Wednesday

I just came from meeting with Dad's doctors. We missed rounds, but they were kind enough to fill us in on their plan. Dad still gained fluids yesterday due to his nicardipine drip, despite the lasix he was given, so they are planning to try to make him lose 2L of fluid today.

Once again, Dad seems to have taken a bit of a turn for the worse. Every day seems to flip between good and bad things, and today appears to be one of the latter so far. Neurology had a dificult time arousing him after taking him off his propofol drip for 10-15 min and are questioning if he had a seizure last night. They are repeating his CT scan as I write this, and will be doing another EEG to look for any seizure activity.

Additionally, he is not responding well to oral antihypertensive therapy, as the 150 of metoprolol tid was insufficient and he had to resume nicardipine. They are changing up his medications some and adding in more oral medications to try to get him back off the nicardipine to keep his fluids level going down. It's likely there are many factors contributing to his current hypertension, not the least of which being his longstanding history of it. Moreover, his brain has suffered trauma from the stroke, and is likely demanding a bit higher BP to maintain perfusion. He is also loaded up with excess fluid, which will drive his BP up, and he is in a stressful setting, despite the propofol hypnotic sedative.

His lungs are doing pretty well now, but he still isn't quite breathing strongly enough to be weaned off the mechanical ventillation just yet, which is unfortunate as we'd love to take him off the propofol at this point. It would be much easier to assess his neurologic status if he was not always coming off sedation.

Like always, thank you all for the love and support.

Update 11:35am: Good news, Dad's most recent CT scan shows no changes or evidence of rebleeding.

Update 7pm: Dad had his EEG done, but the results have not yet been analyzed. Also, he has had more lasix (furosemide) given to help shed some water. The nephrologists came by and are changing his anit-hypertensive drugs around a bit, but I'm not yet sure of the specifics. Hopefully they will come up with an entirely oral regimen that keeps Dad's pressure well controlled. At this time he remains intubated and sedated, and will likely be so for a few more days while they wean him off the ventilator. I for one am eager to have him breathing independently, and unsedated so that we can talk to him once more.

Update 11:59pm: It's clear that Abbey really misses her Dad. She keeps barking all day and insisting on going outside the bedroom at night, presumably to look for Dad. I really hope there's some way we can bring her to visit him in the nearish future (once he's out of the SICU and mobile in a wheelchair perhaps).

Also, success! I just hacked into my Dad's MedCo account and was able to get his current medication lists for the doctors. There has been much trouble getting the right lists to them for whatever reason, so this should be useful. I found that he was on one more anti-hypertensive than I thought; enalapril, an ACE inhibitor.