Rockin' the Defibrillator

"You need to come now, they've got the crash-cart out."

That's what Christa was confronted with while calmly waiting for Ford to come back from his second CT scan this afternoon. Somehow things had gone from stable to !#$@%* during a routine procedure. His sats were down in the teens, his blood pressure was almost non-existent, and his heart rate was struggling with an episode of irregular rhythm. He was hooked up to the defibrillator, had a "chest compression board" underneath him, was receiving boluses of inotropes, blood transfusions, and far too much attention from the available ICU staff.

We're not really sure what happened, or why. But after yesterdays reluctant admission once again spiralled into a crisis, we are thankful that the team here has a hearty measure of intuition and a keen eye for anticipating Ford's now routine brushes with death.

As previously mentioned, there were two main problems they were looking to diagnose today. One, why his left lung was so collapsed and surrounded by such a large amount of fluid. And two, were there new developments in the clots in his jugular and brachiocephalic veins, despite the therapeutic dose of anticoagulants that he'd been maintained on since his stroke in November.

It turns out that after they intubated him yesterday his left lung function improved significantly and what they thought was a large amount of fluid turned out to be much less so (apparently fluid and collapsed-lung are hard to distinguish between on an x-ray). So they decided to forgo the insertion of a drainage tube and turned their attention to the clots. His first CT scan of the day was to check the blood flow through his chest, and once that came back showing things were better than expected they ordered a second one to check the flow through his head, thinking that his Glen circulation was being significantly compromised by a total or partial blockage of the returning blood (one of the symptoms we reported to them was Ford's recent and surprisingly striking episodes of "Glen-head," wherein his head takes on the colour of an eggplant and his lips turn a dusky whitish-blue).

I'm a little unclear about the next bit of information, as I was at home when Christa called me to say how bad things had gone, but it sounds like they did see multiple clots in his upper vasculature. Whether those were worse or different from the ones that had been diagnosed in Toronto, I'm not sure. So amidst the flurry of resuscitation they started him on an infusion of Activase, which is a "clot buster" drug that works to actively and aggressively break down blood clots, as opposed to the Enoxaparin and Heparin that Ford usually gets, which are supposed to passively prevent new clots from forming. The worry here, which is similar but more acute than with Heparin, is that it could prompt hemorrhaging throughout his body, most seriously in his head. But at the moment there isn't any sign of that and Ford is "stable" (relative to his constant un-stable condition). They even felt confident enough to wheel the crash cart back about 6 feet from his bed and roll him onto his tummy to sleep (a manoeuvre requiring 5 pairs of hands).

While I'm growing daily more attuned to the nuances and subtleties of modern medicine, and know that it's a tricky business at best to confidently manage a patient as messed up as Ford, I've been day-dreaming about sitting in on a phone conversation between Dr. Human in Vancouver and Dr. Dipchand in Toronto, where Dr. Human simply says:

Anne, WTF!!?

...and then hangs up.

Pure, prime-time drama.


And so, while things suck about as much as they have sucked so far, I thought I'd back-peddle a bit here and share a couple photos from the last few days in Toronto:

Ford spread out amongst the luggage. Us wondering which bag will have enough space left to pack him in.

Ford Couture - fashionista, living up to his name in H&M with Nana Rhonda asking his opinion on a Star Wars number. The first place we went after getting him out of the hospital was the mall. Talk about out of the frying pan and into the fire. Sad, but true.