Hemorrhagic complications are recognized when anti-platelet agents are used during or after surgical procedures. We present a 69-year-old male patient who developed hemothorax after chest tube insertion for pneumothorax as a complication of clopidogrel and aspirin following ischemic heart disease. Hemothorax associated clopidogrel has rarely been reported and this is the first academic publication of this complication type following chest tube insertion shortly after the cessation of clopidogrel. Our case demonstrates the possibility of hemothorax when chest tube insertion is indicated under such conditions ...

Management of primary spontaneous pneumothorax (PSP) remains unclear. Primary therapeutic goals for PSP include removal of air from the pleural space an prevention of recurrences. The absence of generally accepted and methodologically sound recommendations may account for the extensive variation in practice for air evacuation techniques. Air evacuation may be achieved by simple aspiration (exsufflation) or conventional chest tube drainage. Chest tube thoracotomy remains the most popular technique.Aspiration is a more simple technique, that allows possibility of ambulatory management. The purpose of the present study is to compare simple aspiration performed with a specific thoracentesis device, versus conventional chest tube drainage. Comparison will be performed on immediate efficacity of resolution of the pneumothorax.The hypothesis is that simple aspiration performed with a specific device is not inferior to chest tube drainage for management of a first episode of large size primary ...

BACKGROUND: Chest tube removal is an extremely painful procedure and patients may not respond well to palliative therapies. This study aimed to examine the effect of cold and music therapy individually, as well as a combination of these interventions on reducing pain following chest tube removal. METHODS: A factorial randomized-controlled clinical trial was performed on 180 patients who underwent cardiac surgery. Patients were randomized into four groups of 45. Group A used ice packs for 20 minutes prior to chest tube removal. Group B was assigned to listen to music for a total length of 30 minutes which started 15 minutes prior to chest tube removal. Group C received a combination of both interventions; and Group D received no interventions. Pain intensity was measured in each group every 15 minutes for a total of 3 readings. Analysis of variance, Tukey and Bonferroni post hoc tests, as well as repeated measures ANOVA were employed for data analysis. RESULTS: Cold therapy and combined method

A chest drainage system is typically used to collect chest drainage (air, blood, effusions). Most commonly, drainage systems use three chambers which are based on the three-bottle system. The first chamber allows fluid that is drained from the chest to be collected. The second chamber functions as a water seal, which acts as a one way valve allowing gas to escape, but not reenter the chest. Air bubbling through the water seal chamber is usual when the patient coughs or exhales but may indicate, if continual, a pleural or system leak that should be evaluated critically. It can also indicate a leak of air from the lung. The third chamber is the suction control chamber. The height of the water in this chamber regulates the negative pressure applied to the system. A gentle bubbling through the water column minimizes evaporation of the fluid and indicates that the suction is being regulated to the height of the water column. In this way, increased wall suction does not increase the negative ...

BACKGROUND: A study was undertaken to compare the efficacy of short term tube thoracostomy drainage with standard tube thoracostomy drainage before instillation of tetracycline for sclerotherapy of malignant pleural effusions.. METHODS: The study consisted of a randomised clinical trial in a sequential sample of 25 patients with malignant pleural effusions documented cytopathologically. Fifteen patients were randomly assigned to group 1 (standard protocol) and 10 to group 2 (short term protocol). Patients in group 1 had tube thoracostomy suction drainage until radiological evidence of lung re-expansion was obtained and the amount of fluid drained was , 150 ml/day, before tetracycline (1.5 g) was instilled. The chest tube was removed when the amount of fluid drained after instillation was , 150 ml/day. Patients in group 2 also had suction drainage, but the tetracycline (1.5 g) was instilled when the chest radiograph showed the lung to be re-expanded and the effusion drained, which was usually ...

