Day 3: I got to visit today, and though she is tired and medicated, what a difference! In the years that I have taken care of this girl, I have gotten used to a basically pale and greyish complexion except when she wears makeup on nights when we go out to eat something. Tonight, her colour has changed radically. Cheeks are pink, colour in the lips, overall a flush of health on her. She talks in full sentences without struggling to get air. Saturations 100% on room air with a slow and regular heart and respiratory rate. I do not recognize her at all.
There is still drama to be endured. Her kidneys are not working yet, and it meant that her doses of Dilaudid built up and built up until she dropped off the face of the earth and it all had to be counteracted with Narcan to rouse her. Blood pressure dropped dangerously low during her over-sedation, but has now come back up to normal numbers. The kidneys still need a jump start, but this is something that happens post-transplant, and most often reverses. I heard that the docs aren't even worried about it unless it goes longer than 12 weeks. In the mean time, dialysis to clean out the blood stream. Lots of prednisone. Careful pain control so there are no more narc episodes making her unconscious. Lots of anti-rejection drugs and immunosuppressants, then more tests daily to monitor their levels. Exceedingly complex.
When I left to come home, she was sitting up in a chair, eating real food, still with sats of 100%. And as I drove, I realized that I am now out of a job, and to be replaced by physiotherapists and lab techs. Her air exchange is better than mine. No need for nebs, no more calls in the middle of the night when she needs cpt to clear airways. Wow. I didn't expect to feel so, well, redundant and unneeded. Honestly, in the Respiratory profession we do not have patients just recover and no longer need us. Usually with COPD, asthma, CF, we are locked in a relationship dance for life. It is very strange to see someone progress into another phase of her life and fly free like a baby bird out of a nest. I couldn't be happier for her.
