Tuesday, March 30, 2010

Monday

When we arrived this morning (after 9), the physical therapist was just finishing with Dad. He wasn't responding very much. They said they would be back later. Dad actually started to wake more a bit later, so we were very relieved. He was able to eat some oatmeal and drink some juice. He responded with nods or yes when asked if hungry, and started opening his eyes much more. Both Dr. Park (ortho surgeon) and Dr. Lai came by. Dr. Park said that his leg was fine to stand on and from that point of view he was ready to leave the hospital for intensive therapy. Dr. Lai told us his blood count was still a little low. During his exam, Dad cried out when the doctor was palpating his stomach area. Not sure what the reason for that was. Dr. Lai came by after we had seen Dad waking, so he said he would come back later and maybe he would be able to be released to the transition care unit (therapy). PT returned around 11:30, and saw that Dad was now more alert. They began with leg exercise and noted that he was resisting (flexing muscles) and responding to commands to move sometimes. Unfortunately, not having had any pain meds for over 24 hours, when they moved him to the side of the bed to sit up, he cried out quite a bit. He remained sitting for a while, but he was looking down and it was difficult to get him to hold his head straight. After they finished, we asked the nurse to get him some pain meds. we decided on vicodin instead of morphine and gave it to him crushed in applesauce. He finished the applesauce, but after that became quite sleepy. Barb and I left to have lunch, and when we returned he was quite sleepy still. We could get him to rouse a bit, but not really eat or drink much. Clearly the drugs were making him sleepy, plus perhaps the effort of sitting up. Barb had to return home for Dylan, but I stayed through the afternoon until after dinner. He was mainly sleepy all day. He would occasionally rouse (I would talk to him and gently shake him every 15min or so). By 5 he was a bit more awake and I fed him some more applesauce which he took well. At dinner, he ate several bites of pulled pork, some cheddar potato soup, and mashed potatoes. We discussed with the nurse to admnister tylenol for pain instead of vicodin if he requires it, and we will ask that he get some before the next PT. We are hoping he can move to the transition care unit tomorrow.

2 comments:

suzie said...

I am not sure why Grandpa cried out when his abdomen was palpated, but all of the opiate pain medicines slow down digestion and can cause constipation problems, and of course not walking or moving as much because of the surgery and pain will also decrease GI motility...has he been having regular bms since he fell? I know that is probably not the main concern, but I know it can cause a lot of problems.

Justine said...

The doctor did say this could be related but that the bowels were soft not hard so he was not overly concerned. Dad was given a suppository on Tuesday, which did prompt a BM later that day (it was soft), and he also had another on Wednesday, so things seem to be okay in that area. I agree that while this is not always the primary concern, it gives patients a lot of discomfort. My mom had a lot of difficulty with it.