Hi, it’s Patrik Hutzel from INTENSIVECAREHOTLINE.COM where we instantly improve the lives for Families of critically ill Patients in Intensive Care, so that you can make informed decisions, have PEACE OF MIND, real power, real control and so that you can influence decision making fast, even if you’re not a doctor or a nurse in Intensive Care!
This is another episode of “YOUR QUESTIONS ANSWERED“ and in last week’s episode I answered another question in this series of questions from my client Melissa and the question last week was PART 6 of
You can check out last week’s episode by clicking on the link here.
In this week’s episode of “YOUR QUESTIONS ANSWERED“, I want to answer another question from one of my clients Steve, which are excerpts from phone and email counselling and consulting sessions with me and the question this week is
My 73 year old Mom had a stroke and is intubated in Intensive Care. She can’t come off the ventilator and the breathing tube, can she have a tracheostomy and go home and have INTENSIVE CARE AT HOME? (PART 1)
my otherwise very healthy 73 year old mother had a stroke around 2 weeks ago. She is still in ICU as she needs ventilator with pressure support and the breathing tube to help her breath. The doctors haven’t given her much hope unless her breathing on her own improves. I am wondering if your service INTENSIVE CARE AT HOME can be an option for her?
Just some more details and to shed more light on her current situation. Her CO2(=Carbondioxide) levels were getting high when her pressure support was down to 7 so they’ve put it back up to 8. CO2(=Carbondioxide) levels at the moment are fluctuating between 57-67 mmHg.
She’s responding and she has made it very clear that she wants to fight and that she wants to live!
Also, her blood pressure was a little high getting into the 170s.
I was hoping to get the ICU to do a tracheostomy and then get her home with your INTENSIVE CARE AT HOME service if she can’t get off the ventilator soon.
The doctors in the ICU were quite adamant that tracheostomy isn’t an option for her since the amount she is breathing at the moment isn’t enough to sustain life and they seem to have the opinion that most of the swelling in the brain would’ve gone down by now. Anyway, I was adamant with them about giving her time and they agree with that and are relaying my thoughts to the main ICU consultant on duty this week.
My mother had another CT scan today after she had two CT scans of her brain over the last two weeks since she first went into Intensive Care and the doctors are pretty much saying that it shows the swelling has gone down and so she may never improve.
They’re saying her breathing levels, the amount she’s taking in, isn’t high enough to sustain life. I.e. she’s taking in 200 mls and she needs to be at 400 mls per breath she’s taking. Also they’re saying no nursing home will take someone with a ventilator and I raised tracheostomy and ventilation at home as an option and they said it be highly involved with 24 hour care needed pretty much.
I have also attached a picture of the ventilator so you can see her current settings and levels.
Can you please let me know what our options are?
Thank you for your question and thank you for using my 1:1 phone and email counselling and consulting service.
I can definitely help you with INTENSIVE CARE AT HOME should your mother have a tracheostomy down the line and can’t come off the ventilator. Even if your mother needs ventilation with a mask(BIPAP mask/NIV) down the line in a home care environment I can help you.
We can provide up to 24/7 Intensive Home Care nursing once your mother is medically stable and off inotropes/vasopressors. It doesn’t sound to me like she’s on inotropes/vasopressors, therefore once your mother has a tracheostomy she should be able to go back home with our service INTENSIVE CARE AT HOME.
It’s good to hear that you are standing your ground and it’s good to hear that you are asking all the right questions and that you’re asking for what you want. Most families in Intensive Care are too timid to do that, they are scared and intimidated by the Intensive Care team’s “perceived power” and “perceived authority”.
99% of families in Intensive Care are too timid to ask for what they want and they therefore make no informed decisions, have no peace of mind, no control, no power and no influence!
The good news is that even if your mother can’t breathe by herself without the breathing tube she can have a tracheostomy.
Given that she has now been ventilated for over two weeks it’s time to do a tracheostomy.
Here is more evidence around this and when and why a tracheostomy should be done.
Not doing a tracheostomy after about two weeks is negligent as far as I’m concerned, especially since your mother is awake, can follow commands and is able to communicate what she wants when asked.
As you would have seen by now, a breathing tube whilst being awake is very uncomfortable and it isn’t really best practice as you can see in the articles and videos that I linked towards.
Once she has a tracheostomy and she’s medically stable we can take her home with INTENSIVE CARE AT HOME. This creates a “win-win” situation because we can give you, your family and your mother what you want and we can reduce the cost of an Intensive Care bed by around 50%.
We therefore also help the Intensive Care Unit to save 50% of the cost and free up one of their precious, expensive and “in-demand” Intensive Care beds.
Also, if her tidal volumes are around 200 mls instead of 400 mls of course her CO2(=Carbondioxide) levels are high.
Increasing pressure support(PS) might help and if it doesn’t help, they will have to put her back into a different ventilation mode such as SIMV where she gets more help and assistance from the ventilator.
You see from my perspective, not giving your mother the option to have a tracheostomy will potentially kill your mother and that to me is negligent especially since you, your family as well as your mother have made your wishes clear!
Furthermore, as you may well know, many Patients can live at home with a ventilator and tracheostomy with our service INTENSIVE CARE AT HOME, therefore why deny this service to your mother?
