I was able to see Mikie at every visit today.  He is resting much better but when he wakes up he tries to pull everything out or off.  They have him hog tied now but well sedated as well.  He really looks much better than he has in a while, like he is able to rest for a change.  Tomorrow they will back off all pain meds to try to take him off the ventilator.  I suppose then they will give him pain meds as needed.  The doc suggested maybe it was not so much pain but confusion.  I think I know him well enough to know pain is the problem.  One of the nurses said they had a patient that had similar surgery and he was able to talk about how bad it was, and that it took six weeks to get over it.  Since Mikie can’t just tell us where it hurts we can only make our best guess on what we know about him. It’s quite the balancing act, giving him relief from the pain but not getting him so stoned he can’t breath.

I was reading about the use of morphine with hospice patients and even though very high doses were given those patients lived longer than those with no pain relief.  The body is just so stressed out by pain it can’t function properly and the patient goes downhill quickly.  It seems terrible that we have to cope with pain but we wouldn’t live long without it.  We would ignore cuts and infections and broken bones until we died, where pain tells us to get it fixed.  Take the spinal cord injury patient that doesn’t know that a catheter is blocked or pinched off.  He doesn’t feel the pain but soon the body goes crazy with the heart racing and blood pressure sky rocketing.  BTW, in the past we thought Mikie was having Autonomic Hyper-reflexia type responses, probably to what was going on in his gut but now he is not reacting that way any more.  The most his heart rate goes up to, even with maximum pain, is around 130-140.  In the past it shot up to 200!

He has two procedures tomorrow, the Thoracentecis and placing a pic line in and removing the central line from the groin.  Oh, and getting him off the vent.  Let’s pray it all goes well.