Carrie's tubes switched from throat to stomach

Husband John Krack emailed this Jan. 19 report on wife Caroline "Carrie" Moore Krack, BJ newsroom retiree Tom Moore's daughter, who has been in Akron City Hospital with meningitis all of January:

They did the tracheostomy today and installed a feeding tube through her abdominal wall into the stomach. The tubes are all out of her mouth and throat, giving her upper airway and vocal chords a chance to heal. This setup should be more comfortable for her.

They had her on ventilator support this evening, but she was initiating her respirations. Given that she has recently done quite well off the ventilator, I expect that once she’s stabilized with the trach tube, they’ll disconnect the ventilator again and have her on a low concentration O2 feed.

The surgeon told me yesterday that the stomach tube (called a PEG) will be in for 6 weeks minimum, even if she doesn’t need it that long. When I asked why, he said “statistics.” Apparently, experience shows that it takes about 6 weeks for things to heal to the point where they can pull it with no complications. The body just heals the wound with no issues. If she can eat regularly before then, they’ll just cap it off, coil it up, and tape it to the belly until the 6 weeks are up.

I was quite concerned yesterday morning because her mental status had regressed to about where she was the middle of last week – wouldn’t respond to commands, wasn’t moving around, fixed stare when she opened her eyes. I think this is why they decided not to do the trach/stomach tubes yesterday. When I visited in late afternoon, the nurse said she woke up about 12:30, and when I got there she was nearly back to her peak at the end of last week. Today she was about the same. I’m hoping that, with the tubes out of her throat, she’ll be more comfortable and will be able to resume improving neurologically.

The physical therapist stopped by when I was there this morning and helped the nurse move Carrie from a chair to her bed in preparation for taking her to surgery. The PT had Carrie stand up, pivot, and sit down on the bed. She was a bit unsteady, but the PT said she stood up and supported most of her weight by herself, and was quite pleased that she was able to do that.

I’m not sure what comes next in terms of tests and evaluation, but it appears that the next major steps are to get her stable with the new airway (shouldn’t take long), make sure other systems are OK so she doesn’t come back to ICU, and send her either to the main hospital for a short time to ensure everything’s OK and get a little stronger, or directly to a rehab hospital to work on regaining mental and physical function. That’ll be up to the doctors, based on her condition. Getting her out of ICU will be a big step. By the way, a doctor told me the other day that their rule of thumb is 3 days of rehab for every 1 day in the ICU. If that holds true, we're looking at around 2 months of rehab.

I’ll keep you posted as things develop. Thanks again to all of you for your continued concern and support.

John

Click on the headline for an earlier report on Carrie.