A Week of Hospital Recovery – Day 1

December 29, 2013 by  
Filed under Acute Hospital Care

A Week of Hospital Recovery - Day 1What does a typical week long hospital stay look like?  Here is a day-by-day schedule of our most recent visit.  The patient is Jessica and the treatment was surgery to remove part of the intestine.

 

Day 1:

Rushed to hospital in ambulance.  Patient presents with dehydration and general lethargy.  Scans show a blockage in the small intestine.  The treatment is surgery to remove part of the intestine.  Patient’s medical history includes stroke and heart attack, and she is classified as higher than normal risk for surgery.

Blood work shows patient in a severely weakened state.  Blood pressure is critically low and pulse high.  Some of her cell counts also abnormally low.  Treatment is multiple IV drips to combat the dehydration and improve blood function.  Patient is in surgery within a few hours, and the surgery goes as the doctor expected.  Opened up about 2 hours to investigate and remove about 2 feet of the bowel.

After surgery, patient remains sedated to allow her body to rebound slowly and smoothly from the procedure and the anesthesia.  Patient remains sedated and unconscious for most of the day.  Hooked up to a ventilator for breathing and several IV drips to help normalize her blood work.  A catheter is standard for this type of procedure and it may take awhile for her to regain control of her bowels even after she “wakes up”.

The patient remains unconscious for the majority of the day.  Testing shows gradual increases in blood pressure and other numbers.  White blood count was critically low upon admission and has now swung the other way and is incredibly high.  This often means the body is fighting infection.

Twelve hours after surgery the patient shows some signs of consciousness.  Moves her eyes and head slightly for about twenty minutes.  Drifts back to sleep.

 

Our Thoughts

Jessica is a woman who has been faced with so much adversity.  She has a long medical history and surgery will have a much greater effect on her than it does on an average person.  The moment we were told she needed surgery was pretty devastating.

I didn’t think the problem was this severe prior to the ambulance ride.  It presented a lot like the flu or food poisoning, so I instructed them to take Jess to the closest hospital available (which is in the suburbs).  If I had known she would require surgery, I’d have instructed the ambulance to go downtown.

Surgery is a big deal, especially for someone with a long medical history like Jessica.  It is worth asking the diagnosing physician just how good the surgeon is.  Sure, they’ll always say the surgeon is good at their medical center.  But it’s worth asking anyway.  If you sense any apprehension in their voice or their recommendation, it’s worth considering a move to another facility.  In this case, the diagnosing physician gave a sincere and glowing recommendation of the surgeon.  I had complete confidence that she (the surgeon) was quite good.

It is great to be able to feel confident in the surgeon.  It’s an added bonus to have great communication with them.  Jessica was barely able to pay attention at this point, so I did most of the talking.  It just so happened that our surgeon graduated from the same college we did.  She explained everything well and presented herself as experienced and proficient.  I felt good about it.

Besides the big three organs (heart, lungs, and brain), the doctors were most concerned with the kidneys recovering after surgery.  Kidneys remove toxins from the body and help it maintain chemical equilibrium.  Although there was a good chance the kidneys would function again, it was not a certainty.

The sooner the body could naturally remove toxins and create urine, the faster it would recover.  Everyone was pleased to see the kidneys begin working just a few hours after surgery.  At this point, the length of hospital stay is determined by how quickly her body is able to function effectively.  Working kidneys are a big advantage in getting out of the hospital as quickly as possible.

All things considered, the hospital stay has gone as well as expected thus far.  We hope she is able to come off the vent on day two.  Both are good possibilities, but neither is certain.

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