The Intensive Care team is correct to say that no nursing home will take her and why would you or your mother chose to go to a nursing home anyway if Intensive Home Care is a viable option.
Furthermore, you are dealing with an overtly negative Intensive Care team and they seem to only want to point out the negatives and not look further ahead, which is a shame really.
The good news is that you and your family are positive and staying focused and staying positive helps tremendously in a situation like this!
- 5 POWERFUL THINGS YOU NEED TO DO IF THE INTENSIVE CARE TEAM IS NEGATIVE WHEN YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!
You see, the Intensive Care team is trying to tell you that brain swelling has gone down and that your mother may never improve.
This is complete and utter BS, because two weeks is not long enough to determine whether your mother will improve or not and all the Intensive Care team is doing is they are not wanting to treat your mother to the best of their abilities.
The reality is that everything they are saying is really dependent on their financial goals of the unit as well as the bed management goals of their Intensive Care unit.
The fact of the matter is that everythuing they are telling you is a result of what’s happening “BEHIND THE SCENES” in Intensive Care and is a result of the “hidden agenda” of the intensive care team.
- THE 10 THINGS YOU DIDN’T KNOW ARE HAPPENINGBEHIND THE SCENES IN INTENSIVE CARE THAT HOLD YOU BACK FROM HAVING PEACE OF MIND, CONTROL, POWER AND INFLUENCE, WHILST YOUR LOVED ONE IS CRITICALLY ILL IN INTENSIVE CARE!
- INTENSIVE CARE’S HIDDEN SECRETS AND MYTHS BEHIND THE SCENES, THAT THE INTENSIVE CARE TEAM KEEPS AWAY FROM YOU AT ANY COST AND OTHER FAMILIES OF CRITICALLY ILL PATIENTS HAVE NO CLUE ABOUT THOSE HIDDEN SECRETS!
If they had your mother’s best interest at heart, they would do a tracheostomy because a tracheostomy would make her more comfortable and it would give her time to recover in her own time.
Instead, they are telling you “your mother won’t improve” without looking t what your mother’s life may look like in two months, 6 months or 2 years time.
Of course, there are no guarantees, but throwing in the towel now doesn’t sound right to me and once again not offering a tracheostomy because they think “she’s not getting better” is simply negligent to me.
Your mother is just at the start of what may potentially be a long recovery. There are no guarantees of course, but they need to try and they haven’t really tried yet.
Taking practical steps forward, have a look if they are really following best practice to try and wean your mother off the ventilator and the breathing tube in the first place by reading/watching some guidelines here
If they are following those best practice guidelines and she can’t be weaned, then you can refer back to the articles and videos that I linked to before when to do a tracheostomy.
Also, get an opinion from the neurologist and find out what they think.
You are doing pretty well, positioning your mother’s diagnosis, prognosis as well as her care and her treatment and I can see you are not scared, timid or intimidated which will help you, therefore well done!
Maybe we can have another quick chat tomorrow afternoon and see what’s been happening then.
How can you become the best advocate for your critically ill loved one, make informed decisions, get peace of mind, control, power and influence quickly, whilst your loved one is critically ill in Intensive Care?
You get to that all important feeling of making informed decisions, get PEACE OF MIND, CONTROL, POWER AND INFLUENCE when you download your FREE “INSTANT IMPACT” report NOW by entering your email below!
In Your FREE “INSTANT IMPACT” report you’ll learn quickly how to make informed decisions, get PEACE OF MIND, real power and real control and how you can influence decision making fast, whilst your loved one is critically ill in Intensive Care! Your FREE “INSTANT IMPACT” Report gives you in-depth insight that you must know whilst your loved one is critically ill or is even dying in Intensive Care!
Sign up and download your FREE “INSTANT IMPACT” REPORT now by entering your email below! In your FREE “INSTANT IMPACT” REPORT you’ll learn how to speak the “secret” Intensive Care language so that the doctors and the nurses know straight away that you are an insider and that you know and understand what’s really happening in Intensive Care! In your FREE report you’ll also discover
- How to ask the doctors and the nurses the right questions
- Discover the many competing interests in Intensive Care and how your critically ill loved one’s treatment may depend on those competing interests
- How to eliminate fear, frustration, stress, struggle and vulnerability even if your loved one is dying
- 5 mind blowing tips& strategies helping you to get on the right path to making informed decisions, get PEACE OF MIND, control, power and influence in your situation
- You’ll get real world examples that you can easily adapt to your and your critically ill loved one’s situation
- How to stop being intimidated by the Intensive Care team and how you will be seen as equals
- You’ll get crucial ‘behind the scenes’ insight so that you know and understand what is really happening in Intensive Care
- How you need to manage doctors and nurses in Intensive Care (it’s not what you think)
Thank you for tuning into this week’s YOUR QUESTIONS ANSWERED episode and I’ll see you again in another update next week!
Or you can call us! Find phone numbers on our contact tab.
Also check out our Ebook section where you get more Ebooks, Videos and Audio recordings and where you can also get 1:1 counselling/consulting with me via Skype, over the phone or via email by clicking on the products tab!
This is Patrik Hutzel from INTENSIVECAREHOTLINE.COM and I’ll see you again next week with another update!
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