Life/form Replacement Subcutaneous Surgical Skin Pads for the Chest Tube Manikin-Life/form® Replacement Subcutaneous Surgical Skin Pads. For use with the Life/form® Chest Tube Manikin (LF03770U) and Life/form® Pericardiocentesis Simulato

The patient was transferred to intermediate care unit and positive pressure was stopped. One hour after, he underwent in to acute respiratory failure, requiring orotracheal intubation, invasive mechanical ventilation and admission into intensive care unit. He stayed on mechanical invasive ventilation for 6 days. At the 7th day of intensive care unit stay, there was a complete resolution of RPE, but a persistent air leak was noted, so the patient was submitted to surgical pleurodesis (pleural abrasion) via video-assisted-thoracoscopy. He was discharged 10 days later, asymptomatic and with a normal chest X-ray.. The diagnosis of RPE is made by a combination of clinic and imaging findings. Most common symptoms include productive cough, tachycardia, hypotension, cyanosis, fever and chest pain. The severity of the symptoms is variable, from mild (documented only by imaging), to acute respiratory distress syndrome. The most common finding in chest X-rays is an alveolar filling pattern, usually ...

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Centers RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.. ...

AIRWAY (12) ALGORITHMS (201) Antimicrobials (2) ARDS (5) Asthma (1) Brain injury (6) CARDIAC (32) CNS (42) COVID19 (6) CVC (1) Death (1) DETERIORATING PATIENT (16) ELECTROLYTES (4) End of Life (3) ENDOCRINE (8) EVIDENCE BASED PRACTISE (1) FEVER (3) FLUID AND ELECTROLYTE (6) Fungal infections (3) GASTROENTEROLOGY (22) Haematology (7) Head Injury (3) HEPARIN (1) HEPATIC (3) HEPATIC FAILURE (6) HME (2) ICD (4) IHD (7) INFECTION (5) Insulin (4) labour epidural (1) LBBB (2) METABOLIC (1) MH (1) MI (10) nausea vomiting (1) Neurology (7) NEWSMAKERS (1) NIV (3) Nosocomial pneumonia (3) NUTRITION (2) Obstetrics and Gynaecology (5) Organ Donation (1) Pacemaker (1) Paediatrics (3) pancreatitis (10) PE (5) Percutaneous tracheostomy Video (1) perioperative (3) Physiology (6) PNEUMONIA (3) POST-OPERATIVE (1) Procedure (4) Procedure Video (6) pulmonary hypertension (1) RADIOLOGY (8) Recovery (1) Regional (1) REGIONAL ANAESTHESIA RESOURCES (5) Renal (22) RESPIRATORY (18) Resuscitation (5) RRT (5) Safety (1) ...

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Pleural effusion, which in pediatric patients most commonly results from an infection, is an abnormal collection of fluid in the pleural space. Pleural effusion develops because of excessive filtration or defective absorption of accumulated fluid.

METHODS: After obtaining institutional review board approval, a single institution retrospective chart review of patients undergoing central venous catheter placement by the pediatric surgery or interventional radiology service between January 2010 and July 2014 was performed. Outcome measures included CXR within 24h of catheter placement, reason for chest radiograph, complication, and complication requiring intervention.. RESULTS: In the study population 622 catheters were placed under fluoroscopy. A chest radiograph was performed in 118 (19%) patients within 24h of the line placement with 25 (4%) of these patients being symptomatic in the recovery room. One patient required chest tube for shortness of breath and pleural effusion. Four symptomatic patients (0.6%) were found to have a pneumothorax, none of which required chest tube placement. There were no re-operations because of mal-position of the catheter. In the 504 patients with no postoperative chest x-ray, there were no adverse outcomes. ...

a dart is simply a needle with a cath tip. you put the needle between the ribs, being careful to enter the pleural space just above a rib, and take the needle out leaving the catheter in place. a temporizing measure while you get set up for the chest tube. a chest tube is a bit smaller in diameter than a garden hose and has to be placed in the same manner as the dart but aimed toward the head and apex of the lung. it then has to be sewed in place and connected to water suction apparatus that will provide continuous mild negative pressure to the pleural cavity. chest tubes, im told, hurt a wee bit and i use lots of lidocaine and generous ammounts of drugs when able. sometimes you just have to do it immediately as in the case of a tension pneumothorax. this case was a bit weird in that, as you can see, there is some debate as to whether his collapsed lung was under increasing internal pneumatic pressure (tension) or not (spontaneous pneumothorax without tension). bottomw line, he needed a chest ...

a dart is simply a needle with a cath tip. you put the needle between the ribs, being careful to enter the pleural space just above a rib, and take the needle out leaving the catheter in place. a temporizing measure while you get set up for the chest tube. a chest tube is a bit smaller in diameter than a garden hose and has to be placed in the same manner as the dart but aimed toward the head and apex of the lung. it then has to be sewed in place and connected to water suction apparatus that will provide continuous mild negative pressure to the pleural cavity. chest tubes, im told, hurt a wee bit and i use lots of lidocaine and generous ammounts of drugs when able. sometimes you just have to do it immediately as in the case of a tension pneumothorax. this case was a bit weird in that, as you can see, there is some debate as to whether his collapsed lung was under increasing internal pneumatic pressure (tension) or not (spontaneous pneumothorax without tension). bottomw line, he needed a chest ...

