Greetings:
It is Friday morning - yesterday the staff at OHSU worked hard to balance Micki's blood pressure with heart rate. They reported to us that her fever broke, and she seems to hover around 100 degrees F. Her pressure in her head is holding steady, but even with that, the care internist (Dr. Fields) is certain Micki has had small vasospasms in the left side of her brain. Today we expect them to perform a cerebral angiogram to check vessels , inject medications to open the vessels, or even use what I'll call angioplasty (a balloon) to open vessels. (I don't know if they call it angioplasty in your head, too, as they do for the heart).

Goes without saying, Micki is intubated (breathing tube) and when we left last night the staff were testing her arterial blood gases to determine the amount of oxygen getting to her. She initiates her own breathing (CPAP) but they were considering having the ventilator rule the breathing rate.

Micki is heavily sedated. On Wednesday, she didn't wake during our visit, nor even move her hands to try to yank out tubes. On Thursday, she had lots of, what the nurses call, purposeful movement - meaning mostly, she becomes conscious enough that she tries to yank tubes out. Can you imagine having a tube breathing for you, shoved down your throat, you'd feel like choking - which does make her cough - and on top of that, a hose running through your nose as well (which feeds her)? Ok, too much of a picture but I am distressed by her distress. Anyway, Micki was much more wakeful Thursday and for a time even knew Steven and I were in the room and she could nod when asked yes/no questions. The staff has to balance this wakefulness, which disturbs or agitates Micki, with keeping her peaceful yet breathing adequately.

This is the most critical time for "spasm watch" for Micki. Each day she doesn't have serious spasms means the likely hood of them happening diminishes - that is great because on Monday Stacy reported how "with it" Micki is and OHSU staff, as well as we, are confident she will get out of this mentally intact. Even though the magic 7th day is passing with no major complication, she is still in the woods - infections always a worry, pneumonia always a worry with ventilators, and spasms still a possibility.