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Serious Information

by on January 3, 2011

Another palliative care RN arrived and performed Satomi’s last official blood draw.  The RN had a hell of a time with the veins in her left arm.  Since it was only a draw, we all agreed that the risk was minimal so she pulled the blood from Satomi’s right arm.  It was relatively easy. 

This RN was a breast cancer survivor so she was quite sympathetic to our situation.  We discussed Satomi’s specific problems and she was quite forthcoming.  Maybe a bit more than she is suppose to be so I’m not putting her name here.

The RN warned me about Satomi’s position.  She said that brain stem tumors are very positional and lying flat could put the body, spine, neck, and head in a position that could put pressure on the brain stem which could trigger a seizure or worse.  This could explain the seizures we had on the radiation table and her insensitivity to all the anti-seizure and swelling drugs.  She warned me about allowing Satomi to sleep with her head unelevated.  It could compromise breathing or other autonomic brain function.  Its dangerous but the simple fix is to elevate and support the head.

She explaned that the “canal” that contains the brain stem and all cranial nerves to the spine is very narrow.  It is conceivable that the shift of cerebrial fluid from an upright position to a lying position is the primary inducer of Satomi’s dizziness-Smooth, slow, and careful movements is definitely better for her condition.  The issue then becomes her strength.  From experience I know that a common remedy for weakness is momentum-Meaning you throw yourself up into position or fall down onto the bed.  That maybe good for weak muscles but it is nothing but bad for sloshing brain juice.  The RN agreed with my conclusions.  When we move her, we’ll have to do more to support her.

Blood pressure changes will also effect both of these things.  High blood pressure can cause soft tissue to expand and squeeze nerves while low blood pressure can starve organs especially when standing up or sitting down.  Satomi’s blood pressure was a verified 76/60 and is a clear sign that she is dehydrated.  We immediately increased her fluids.  The obvious problem becomes more potty trips.  It’s a vicious cycle.

A fall could be terribly painful or even fatal.  With these risks it sounds more and more prudent to use a hospital bed and minimize her movement.  I’ll have to talk to the hospice people about it on Wednesday.

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