I haven’t visited Athena since Monday when the speaking valve was installed and afterward a new trach installed due to a leak in her trach cuff that was discovered. Athena has been battling tremors and seizure like activity since she has been at Regional. The problem is once Athena starts the tremors, a fast heart and breathing rate follow. The care team has been trying to find a balance of hydromorphone and Haldol to control her vitals but it’s been a challenge.
When Athena was at Harborview in the early part of the H1N1 battle, she was on levels of morphine that were off the scale to keep her sedated (along with paralytics) so that the limited ability of her lungs at the time could keep her alive. The down side of this is Athena has a bad morphine addiction and it’s going to take moving slowly to wean her off of the levels her addiction says she needs. Tonight my theory may have been proven when no amount of Haldol would keep her heart rate and breathing rate at a safe level. Athena’s on-call doctor put her on a Fentanyl drip and Athena’s tremors stopped, heart rate returned to normal and she was calm while awake. Fentanyl is 100 times more potent then morphine and is used in pre-op or as a strong sedative at lesser dosing levels.
I think if you take the time and scroll back through the blog, I have mentioned Athena’s ICU induced addictions and it contributing to her unexplained neurological issues multiple times. I plan to visit in the morning and hope to find Athena in a more normal awake state. (no tremors, grimacing or eyes unable to remain center lined) Once Athena is off the vent and able to communicate, it will be much easier to work with her on multiple levels to reduce her dependencies.
