for the day when we got there. Normally he's there at 8:30 am, but on weekends it's 6:30, so we arrived at 8 and missed him. The good news is, Dr. Bailey wasthere and he's wonderful about answering any and all questions, clearly. We also had an awesome nurse (yeah they all are) who went out of her way to make sure we had gotten all of our questions and concerns addressed.
And here's where we stand:
They had mentioned the possibility of a cath earlier, it was cancelled because he seemed to be doing better, and they assumed that the infection/pneumonia had been the problem. Last night's problems with coming off the vent changed that, and the catheterization was again brought up.
"Why does Dr. Stern want to do a heart cath?"
They want to see if there is a problem with the vessels to the left lung being too small, or if there are additional collaterals that are "stealing" the blood away from the left lung that need to be repaired/blocked - his trouble with breathing may be due to this situation. If they go in and find that this ISN'T the case, then that's ruled out and they'll dig deeper to find out exactly what the problem IS.
I asked Dr. Young that exact question last night - and I just don't understand what the problem was with telling me what the thought process was. Dr. Bailey had no problem doing it, I have no idea what Dr. Young's hang-up was.
"OK, now if they DO find the above problems, what then?"
They'll do one of three things. If they find that the arteries are too small, they'll either balloon them to stretch them to a more acceptable and adequate size, or, if need be, they'll stent them open. If they find problematic collaterals, they'll "coil" them to occlude or close them.
"Do the stenting or coiling require opening the chest back up?"
No, all of them are procedures done during the cath, and will be done immediately if they need to be done at all.
Did those sound like difficult questions or answers? Sheesh! I thanked him loudly and repeatedly, and asked him why the doctor last night couldn't just answer me like that, because he's gotten an attitude and beat around the bush last night, and hadn't answered ANY of my questions. The look on his (and the nurse's) face was priceless, and with a little gasp they wanted to know which doctor. I, of course, loudly announced that it had been Dr. Young who'd all but refused to answer me, had taken a condescending tone, and really pissed me off. Neither of them made any comment, but I made my point.
Needless to say, I really like Dr. Bailey. I have since day one. He's always answered any question I asked, regardless of what it was, and did it happily, and when necessary, at length. He's friendly and seems to understand my need for knowledge. Dr. Young acted like I wasn't allowed to know, and Dr. Watts sometimes talks over my head. That's my lack of understanding, and definitely not any unwillingness on his part to let me know what's going on. He's just so amazingly intelligent (I'm honestly in awe of his abilities) that it's almost like he explains too much... No not too much, too many different ways.
If I ask for directions to Duncan Donuts, tell me the most direct path, but don't follow that with the 13 other ways to get there, know what I mean?
Anyway, the cath (and whatever other procedures they decide to do) are scheduled for 1:30 Monday afternoon.
As for today:
He was taken off of his dopamine and maintained a good blood pressure. He had to have his other femoral PICC line moved because it was just overworked and worn out - it was moved to his right shoulder.
They took him off of the new sedative (which I can NOT remember the name of) and put him back on ativan and versed. Not what I wanted to hear, but necessary, because the other wasn't keeping him calm and they actually had him restrained to keep him from yanking out his tube. Plus, the way he was turning his head back and forth was possibly causing friction on his throat, which causes swelling, which makes it MORE difficult to extubate. So he needs the narcotics to keep him calm. Damn it.
Man this is a long post. Sorry!