"8.30 am visit - Edi tried to tell me something and it frustrated him that his voice was too soft for me to catch his words. But the good thing is that he tried, stopped and tried again. This is exactly what the speech therapist wants him to do. Finally I worked out that he wanted a wet face washer to clean his eyes.
Last night (after my departure) and again this morning, his heart rate raced to 150 for about 5 mins. The doctors were consulted who decided to give him some magnesium drip. The heart fibrillation is apparently common in heart bypass surgery and is expected to be a temporary condition. With the high heart rate, his b/p fell and he felt dizzy. Due to this development, they aborted the idea of giving him a shower (how glorious the word "shower" sounded when the nurse first suggested it).
Edi wrote on a paper (Terry, I was reminded by your email about him wanting to write as he feels up to it; he doesn't have a steady hand yet, see scanned doc. Edi wrote it at 11'ish am on Fri, 27/11/09 - I'm going into such details as my updates will be a diary for him to read when he's ready). It took some questioning before I could decipher the last two words of the sentence, I want to drink milk. I explained that the speech therapist must give the OK first. I also thought with his diarrhea, milk might not be a good option even when he is allowed fluids. Then he said he wanted water. When Bernadette (speech therapist) arrived to assess him today, thickened orange juice was given to him which made him cough, suggesting that he wasn't swallowing properly. There was a small leak of the juice from the incision at his throat.
Edi kept asking for water but she said giving him anything thinner than the thick orange juice he's just had, is likely to get in the wrong way and end up in his lungs and introduce the risk of pneumonia. She returned with another two tubs of stuff. One was water pudding, just water that looked like glue and it was classified as Grade 3 - the thickest consistency, perhaps - to test on Edi's swallowing function. Thankfully, it went in OK, he neither spluttered or cough. You can imagine if Edi didn't clear this hurdle, how devastating it would be for him after such a promising start to the morning. Bernadette also placed her fingers on his throat and asked him to get ready for a hard, decisive swallow of the water pudding. Then to say "ah" for her. The voice was weak. She has recommended up to 5 times daily intake of Grade 3 fluids for the weekend with the hope of moving him onto purees early next week. She says to have the thickened fluids when seated up, swallow some, rest the muscles and have some more - act of swallowing strengthens the muscles concerned.
For the weekend, he will have fruche vanilla, thickened apple juice and plain yoghurt. He was asleep when the dietitian checked what he might like, I hope he likes my choices. Bernadette is unsure why Edi is not talking in the way she wants: might be the voice box has been damaged or his vocal cord muscles are so weak that they must be re-conditioned to function properly.
Bossy Sandi , the psysiotherapist had Edi walk a few steps before again being seated on a chair. He soon wanted to get back to bed as he felt weak and tired. Sandi explained to him that he would recover quicker off bed than in it. Anyway, soon after it was back to the use of the walker again before returning to bed where he promptly dozed off. He was exhausted.
Later in the morning, when the nurse had him on the nebulizer (cold sprays of liquid mixed with medicine inhaled into the lungs to break up sputum and to help cough it out easily) he tried to take it off after a bit. He is at the end of his tether - pulling out feeding tube, now this, not taking deep breaths during the nebulizer exercise despite the nurse asking him to do so again and again and being angry with Bernadette for not giving him water (but I suspect at times that he's more discouraged than rebellious).
As of yesterday, I started playing some music from his mobile phone and he didn't seem to mind. The next thing is to get him to switch on the telly, even if it's just to glance at it cursorily for starters."
This is what Edi wrote on that paper:-
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