So they want to put my dad on a vent. Just maintaining his oxygen with Bpap.
On all the meds they normally give. Remdemsivir etc.
Is vent the only real option? Is it better to take a chance on staying with the bpap?
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So they want to put my dad on a vent. Just maintaining his oxygen with Bpap.
On all the meds they normally give. Remdemsivir etc.
Is vent the only real option? Is it better to take a chance on staying with the bpap?
Very sorry to hear that. Hope and pray he does well.
I need to preface the next bit by stating that I haven't been doing critical care for the past 10 years, and have not been involved with the acute emergent care of covid at all, my focus is outpatient medicine.
Very difficult to answer your question without knowing the exact specifics of the situation. In general critical care physicians use BiPAP as a bridge to maintain someone on their own while you're waiting for something to work. That something can be antibiotics, steroids, Lasix, Etc. Hopefully they will work rather quickly.
If they're not working quickly in the person is just sitting there not improving on BiPAP, then you're faced with a difficult decision of either continuing with it for longer and seeing how things go or going ahead and placing them on a ventilator.
Remaining on BiPAP has certain issues. Patients typically can't eat or drink while on it. They may be tiring out the respiratory muscles. You can run into issues with too much pressure on the skin where the mask is.
And furthermore, most of all, if you wait until they completely tire out before putting them on the ventilator you've now created an emergent situation. And there is a much higher chance of having complications.
If you can put them on a ventilator in a more controlled, calm, elective situation, things tend to go better.
Well I definitely can't like this post Newbie, but I will say a prayer for your father's recovery and well being.
The information you got from CCMFD is what I would say as well. Too much time on the BiPap can cause it's own set of problems.
You'll be in my thoughts man. Hang in there.
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Thanks guys. We may have strong differences but I know we still support each other in tough times.
I just wanted to double check that I wasn’t missing anything. I trust the medical staff here but you know how it goes, you have to ask.
I actually feel bad for the overworked staff who have to enforce insane visitation rules that that likely do not agree with but get the brunt of the misdirected anger from families.
I’ll update everyone, and again thanks.
Hoping for the best, Newb.
So they want to try a heated bpap first. He is lucid.
If he wasn’t coughing so much I don’t think he would feel so bad.
@Newbie I’ll be thinking of your Pops and family.
Our own Sensei, who has been doing critical care for covid patients, also covered your earlier question in this post about the dangers of keeping people off of ventilators for too long.
https://pistol-forum.com/showthread....=1#post1313074
Thanks again.
They said his Bpap settings are normal except for oxygen at 100. They are trying the heated Bpap first and then see what happens. They also mentioned ECMO.
He was doing ok with Covid but suddenly developed a cough and went down hill. He’s not getting a lot worse but he’s not getting better.
Appreciate the thoughts and prayers. I may disagree with some of the pre Covid ideas people have but I do trust the medical personnel once a person gets to the hospital. It’s part of the reason I’ll say thank you, even to a nurse that’s not part of my father’s care.
@TheNewbie I wish you and your dad the best of luck and grace with his treatment and recovery. I’m sorry you are dealing with this.
Thank you. My dad looks good, can talk some, but it’s simply an oxygen issue. I just at to seem intubated unless it’s the absolute best option. Still, if everyone is telling me the same thing, I tend to trust it.
My dad raised me to deal with tough stuff with a good attitude. He also raised me to question everything and seek know and truth. The questioning part has been a blessing and a curse, and an annoyance to many here and to my supervisors. lol
@ TheNewbie - You and your dad will be in my thoughts in the coming days.
I wish him strength and continued determination to deal with this.
So his BP is low so they can’t use lasixes . I wonder if I they lowered or removed the BP meds if that would allow the lasixes to be used.
I’m sure they are aware of this at the hospital and there is a good reason it isn’t happening, but again, I have to ask.
I would like for my wife to be able to see the lung x-rays but she told me that sometimes the X-rays don’t tell the full story of what is going on. Meaning the look can be deceiving.
If the cough and low oxygen levels are sudden, I wonder if they have not already considered checking his D-dimer levels or running a CTA and Echocardiogram (a heart ultrasound) to rule out a clot of some sort? If his pressure is lower it could be a result of heart strain brought on by a large PE.
They probably check those labs daily (at least we do) and if they're abnormally high our doctors may automatically begin a treatment dose of a blood thinner (so long as there isn't a contraindication) even before going to a scan like a CTA.