They also said that she has subcutaneous emphysema which is when some of the air leaks out of the chest tube and gets stuck between the muscles. For her it is in between the muscles behind her shoulder and in her left side under her arm. This too is really painful and can move around a bit from the incision/lung site so this could explain a lot of what Tam is experiencing in her chest as well. In addition we were told that they saw some apical scaring on the lung and that there was still a small pneumothorax present after the chest tube was removed in addition to a UTI because of being repeatedly straight-cathed last week after the surgery. They are hoping that the small pneumothorax and the subcutaneous emphysema heals on its own in time and she is receiving high strength IV meds for the UTI. We are being told that some of this is common (finally) and can be happen with chest tubes, so they are hoping it resolves itself. We just really need to get the inflammation and the painful subcutaneous ...

The practice of neck drain insertions in patients undergoing thyroidectomies is associated with higher risks of hematomas and surgical site infections, and longer hospital stays.

After surgery you will have a chest tube placed. It will stay in for several days to a week, depending on your healing process. To ensure we placed your tube in the most optimal location for your lung, we will give you x-rays and an examination. You will need to stay in the hospital while the chest tube is in place. After removal of you chest tube and before you go home, your doctor will confirm that your lung has not re-collapsed. We give you instructions on breathing exercises, called incentive spirometry. These help expand your lungs and dialate your air sacs. This will help prevent pneumonia.. If you smoke, you should stop smoking. Smoking can increase your chance of getting pneumothorax. Smoking cessation will help your body recovery more completely. It will also help with your wound healing treatment.. You should also ask your doctor when you can fly in an airplane again. You will generally need to wait at least 2 weeks, and up to 12 weeks, before using this transportation. Flying in an ...

Despite numerous studies over the past few decades, the optimum strategy for deciding when to remove drains following axillary lymphadenectomy remains unknown. This meta-analysis aims to compare time-limited and volume-controlled strategies for drain removal.A total of 584 titles were identified following a systematic literature search of EMBASE, MEDLINE, Cinahl and the Cochrane library; 6 titles met our eligibility criteria. Data were extracted and independently verified by two authors. Time-limited drain removal was defined as drain removal at |5 days; volume-controlled strategies ranged from |20 ml/24 h to |50 ml/24 h.In all the studies, the time-limited approach resulted in earlier drain removal. Development of a seroma is 2.54 times more likely with early drain removal (Mantel-Haenszel Fixed Odds Ratio (OR) 2.54, p | 0.00001). However, there is no difference in infection rates between early and late drain removal (OR = 1.07, p = 0.76).This meta-analysis demonstrates that a strategy of early drain

A 30 year old man is brought into the Emergency Department after a road traffic accident. A chest X-ray taken as part of the ATLS trauma series is normal and he has no clinical signs of chest injury. He goes on to have an abdominal CT for investigation of blunt abdominal trauma. This reveals an occult pneumothorax. You wonder whether you should insert a chest drain ...

The diaphragm needs to be identified to avoid intraabdominal tube insertion. Once the intercostal space where fluid has been identified is localised, the probe can then be rotated so that it lies between the ribs (transverse plane). At least 10mm of pleural fluid should be present for aspiration. The measurement is taken from the visceral pleura to the pariental pleura in inspiration.. There are 2 methods of aspiration. One is by marking the spot where the needle insertion should occur and doing it without using direct ultrasound visualisation , the second by leaving the probe on the skin and inserting the needle using direct visualisation.. The recommendation from the BTS guidelines however states that:. The marking of a site using thoracic ultrasound for subsequent remote aspiration or chest drain insertion is not recommended except for large pleural effusions. (C). Clearly ultrasound guided needle insertion is going to be essential in drainage of complex pleural effusions especially loculated ...

