The last 24 hours have been all about balancing pain management and GI symptoms. We’re trying to use fewer narcotic pain meds to prevent all the gastric issues he experienced last time. But that means that instead of pain levels of 0, 1, or 2, he’s been getting into the 4-7 range frequently, with 4 tolerable and 6 or 7 not so much.
Last night, with Oscar perseverating and anxiously firing questions at me every half second, we added a tiny amount of Valium to see if it would take the edge off. Within seconds his face relaxed, his eyes closed, and, for the first time post-op, he finally fell asleep. It didn’t last though, and Paul, on night duty, approved more of that and a bit of a narcotic. Finally the two of them got a solid four hours of sleep. Today we’ve kept up spaced-out doses of the narcotic to keep Oscar comfortable and allow him to move around more.
And when we did, this happened:
Oscar got out of bed and sat upright for over an hour. He was dizzy and lightheaded so we placed cool washcloths on his forehead and neck and directed a fan at him. He just kept repeating, “I don’t feel right. My head hurts.” We found more pillows and propped his arms and eventually he was comfortable enough to fall asleep. When he woke, his blood pressure had risen and his color returned. He was in good spirits but wanted to get back to bed. Instead, his nurse and I suggested a walk. He resisted, but then Jesse said, “You don’t have to right now, but we’re definitely going for a walk before we get you back into bed.”
Those were the magic words. Oscar agreed. We helped him stand, and with me holding his hand and two nurses trailing with IV poles and chest tube drains and the urine bag we set off down the hallway. Oscar moved well, faster than we expected, and made it all the way to the end of the hallway and back, a stellar effort that caught the attention of the PICU doctor and all the nurses.
I expect tomorrow will be more of the same. More sitting, more walking, and more breathing exercises to help his lungs heal. Maybe, just maybe we’ll take out one of the chest tubes. Hopefully we can keep the pain below a 4, and hopefully he’ll get a little sleep, and start to feel a little more like himself. I sure miss his smile!