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His levels are mostly good. When he arrived they did a scan and no signs of clots. Not sure about the echo.
We will ask tonight.
It really just seems to by the oxygen. Besides the quality staff at the hospital, we have my wife, a NP pulmonologist friend, and you guys watching. I always try to be humble when I talk to the staff because they are the heavy lifters doing the work everyday.
I am hoping for a speedy recovery for your father @TheNewbie.
Talked to my supervisor. His dad was in almost the exact situation, though even worse initially. Dad came in with 105 fever and 38 oxygen. My dad had 80s oxygen and a lower fever.
Of course even the exact same situation can have a different outcome for two different people. Plus my dad is about 10 years older being 76.
Bpap-100% and then heated Bpap ..... 11 days in icu. Now he’s on regular oxygen.
My dads nurse just said his Oxygen goes from 92 down to the 80s and that they would exhaust all options before vent.
Thoughts and prayers for you and your fam. Let me know if there's anything I can do.
Newb,
Thoughts and prayers to your Dad and family...
Appreciate everyone’s help and support.
Things are about the same now. Breaths per minute around range from 14-25. Still on hi flow oxygen. He’s lucid but obviously feels horrible.
Extra Air space around his lungs, but no signs of clots or fluid. Normal white blood cell count. Heated breathing treatments every six hours.
Yes we may still differ on things, but everyone will support each other. Heavy, hope your mother is doing better.
My mother had it a couple of weeks ago, 70 years old, and she had not even what would be classified as a bad cold. She seems to be almost totally fine, other than her energy is a little lower (not much just a little) than before, and the cold air hurts her lungs a bit, though not severely.
My dad is having a hard time drinking or eating, so that’s an issue.
Best wishes to your father, Newbie.
He seems “slightly” better today.
They tried to sedate him but his heart rate got too low. Took him off of that and he’s better now. Heart rate- 75 Oxygen -94 (on 100% bi-pap) breaths per minute in the 20s
He finally ate a bit.
Extreme discomfort in nose from the forced air.
Nurse had a more slightly positive than negative outlook.
My dads case is eerily similar to my supervisors dad. But his dad is coming home tomorrow so I can only hope my dads goes the same.
ER doctor friend recommended pushing bi-pap as long as possible vs vent, but he also said when they get that bad he’s not the one treating them.
The support I’ve received both here and in person has been humbling.
I have a lot of thoughts about all this that I’ll write up when the outcome is known. We may still disagree on some things but I know we are working towards the same goal of wanting people to be well. Like I say, I have a lot of thoughts now, even more so than before.
One thing I’m impressed with is the level of patience and knowledge the nursing staff has.
I was over with my mom and he called. To say he was loopy is to understate it, but him talking for 30 seconds is a plus. He sounded better (not good but better) than anytime since Friday. The red heeler/collie/mutt mix seems to be curious where he’s at.
Breathing was not great but better and cough was much less.
My supervisor’s dad had the exact same thing. So if anyone else has family going through this, it might be “normal”. However the medical personnel here that see these people everyday would know better what normal looks like.
Really sorry to hear about your dad. Regrettably it is pretty normal for people who have had severe COVID-19 to take a very long time to recover. It sounds like your father's lungs have unfortunately been pretty significantly injured by the virus and his lung function is pretty significantly impaired at this time.
Likely a very long road ahead. From what you've written I would guess he will be in the hospital for a while longer, and likely need to be discharged to some sort of rehab facility afterwards to help him recover from having been so sick for so long. Just want to be open so these possibilities are on your radar.
Will keep him in my thoughts, let me know if I can be of any help
Stomach bugs are the most sick I’ve ever been.
My dad is being brought down on how much more oxygen he needs, at 80% now with heated hi flow and a rebreather for a break. He’s more alert, called my mom last night.
Vitals signs good, limbs are fine, organ function good.
He’s on diuretics to prevent fluid build up on lungs.
Doctor cautioned that things can change for the bad, but right now he seemed hopeful and said my dad is heading in the right direction.
Thanks for the support.
Good news, @TheNewbie!
Covid has got to be the strangest disease I’ve ever encountered. Here’s my families story:
Jan 1 wife tells me she suddenly cannot taste. Tests on Jan 3 and she’s positive for Covid. We’re both vaxxed. I never distance myself from her (probably stupid but by that point I was pretty sure if I was gonna get it from her I was gonna get it). She recovered her taste and smell in a week without issue. I never got sick and neither did our kid.