Common and rare genetic variants of human red blood cell enzymes in Italy. Does the usage of digital chest drainage systems reduce pleural inflammation and volume of pleural effusion following oncologic pulmonary resection?-A prospective randomized trial. Effect of sexual intercourse on the absorption of levonorgestrel after vaginal administration of 0.75 mg where to buy viagra in Carraguard gel: a randomized, cross-over, pharmacokinetic study. Additional strategies may need to be paired with the online BA training to assure the long-term implementation and sustainability of BA in clinical practice.. The pharmacokinetic profile of drugs may vary between populations and this may be influenced by genetic factors, lifestyle, drug interactions, etc. The tumor is presumed to have arisen from the cardiac glands in the lamina propria mucosa of the lowermost region of the esophagus. Previous research suggested a special sensitivity of the brain to valence differences in emotionally negative stimuli. The ...

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|b|I am a 27 years old female, who had ectopic pregnancy in left tube, which was operated by laparoscopic surgery four months back.|/b| During surgery, left tubal abortion was done. While examining tissue of the tube, tuberculosis (TB) in my fallopian tube was found. Then, I was kept on the treatment of AKT-4 anti TB medicine and medication will continue up to six months. After the surgery, my Beta HCG test was monitored every week and has declined for two consecutive weeks. But in 3rd week, it started increasing. After a month, ultrasonography was done and it was found that some pregnancy still persisting in my left tube. Then, I was again kept on medication of methotrexate for four days. Finally, after a couple of days, the doctor removed my left fallopian tube. Will tube removal and tuberculosis lead to infertility? How can tuberculosis in my fallopian tube be treated? My TSH level is 3.75.

I have a procedure that I am not sure how to code: EGD through gastrostomy after PEG tube removal with a removal of a pancreatic stent by snare. The s

Results:. During this period, 405 outpatients underwent biopsy. Of the 405 patients, 13 (3.2%) were admitted with complications after biopsy. Five patients (38%) were admitted with persistent localized pain, five (38%) with orthostatic hypotension, one (8%) with both pain and hypotension, one (8%) with peritoneal signs, and one (8%) with lightheadedness but no orthostatic changes. All complications were noted within 3 hours after the biopsy. Bleeding, potentially the most serious complication, was radiographically defined in 5 of the 13 patients (38%) admitted. Only two patients, however, required blood transfusions. No patient required invasive management such as surgery or chest tube placement. The average length of the hospital stay was 1.5 days. ...

A 21-year-old healthy male athlete was brought to the emergency department after suffering 2 stab wounds: one to the superior left trapezius, and another to the left flank, in the posterior axillary line over the lower rib cage. In the emergency department his heart rate ranged from 46 to 64 beats/min and his systolic blood pressure ranged from 127 to 150 mm Hg with diastolic pressures of 55 to 76 mm Hg. He was found to have a diaphragm injury, a splenic laceration, and a gastric injury. He was taken directly to the operating room, where he underwent exploratory laparotomy, with repair of the gastric, diaphragmatic, and splenic lacerations, and left chest tube placement. He was extubated in the operating room immediately after the surgery, but had to be re-intubated within several minutes, due to respiratory failure with paradoxical respiratory efforts and desaturation.. He was then admitted to the surgical ICU with ventilator settings of pressure support 10 cm H2O, PEEP of 8 cm H2O, and FIO2 ...

The Essential Guide to Primary Care Procedures, 2nd Edition , is your go-to guide to more than 125 of the key medical procedures commonly performed in an office setting. This hands-on manual provides step-by-step, illustrated instructions for each procedure, as well as indications, contraindications, CPT codes, average U.S. charges for each procedure, and more. From the basic (cerumen removal and simple interrupted sutures) to the complex (colonoscopy and chest tube placement), this atlas covers the vast majority of skills youll use in your day-to-day practice.. ...

Baby had a small pneumothorax. Symptomatic with sustained tachypnea and difficulty maintaining oxygen saturation. I expected a chest tube insertion, but the doc wrote for a nitrogen wash-out under oxyhood instead. What. is. that? So, lets think for a minute. Pneumothorax is a bubble of air outside the lungs, where it shouldnt be. Right? And…

Surgical/invasive procedures falling within the scope of universal protocol guidelines include, but are not limited to, cardioversions, cardiac and vascular catheterizations (ie, pulmonary artery catheter placement and vasculare cannulation), transesophageal echocardiography, endoscopies, thoracentesis, chest tube insertions, paracentesis, lumbar puncture, incisions and drainage of wounds, and so on ...

