Solving the Puzzle

Solving the Puzzle in Boston

Lung Transplant Update and Hospital Admission

Before heading to Australia Tony came up to Wellington for a routine appointment with his lung specialist. She had news for him regarding Sydney’s opinion of him having a lung transplant. Sydney confirmed their agreement with Auckland’s recommendation of him to not have one. They had done a lot of research and sent this through to Wellington, which explained that his quality of life after transplant could become worse than what it is now due to the variety of medications and complications which come during and after transplant. His specialist said that lots of people can’t have transplants for various reasons, and so this is just a bend in the road for him.Tony’s specialist then spoke of doing a planned admission to improve his health as much as we possibly can in the next few weeks. As he was going to Australia the next day he couldn’t stay then.

Going to Australia

We then went to Brisbane, Australia for four days for Tony’s uncle’s birthday. We left on the Friday morning from Nelson to Auckland and he got to use one of the medical rooms to do his physio before getting our flight to Australia.
His lung specialist said that he had to use a wheelchair at the airport to conserve his energy and breathing. He also used a oxygen concentrator on the flight to Australia and back. We got the oxygen concentrator as a trial run for America and are glad that we did. It definitely helped to have the oxygen and it helped with bringing his oxygen sats back up into the 90’s. We had a problem with the oxygen concentrator and it stopped about 2/3 of the way across. His oxygen sats dropped into the 80’s and stabilized around 84. We swapped the battery and got it going again and they came back up into the 90’s. We had great time there with the family celebrating a great birthday. He was a bit tired after the trip and started antibiotics after he noticed his sputum changing colour slightly. Everyone else in the house had the flu at the time and we didn’t want to chance it turning into a chest infection for him.

Hospital admission

Last week Tony was flown up to Wellington and was admitted to the respiratory ward. Upon arriving he was very quickly greeted by a variety of lovely nurses and ultimately was settled into his own room.He met with his respiratory team and medical staff shared with him their plans for him to see the physio and dietitian promptly as well as him getting his first ever Picc line.
Day 1 saw Tony meeting a familiar physio and discussing different treatment options which we started straightaway in the form of percussion postural drainage (aka a good beating :-)) which has continued daily. Other strategies discussed was Autogenic drainage which Tony tried on day 2 of his admission with good results. The final idea from the physio included a Pari-Pep device which has the same principals as an accapella. It can be used at the same time as his nebulizer and may help to reduce the time it takes for him to get through his physio in the morning & evening. Visits to the gym have also been occurring upon our arrival here and happening every few days.
Tony’s picc line insertion went ahead very promptly on day 1 and has been very effective in him receiving his antibiotics. He says its more comfortable than having an iv line in and doesn’t need to be changed every few days. It was very interesting the way that they put the picc in. They used an ultrasound to find the vein and a tracking device which showed the Doctor where within the vein the line was. When Tony’s brother (Aaron) used to have picc lines inserted, they had to insert it, then get a xray to see if it was in the correct place.
Day 3 spirometry showed stable results and that his lung function had not decreased. We also started communication with his respiratory team about a drug called Danazol, in which we sent an article through to them. Different specialist departments were consulted and awaiting their responses. Seeing his respiratory team on Friday (day 5) led to them saying that he could possibly go home on Monday, pending weekend results. A second spirometry was scheduled for Monday. Weekend results showed an increase in Tony’s weight and a good feeling that his lung function may have turned a corner and could be on it’s way back up slowly!
Daily discussions with Tony’s physio over the course of his first week, has led to us organizing to collect a Pari-pep upon our return to Nelson.
Tony’s lung specialist thought that it would be a good idea for him to talk with the palliative care team, but not for the reasons you automatically assume when you hear this term! Palliative care covers a very wide range of responsibilities for people who have long term conditions that can’t be fixed immediately. End of life care is a very small part of what they do in their jobs! Meeting with them, led to a mutual agreement between all of them that talking and offering emotional/spiritual support sounded like a good way to go. They were very excited to hear of his upcoming plans that are in store for him and they look forward to hearing how he get’s on.

Monday – discharge day

Tony did a lung function test on Monday morning before being discharged in the evening and it was up slightly. He was told that doing a peak flow meter could help improve his technique.
Once back in Nelson a district nurse came to see him each day around 11am to give his IV antibiotic daily. This is to last for a week once home from Wellington hospital to make up two weeks worth altogether. He is feeling better being home and is enjoying his own bed and not being woken up at night for obs and antibiotics 🙂

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