January 24 I went to work at 0530 feeling perfectly fine. By 11AM I was sent home due to fever and generally not feeling well. There was just no way I had Covid (note my wife tested positive 3 weeks before and I never had a single symptom. To make my employer happy I took a test on Jan 25. Took 3 days to get results and I came back positive. I had 3 days of fever plus two more days of the worst bout of sore throat I’ve ever had. Plenty of congestion in my sinuses and a cough too. This time the kiddo got sick too, similar symptoms to mine except no fever for her. Kid is all healed up now too.
I’m finally going back to work tomorrow. I’m all recovered except the cough which I’ve been told can linger for a bit. So two breakthrough infections in my home 3 weeks apart plus the kid who hasn’t been vaccinated yet due to age. I don’t know what to say at this point except I’m grateful it wasn’t any worse on us than it was. This is the third time I’ve noticed the kid follows me when it comes to getting sick. For some reason she tends to not get sick when her mom/my wife does, but let me fall I’ll and she’ll have near identical symptoms within 48 hours.
Newbie, glad your Dad is doing better. Haven't piled on with the commenting about it until now, but just wanted to say.
I'm stuck at home with it now. I think I've had it since last Thursday, similar to stated above. I had kinda mild fevers at night, mild enough that I didn't really think about them til later. I just kicked the blanket off and was fine. Then got a sore throat that, as above, was the worst one I've ever had. Impossible to ignore. On the 3rd day of that I went to the store and got a box of Allegra-D and the next day it was mostly better, then the day after that completely better. So I was like, OK, I had a cold. Then the next day at lunch I bit into a cheeseburger and couldn't taste it. Took a drink of Dr Pepper, yep, no taste. That was Monday. So today I forced myself to stay home all day and I am bored SILLY. I feel perfectly fine again, just a little stopped up in the sinuses but not bad. Coughed a teensy bit of stuff out of my lungs Saturday, but after that nothing and they feel empty now.
I haven't taken a test yet because I feel like it's a waste of time. I haven't had a fever since Saturday when I realized I needed to be checking myself, and my oxygen level stays at 96% on this doohickey that my parents gave me last Fall "just in case." I was vaccinated with Pfizer in August, no boosters and not really feeling an urge for them either.
My sore throat was the worst one I've had in a long time. Last Monday night, things kicked off with an irritating cough and sort of sore throat. Negative home test Tuesday morning. The cough mostly went away Tuesday with just an occasional hack, no production. Overnight Wednesday my throat hurt so bad it was hard to sleep and I decided I must have strep or something instead of covid. Tested positive at home Thursday morning. I think Tylenol helped the throat. My only fever was about 1 degree for a few hours Thursday evening.
Things got notably better by Friday morning. No more sore throat, minor congestion, generally feeling good all around. The cough moved from my throat into my chest and I have a little chest tightness but nothing special and I don't get winded doing easy indoor bike stuff so I expect that to resolve without drama.
My only plot complication is I home tested positive again on Monday evening, so a week after symptom onset and 3-1/2 days after first positive test. Other than that I'd meet the guidelines for ending isolation at the five day after onset mark. I'm laying low for a couple more days.
Mrs. DG has not gotten sick at all.
So my dad is a little weaker today and they had to increase his oxygen. He is still on heated hi flow and sometimes uses the non rebreather.
The nurse caring for him today was less optimistic and thinks things are degrading and mentioned the vent but the Intensivist seemed “more” optimistic today and basically says he should get better and didn’t see the vent in his future.
His oxygen would go down, even hitting the 60s at times, during hard coughing fits, but is otherwise doing well if he’s not coughing.
We’ve talked to him several times today, and while he has what sounds like a dry cough, he can talk for several minutes.
We were warned that set backs may happen but it’s still stressful to deal with. Hopefully it’s one step back and two step forward.
Just an update, and I’m open to any advice from the medical staff, or anyone else with a good idea.
Sorry to hear your dad is sick Newbie, hope he gets well soon!
40 hours in, side effects more or less consistent with the first three shots — some aches and tiredness, didn’t stop me from serving at mass, taking the boy on a train tour, or doing a two mile scout hike. If anything it’s milder. Haven’t grown a third tit, little disappointed.