Our 34-bed facility specializes in caring for critically ill adults. Patient transfers from other hospitals can be done by ground ambulance or the LifeFlight air transport service.. A number of faculty attend in the MICU and all have been board-certified in internal Medicine, pulmonary disease and critical care medicine. This team carries out procedures including diagnostic and therapeutic vascular catheterization, intubation, chest tube insertion, thoracentesis and bronchoscopy.. The MICU has an active program of research projects to discover new therapies and improve patient care.. For a critical care consult or to transfer a patient to the MICU call the Transfer Center at (615) 343-0976. Non-emergent consults should be referred to the Pulmonary Consult Fellow. ...

Genomic selection (GS) is a promising approach for decreasing breeding cycle length in forest trees. Synthesis and elimination of lactose in cialis 20 mg the colostrum perior of lactation Bone marrow-derived cell regulation of skeletal muscle regeneration.. Fractionation of an ethanol extract from the roots of this plant led to the isolation and identification of a novel cyanogenic glycoside, 2-(beta-D-glucopyranosyloxy)-4-hydroxybenzeneacetonitrile (1). Prevention of ischemia/reperfusion injury buy generic viagra pills online by hepatic targeting of nitric oxide in mice. The faster component seemed to be at least partially suppressed at red-light irradiances which were not saturating for photosynthesis. There were no differences in the coagulation tests, platelet counts, chest tube drainage, or allogeneic blood product transfusion requirements between the two groups at viagra tablets any time. Quantum tunneling for the sine-Gordon potential: Energy band structure and Bogomolny-Fateyev relation. ...

23/01/2015 Maquet Medical Systems USA announced today an exclusive US distribution agreement with ClearFlow Inc. for its innovative PleuraFlow® Active Clearance Technology® (ACT™) System. The PleuraFlow System enables caregivers to actively keep chest drainage tubes clear of clot in the early hours after heart surgery. Maquets sales representatives in the United States will begin selling PleuraFlow ACT during the first quarter of 2015.. PleuraFlow ACT received 510(k) regulatory clearance from the U.S. Food and Drug Administration in December 2010. In October 2014, ClearFlow announced positive results from the Prevention of Retained Blood Outcomes Using Active Clearance Technology trial, (PRO-ACT), a clinical study evaluating the use of PleuraFlow® Active Clearance Technology® System.. Too many patients are experiencing complications and additional procedures as a result of the common occurrence of chest tube occlusion, said ClearFlow President & CEO, Paul Molloy. Meanwhile, ...

Learn more about Pulmonary Lobectomy at Memorial Hospital DefinitionReasons for ProcedurePossible ComplicationsWhat to ExpectCall Your Doctorrevision .....

What happens during a thoracentesis?. Your doctor will use medical imaging to find the pocket of fluid. After cleaning your back, your doctor will numb your skin. She or he will then place a thin tube into the space surrounding your lungs and drain the fluid through tubing and into a bag. The procedure usually takes a few minutes. Your doctor will remove the tube at the end.. Sometimes it is necessary to leave a little tube in your chest to continue draining fluid or abnormal air around the lungs. This is called a chest tube. ...

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APS is exploring the expansion of the program to additional schools. The support line is available now through September 30 to provide a vital resource for crisis support and referral support. It is available 24/7/365 to students age 14 and over, staff and parents. Staff on the line are trained in crisis response and can help in English and Spanish and can link callers to local resources. Other languages are available through the Language Line. Help is available by calling 833-Me-Cigna (833-632-4462).. Experts on ...

A device for clearing obstructions from a medical tube, such as a chest tube, is disclosed in various embodiments. The device features a shuttle member that is magnetically coupled to a guide wire within a guide tube, through the guide-tube wall, so that translation of the shuttle member induces a corresponding translation of the guide wire within the guide tube, without penetrating or compromising the guide-tube wall. In this manner, when the guide tube is coupled to a medical tube where obstructions have formed, the guide wire and clearance member may be inserted into and withdrawn from the medical tube, via actuation of the shuttle member, to engage and help clear such obstructions from the medical tube without compromising the sterile field. Methods of clearing a medical tube of obstructions are also disclosed.

