FEES to Eat

Amanda slept the best last night, not sure if she got a full night’s sleep, but the nurse said she got 3-4 hours of solid sleep without waking. After I got back from getting coffee, the nurse was donning glown and gloves to go in. She’s a 100 percenter and found an old contact order from before that they discontinued. It had something to do with the pneumonia, but it wasn’t antibiotic-resistant, so there wasn’t an issue. I tried to explain, but she still had everybody putting on gowns. The nurse from yesterday even told her the issue was resolved, but it didn’t matter. I haven’t put on a gown or anything after being in this room so much. If I were going to get it, I’d already have it! 

The FEES (Flexible Endoscopic Evaluation of Swallowing) was fairly early in the morning. That was what Amanda was waiting for; she wanted her refresher! She’d had a swallow test before, but not a FEES before. They use a small wand camera to insert into the nostril, allowing them to view down the throat and ensure nothing enters the airway, which could cause aspiration and complicate the situation further. She tried ice, water, juice, apple sauce, and a graham cracker. Everything was dyed blue except the graham cracker. She passed, but the tech had to review the video in slow mode to make sure before she gave the team her official all clear.

Amanda had been peeing in her own and her blood pressure was low. They took these as signs that her kidneys were improving. The low BP was when they were pulling on fluid hard, so they think she’s getting dry. The nephrologist was happy to see that Amanda had ankles again! All of this led them to stop the CRRT today. This is not to say they won’t start it or another type of dialysis, but the need for constant dialysis is done for now. 

As Amanda was up and down a few times, her blood pressure was getting pretty low. I had to increase the IV medication that helps her maintain her BP. I think it was because at the time, the CRRT was still running. Since they stopped the dialysis, she hasn’t had any BP issues. They did start a BP med just in case, but it was one Amanda had previously had a reaction to. She told the NP about it, but they still wanted her to take it. Hoping it doesn’t cause any issues like last time.

Her oxygen has been fluctuating a little, too. Her lips were a bit blue today after getting up and down. She’s been pretty nauseous; she thinks it’s the NG tube. It’s been at the top of her list to get that thing out. They won’t even consider it until she’s eating a decent amount. The problem is that they are tube feeding her, and that makes her nauseous. We finally got the call clear on the FEES test, and I was off to grab a refresher. They had been out of the one she liked in the cafeteria, but there was one more I knew of in the hospital. So, I went to give it a try, and I was in luck and saved a walk to the real deal. After drinking, she was coughing up some junk. I think the tube was just really bothering her after she started drinking,

Nutrition came by to talk with us. It was the same nutritionist that we saw for evaluation. She remembered that we were plant based and offered some shakes. After all our issues with ordering plant-based off the menu, I expressed our frustrations that they have items but no menu. I’m not sure how they expected us to order food without knowing. She already knew the issues and was going to work on things. I ended up ordering some pho for lunch from Uber Eats. Amanda ate some broth and noodles. She’d already had her refresher, some water, and a ginger ale. The nurse came back wanting to put Amanda on the tube feed. She was frustrated, and so was I. The nurse said they were worried about her not eating enough. I told the nurse how they expect her to eat when the tube feed makes her nauseous. Common sense says that’s a bad idea and sets her up for failure. The NP just came by and I told her just that. They had already talked about doing the feeding tube at night only until she could eat a substantial amount. She was going to speak with he team and see what they thought.

They were teeing her up for a walk with all the equipment, then her blood sugar went in the tank. She started to feel bad and got sweaty. I gave her some of the sweet tea that was on her tray. Then got her some candy out of the vending machine. The nurse also gave her some IV meds to help level off as well. That all knocked the walk out and had her feeling pretty bad. There has been a fluctuation in her blood sugar levels; they take her off the insulin then issues, put her back, issues again. It’s just this on-and-off cycle.

The dinner tray was one of the better plant based hospital meals here, so she ate a little bit. Later on, I ordered some dinner, and she wanted mashed potatoes. I got some along with eggplant parm with fettuccine; I figured she might eat a little of that. She thought the potatoes were spicy. They weren’t; she has weird taste sometimes after surgery. She did eat some of the fettuccine and bread, though. She fell into a deep food coma afterward; I mean, she was out cold! She had been awake all day, and I guess it caught up to her. We’re still off the feeding tube, so far. I guess my baulking held them off.

At nine, the nurse woke her up from her deep sleep to give her night meds. I told her she would really have to shake her to get her up. I’d tried earlier to keep her up, but she had dug in deep. There were a ton of pills in the night meds. It took Amanda a while to get them down. There was a lot of stalling on Amanda’s part and a lot of encouragement that turned to nagging on my part.