We had a tense morning with all Pat’s vital signs, but he is now stabilized! His nurse is staying right on top of every single detail. They needed to raise his blood pressure to keep his Cerebral Perfusion Pressure at an acceptable level. I am now quite relieved.
This is Mary, Nancy’s sister. When I arrived at the hospital earlier today, around 11:30 or so, we found that there were a couple of concerning issues going on. It was a little scary for a while, but Pat has an excellent nurse and the doctors are easily accessible and everyone is RIGHT on top of every new situation. I can’t say enough how pleased we are with Pat’s medical care, and that means so much, to have that trust in the doctors and nurses – it gives us so much peace of mind.
Some of Pat’s vital signs were out of balance – and that is the best way to describe it, as it is truly a balancing act with his blood presure and intracranial pressure (ICP). By taking the mean blood pressure and subtracting the ICP, you get a value called the cerebral perfusion pressure (CPP). This is the pressure needed to make sure his brain is getting enough blood. With an elevated ICP, you need a little higher blood pressure to overcome that pressure and deliver blood to the brain.
Since Pat is in such extraordinarily good physical condition, his blood pressure naturally runs low. To a point, his body is used to delivering enough blood to his brain under the condition of a low blood pressure. But with the elevated ICP, the doctors needed to order some medicine to increase his blood pressure. Meanwhile, they are also ordering a couple medications to decrease the ICP, which unfortunately can have the side effect of lowering the blood pressure. And around and around you go in that circle sometimes…. Right now the CPP is adequate.
The other issue was that Pat has a lung infection. He is on antibiotics for this and hopefully this will start to improve soon. Due to the infection, his oxygen levels were getting a little low, so the doctors gave an order to increase the oxygen delivered by the ventilator. Pat is also getting a blood transfusion right now. He is a little anemic, possiby from the surgery.
Overall right now, he is still very critical, but stable. Today is the 4th day since his accident, and from information we have read, the brain pressure can continue to rise up to about the 4th or 5th day. Hopefully we have reached the turning point, and we can now start to see the pressure decrease. They cannot begin to try to wake him up until the pressure is much lower, so this may still take several days.