At the end of your operation the wound will be stitched together. The stitches are usually dissolvable and do not need removing. Your wound may feel tight or swollen at first. Do not worry about pulling the wound open, you would feel pain well before the risk of damaging your wound. The tightness will settle with time. You may be able to feel the end of the suture, this is normal and it should settle over time. While you are in hospital, your wound dressing will be checked daily; once the dressing is clean and dry, it can be removed completely. If you need any special dressings when you go home these will be explained to you on the ward. The chest tube stitch does not dissolve, it will need to be removed 5-7 days after your drain was removed by your practice or district nurse.. The skin takes 2-4 weeks to heal. You can shower or bath but do not rub or soak the wounds until they are fully healed. Avoid having the water too hot, it may make you feel faint. It is a good idea to have someone else in ...

My bike seems to bog down when you open the throttle quickly. Ive stripped the carb and put it in my ultrasonic bath but I didnt remove the emulsion tube as I

I am so glad my mom was able to share a post for me yesterday, things got really intense. When we got to the NICU about 11am we were worried Harrison may not even make it. At last his little body began to respond once they started feeding some nitric oxide through the ventilator. This helped open up the blood vessels around his lungs, which had basically clenched up. His lungs are so underdeveloped that they are comparable to those of a 24 weeker, the doc said, despite being born at 29w5d. Hes also developed sir pockets inside his lungs, but today they appear to be smaller. And the pneumothorax on his right side (air pocket outside the lung) is slowly decreasing via the chest tube they placed several days ago.. While these are considered normal issues for a preemie, hes dealing with a more extreme case of delicate lungs in addition to several other complications. The docs are keeping an eye on the PDA in his heart, a valve that hasnt properly closed. We can hope he grows out of this. And ...

So Im still in the CICU, but only because there are no ward beds at the moment. Ive been breathing with the help of very minimal oxygen and have even had milk. The chest tube has been taken out and the swelling is going down from the air leak. The canular has also been removed and they are using my central line. Im still on some good drugs, but am happy to hold mum and dads hand today ...

Women will be found eligible for this study after an eligibility questionnaire given over the phone. If one is found eligible, she will be sent a consent and paper survey to fill out and send back to the research coordinator. Once that is completed, she will be given a phone interview in order answer additional questions of interest. Lastly, the study participant will be contacted once a year over the phone to obtain follow-up information ...

One cause for confusion of junior residents has been the type of equipment and the inappropriate use of it. For example, although a chest tube comes with a central trochar, for years, it has been taught that the trochar should not be used for fear of puncturing internal organs. However, unless there is stipulation from trainer that the trochar should not be used and that forceps introduction of the drain is safer, it is easy to see how wrong techniques and subsequent mistakes on patients can occur, especially if supervision of junior residents is not optimal. No junior doctor should ever be let loose to Just Do It without first training the doctor appropriately and ensuring that they are safe for the patients. Many modern texts exclude the use of the trochar because it is dangerous. It should not be used. We need to diverge from the Eminence Based Instruction of this is how I learnt it and this is how I will teach it to you concept and use Evidence and Benchmarking as much as possible, ...

Life has been hectic since this past Sunday when Lorie and I drove to New York City for another visit to Memorial Sloan-Kettering Cancer Centers (MSKCCs) urgent care facility. Drainage from my chest tube once again changed from amber fluid to the color of a fine Cabernet wine, which signaled that bleeding resumed. More alarming was the accompanying shortness of breath and increased coughing. I was out of breath even from walking a short distance to go to the bathroom.. We arrived at MSKCC around 10am and, following a brief review of recent events, had a chest x-ray taken to get a quick read on the situation. The resulting images showed a complete white-out in the left lung, which indicated that fluid had essentially filled the entire space. Normally, the lungs look transparent or black on an x-ray due to air in the lungs.. The fact that I had only one viable lung explained the shortness of breath and coughing. What the x-ray couldnt reveal was the composition of the fluid (serous fluid, ...

