Dad

Needless to say, the wife, kids and I have been spending a lot of time at the VA. Dad is feeling much better and now is getting hungry - after all, other than some malted milk looking soy sauce through a NG tube, he hasn't eaten anything in well over a week.

He seemed confused when we visited him yesterday. He thought his apartment was upstairs from the ICU room and that as soon as the dialysis was over he would go upstairs and get cleaned up. We tried telling him that he was in the hospital but it just didn't sink in. There is something called "ICU Psychosis" where there are so many stressful things happening to an older person that they "escape" to where things are more normal; sorta like a happy place. This may be happening to Dad.

He failed his "swallow" test yesterday morning and the doctors won't allow him to eat until he can be re-evaluated on Monday. They figure as he was just extubated the day before, it may take a few days for his throat to settle down and sort things out. Until then, he runs the threat of aspirating whatever he eats.

The staff knows that he needs nourishment so a nurse tried to insert another NG tube while we were in the room.

The nasogastric tube is a long plastic tube that is inserted down one of your nostrils; you keep swallowing so the tube goes down your esophagus instead of your windpipe. It can be pretty unpleasant while it is passing through the back of your nasal cavity and down the back of your throat. But once it is in, liquid can be passed directly to the stomach.

Good luck.

I have never heard my FIL swear like that before. He started to fight the nurse and when she finally got it all the way in, he yanked it right out. I was surprised at how strong he still is when he's pissed off. I tried to calm him down, as did my wife, the nurse and the ICU doctor. Nothing doing. I was pretty anxious about how upset he was and was watching the heart monitor, but everything seemed pretty good. My wife got upset and left the room, but she could still hear him yelling down the hallway.

This is what got him in serious trouble a week and a half ago. He got pissed, yanked the NG tube out and then aspirated.

The nurse told me later that the doctor told her to restrain him with wrist straps and then insert the NG tube, but she refused to do it. I agree. That would only infuriate him even more and lead to worse problems later on. He is still frail and his heart couldn't put up with it.

They are going to let him take sips of sugar water for the weekend - but no food.

He wouldn't give it up either; even after the nurse and doctor told him that they wouldn't force him to have it done he was still pissed. No tubes, no wires, no dialysis, no needles, no nothing - he refuses everything. I trust he will calm down overnight, but when we left he was still sitting there like a little angry gnome.

I notice now where my wife gets her "seriously pissed" look from. It is a scary thing.

UPDATE:
10/20/07 He let them insert the NG tube today.

UPDATE:
10/20/07 He is out of ICU and back in the general medical population.