Thursday, September 12, 2013

Chest Tube Pain

Last night a bed became available in the cardio-thoracic step down unit (CTSU), so we moved to room 308. This is the last stop before home, so that's wonderful news! The nurses in this unit have been timely in giving Danny his medicine, which is another thing to be thankful for.

This morning when the occupational therapist (OT) came to work with Danny is when things got hairy...

Quick lesson on chest tubes:

Danny currently has three holes in his abdomen. From his perspective, the driveline (the cord that connects the LVAD to the external power source) comes out more toward the right side of his abdomen. Danny also has had two chest tubes since the surgery. These tubes (similar to 3/4 inch clear rubber tubing) come out through his abdomen on each side and a little lower than his belly button. Internally, the chest tubes go somewhere in an area around the heart where the LVAD and its two artery connectors are attached. The internal ends of the chest tubes are similar to soaker hoses in that they have a bunch of little holes through which the excess bloody fluid can drain. The surgeon has a fancy little trick he does where the two tubes come out of Danny's abdomen. He uses the "string" that he makes stitches with and ties (sort of) a slip knot in the skin at the opening. He also uses a little stitch to hold the tube in place. When its time to pull out the chest tube, one doctor pulls the tube while the other quickly pulls the slip knot shut and makes a knot. It's pretty quick and simple. The first tube was removed last night in the ICU with no problem.

This morning's unfortunate experience:

The OT wanted to watch Danny stand up and stay standing by himself for two minutes. She is in charge of making sure all of his IV lines and other tubes are free and Danny is in charge of holding his bag with his controller and batteries. When the OT said it was OK to stand up, Danny did but his chest tube got stuck under the chair and pulled on where it comes out of his abdomen. It really hurt and he sat right back down.  The OT called the nurse, who checked out the bandages. She didn't see blood draining through the bandage so assumed it was OK. The OT had him continue his exercises and then finally left him alone. When lunch came, I helped him put down the foot rest to his chair, which moved the chest tube ever so slightly. This time it did start bleeding and so the nurse did a dressing change. We are praying that the doctor will see fit to remove the second tube today so there isn't a risk of it getting snagged again. The surgeon will remove it when it isn't draining anymore, so the specific prayer should be that it stops draining immediately!!

As a result of the chest tube incidents, Danny is scared to even move. He is tired and nauseated from the pain and just wants to be able to sleep...without nightmares or pain.

Lord, give Danny rest. Take away his pain or make it manageable. "For you did not give us a spirit of fear, but of power, love, and a sound mind". Pour your Spirit into him right now and comfort him. Strengthen him and make that verse a reality in his life right now. May your spirit of power, love, and a sound mind smush out his fear. Help him to keep his eyes and mind focused on you while you carry him through this LVAD journey. Let this be a season in his life where your presence each second is so prevalent that all he can possibly feel is joy and praise about your love for him and your faithfulness. We know that you never leave us alone, but even so, sometimes we feel alone. I pray that each and every second he feels your arms around him and feels safe and unafraid.  Please also help me help and support Danny. Show me what he needs from me and how I can help him. Use this whole thing to teach the kids about who you are--you are loving, and merciful. Gentle and kind. Patient and forgiving. You are good and trustworthy. You are faithful to your word. Help them know these things for themselves rather than just because they believe what Danny and I say. 

Lots to be thankful for and lots to keep praying about!!

I have learned how to do sterile dressing changes and it's fun!! You can see the white driveline coming out from his abdomen on the left side of the picture. That's the part that has to be a sterile dressing because that driveline connects to his heart and infection could/would kill him. The dressing on the right side of the picture is covering the chest tubes, which will be gone soon we hope!


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