Life has been hectic since this past Sunday when Lorie and I drove to New York City for another visit to Memorial Sloan-Kettering Cancer Centers (MSKCCs) urgent care facility. Drainage from my chest tube once again changed from amber fluid to the color of a fine Cabernet wine, which signaled that bleeding resumed. More alarming was the accompanying shortness of breath and increased coughing. I was out of breath even from walking a short distance to go to the bathroom.. We arrived at MSKCC around 10am and, following a brief review of recent events, had a chest x-ray taken to get a quick read on the situation. The resulting images showed a complete white-out in the left lung, which indicated that fluid had essentially filled the entire space. Normally, the lungs look transparent or black on an x-ray due to air in the lungs.. The fact that I had only one viable lung explained the shortness of breath and coughing. What the x-ray couldnt reveal was the composition of the fluid (serous fluid, ...

Julie and I walked down had breakfast together. It was nice to be with her last evening and today. Thanks to Julies friend Heidi, I was able to spend the night here. She camped out with the boys at home. We have ha a lot of help from Mary our nanny, neighbors, family, and my parents stayed there the first night. I dont think they had much sleep as they were keeping up to date with the blog/surgery.. We had an xray this morning, and of course she walked there too. Rick was up to visit and watching those two together is always entertaining. Julie calls the collection canisters for her chest tubes her suitcases, her tubes her jump ropes, and youll have to ask me what she calls her catheter and tube that has a bulb on the end of it. We had some good laughs.. Right now we are in endoscopy waiting for a bronchoscope. Her xray looked pretty good this morning; better than yesterday. There is still some junk in the upper right lobe ...

Needless to say from this pic, the coma was a nightmare, he reacted more than we ever thought he would. He blew up like a balloon, and he wasnt stable on the vent. The settings were maxed out. They mentioned the O word (oscillator) which is the high frequency vent, but our prayers must have been answered that day because they never had to use it. They kept telling us that the coma itself would probably take his little life, and if it didnt, the status could very easily still be there, I guess only about 20% actually stop. Yikes. But as he slowly woke up, it looked like the status was gone. We had started him on the ketogenic diet so we dont know what actually helped. He still has around 50 siezures a day, but nothing like he had before. Another miracle.. He has been hospitalized multiple times since, for various reasons. his nissen, respitory distress. In October 08 he had bilateral plureul effusions and had two chest tubes placed. Thats when the clot was found and they discovered that he ...

Everything went very well. Surgery went smoothly, Jake had no issues coming off of the bypass machine or the ventilator. He was extubated by the time we saw him. He only had one chest tube, a inter-cardiac line which goes directly into his heart, and an arterial line. They had to put the art line into his groin area because his his veins and arteries are so used up. They tried the hand but were afraid pushing it anymore could risk him not getting any blood flow to his hand which would be VERY BAD. He only needs the art line for the heperin they are giving him, once they get him to therapeutic levels they can switch him to lovenox. He is on the heparin because of his factor IV Leiden gene. He is at risk for clotting so we need to have him on anti-coagulants for a few months post-op. They have already gone down on his heart med (Milrinone) and he may not even need enalapril (Blood pressure med he was on at home) anymore once he goes off of the milrinone. He is getting some dex to help take the ...

You guys liked my last story about by pain in the ass but pretty good guy dad, so heres another one. You might want to skip this if discussion of medical procedures bothers you.. As I mentioned in the last post, the old man was a country doctor. He did some surgery, and delivered many (~3,000) babies. When he was in his prime, he was deft with his hands, and fast. Now that hes in his late 80s, he has degenerative arthritis everywhere, and his hands arent what they used to be. For example, when I was home a year ago, I had some stitches that had to be removed, and I basically ended up doing it with his direction because he couldnt do it. This is a minor procedure he would have done in a minute, tops, when he was in his prime. For a lot of us, the Grim Reaper doesnt take us with one fell swoop of his scythe - he hacks us to bits piece by piece.. Anyway, as some of you know, my mom has lung cancer. At one point in the course of her illness, she had a chest tube placed which could be drained by ...

8) Doctors arent always reliable, and dont necessarily know everything. If a patient rips his chest tube out and is at risk for respiratory distress or a pulmonary embolism or stroke or worse, the doctor on call should get out of his bed and come to the hospital to assess him. Always advocate for patients to get the care they deserve ...