Intensive.
Mom's in intensive care.
At St. Lukes this time.
Nobody fucking listened to me when I said something was wrong.
I always know what she looks like when she's retaining carbon dioxide.
I've seen it happen a million times. I know the signs. That's WHY I spoke up and said it was happening.
But no.
So now she's on a bipap machine, I don't know if they've taken her off of it lately but the first time they tried her o2 level dropped so they had to keep her on it.
Incase you don't know what that is, I'll post info under a cut here.
PAP ventilation is often used for patients who have acute type 1 or 2 respiratory failure. Usually PAP ventilation will be reserved for the subset of patients for whom oxygen delivered via a face mask is deemed to be insufficient or deleterious to health (see CO₂ retention). Usually, patients on PAP ventilation will be closely monitored in an intensive care, high dependency, coronary care unit or specialist respiratory unit.
The most common conditions for which PAP ventilation is used in hospital are congestive cardiac failure and acute exacerbation of obstructive airways disease, most notably exacerbations of COPD and asthma. It is not used in cases where the airway may be compromised, or consciousness is impaired.
Unlike PAP used at home to splint the tongue and pharynx, PAP is used in hospital to improve the ability of the lung to exchange oxygen and carbon dioxide, and to decrease the work of breathing (the energy expended moving air into and out of the alveoli). This is because:
During inspiration, the inspiratory positive airway pressure, or IPAP, forces air into the lungs - thus less work is required from the respiratory muscles.
The bronchioles and alveoli are prevented from collapsing at the end of expiration. If these small airways and alveoli are allowed to collapse, significant pressures are required to re-expand them. This is because of the Young-Laplace equation (which explains why the hardest part of blowing up a balloon is the first breath).
Entire regions of the lung that would otherwise be collapsed are forced and held open. This process is called recruitment. Usually these collapsed regions of lung will have some blood flow (although reduced). Because these areas of lung are not being ventilated the blood passing through these areas is not able to efficiently exchange oxygen and carbon dioxide. This is called ventilation/perfusion (or V/Q) mismatch. The recruitment reduces ventilation perfusion mismatch.
The amount of air remaining in the lungs at the end of a breath is greater (this is called the Functional residual capacity). The chest and lungs are therefore more expanded. From this more expanded resting position, less work is required to inspire. This is due to the non-linear compliance-volume curve of the lung.
Last time all these shenannigans happened, she ended up in a coma for an estimated five months.
They said she's only going to be in there a few days, I know better.
I'm really upset now.
I really need a hug.
It's times like these when I HAVE to come to terms with how sick she really is and I hate doing that. I like having optimism. I know she'll never come home again, they've told me that. She's been in the hospital 2 years at the end of this march, but I like THINKING she'll come home. That's why when my father took me to look at that mold infested house the other day (if you want the story, ask.) I cried and said "the only time I want to move from this house is if I move on my own because it feels like mom already died any other way."
Fuck. I don't know how to feel or what to do right now.
I really wish John was home for me to go see or talk to.
I really wish I had the car so I could go for a ride to just relax for a bit, too.
I just want her to make it out of this one like she has all the other times, but I know she's getting weaker now, so I'm a lot more scared this time than I've ever been. If her lung collapses again, I think that'll be it, and I don't like thinking about it.
I love you, mom.
<3
I really do.
At St. Lukes this time.
Nobody fucking listened to me when I said something was wrong.
I always know what she looks like when she's retaining carbon dioxide.
I've seen it happen a million times. I know the signs. That's WHY I spoke up and said it was happening.
But no.
So now she's on a bipap machine, I don't know if they've taken her off of it lately but the first time they tried her o2 level dropped so they had to keep her on it.
Incase you don't know what that is, I'll post info under a cut here.
PAP ventilation is often used for patients who have acute type 1 or 2 respiratory failure. Usually PAP ventilation will be reserved for the subset of patients for whom oxygen delivered via a face mask is deemed to be insufficient or deleterious to health (see CO₂ retention). Usually, patients on PAP ventilation will be closely monitored in an intensive care, high dependency, coronary care unit or specialist respiratory unit.
The most common conditions for which PAP ventilation is used in hospital are congestive cardiac failure and acute exacerbation of obstructive airways disease, most notably exacerbations of COPD and asthma. It is not used in cases where the airway may be compromised, or consciousness is impaired.
Unlike PAP used at home to splint the tongue and pharynx, PAP is used in hospital to improve the ability of the lung to exchange oxygen and carbon dioxide, and to decrease the work of breathing (the energy expended moving air into and out of the alveoli). This is because:
During inspiration, the inspiratory positive airway pressure, or IPAP, forces air into the lungs - thus less work is required from the respiratory muscles.
The bronchioles and alveoli are prevented from collapsing at the end of expiration. If these small airways and alveoli are allowed to collapse, significant pressures are required to re-expand them. This is because of the Young-Laplace equation (which explains why the hardest part of blowing up a balloon is the first breath).
Entire regions of the lung that would otherwise be collapsed are forced and held open. This process is called recruitment. Usually these collapsed regions of lung will have some blood flow (although reduced). Because these areas of lung are not being ventilated the blood passing through these areas is not able to efficiently exchange oxygen and carbon dioxide. This is called ventilation/perfusion (or V/Q) mismatch. The recruitment reduces ventilation perfusion mismatch.
The amount of air remaining in the lungs at the end of a breath is greater (this is called the Functional residual capacity). The chest and lungs are therefore more expanded. From this more expanded resting position, less work is required to inspire. This is due to the non-linear compliance-volume curve of the lung.
Last time all these shenannigans happened, she ended up in a coma for an estimated five months.
They said she's only going to be in there a few days, I know better.
I'm really upset now.
I really need a hug.
It's times like these when I HAVE to come to terms with how sick she really is and I hate doing that. I like having optimism. I know she'll never come home again, they've told me that. She's been in the hospital 2 years at the end of this march, but I like THINKING she'll come home. That's why when my father took me to look at that mold infested house the other day (if you want the story, ask.) I cried and said "the only time I want to move from this house is if I move on my own because it feels like mom already died any other way."
Fuck. I don't know how to feel or what to do right now.
I really wish John was home for me to go see or talk to.
I really wish I had the car so I could go for a ride to just relax for a bit, too.
I just want her to make it out of this one like she has all the other times, but I know she's getting weaker now, so I'm a lot more scared this time than I've ever been. If her lung collapses again, I think that'll be it, and I don't like thinking about it.
I love you, mom.
<3
I really do.