Cassie has continued to make tremendous progress in her breathing ability without the ventilator. Today she was able to tolerate 7 hours of room air without the support of a ventilator. She beat her record of 4 hours from yesterday. While on the room air she had a physical therapy and occupational therapy session where they were able to sit her up on the side of the bed. While sitting up she was able to move her legs and arms with assistance from the staff. She has not been in pain today after the amputation yesterday as the medical staff continue to monitor the pain levels.
Cassie had an amputation performed on her lower left leg. Earlier this week the doctors confirmed that there was no recovery in most of her lower left leg, and her left foot was completely dead. The doctors performed the first operation of a below the knee amputation. While this is not ideal, the amputation was an important step to her recovery. Cassie will still be able to live a very functional life with the use of a prosthetic and get back to doing some of her favorite activities like pickleball, tennis, hiking, and strolls around the neighborhood. The doctors are continuing to closely monitor her right foot which was also affected by the loss of blood flow. She still has the ability to wiggle her toes in the right foot, but there is concern for future functionality once she is able to walk. No procedures on the right foot need to be taken at this time as the medical staff will let her body recover more before deciding the next course of action.
Cassie has continued to progress in a number of other areas in her recovery. She was able to be on “room air” for 4 hours and was able to tolerate the speaking valve for 15 minutes. While she is still not strong enough to be able to speak, they will continue to increase her time on “room air” with the use of the speaking vent to build up the strength of her diaphragm so she can speak to the family. Please pass along your thoughts and prayers to Cassie today as she will need them to strengthen her spirits.
Cassie has continued to progress in her recovery. She was tilted twice today for 35 minutes each time. She also was able to tolerate room air for 3 straight hours today. As she continues to be able to breathe this room air without the use of the vent, the speech team will evaluate her for a speaking valve in the coming days. She also met with the PT / OT teams today and they were able to work on her grip strength and sit her up on the edge of the bed. The family would like to thank everyone for the constant outreach, prayers, and meals.
Cassie has continued to progress well in her recovery, making progress in her fluid offload, reducing her reliance on blood pressers, and reducing her reliance on the ionotropic medicine as well. She was able to match her tolerance of “room air” of up to an hour today, as well as continuing her “tilting” for longer than she has before.
Cassie took her 12th trip to the OR today where the doctors reassessed the fasciotomy wounds in her left leg. The doctors confirmed that there was no infection and that she maintains muscle reactivity in the back of her calf. The doctors are continuing to evaluate next steps for her left leg and right foot. Both of these extremities were affected by a lack of blood flow while she was on the ECMO machine.
Cassie has continued to increase her awareness over the past few days. She was able to sit up and watch Pastor Dan’s sermon at St. Mark’s with her family. She greatly appreciates all the videos and audio messages that have been sent to her. Her smile lights up the room when she gets to hear all of your voices. While she is still physically lying in bed, Cassie is cognitively back in shape. The family is overjoyed with her memory recollection, humor, and responsiveness to our conversations.
Cassie has continued to reduce her need of blood pressers and has been off the blood pressers since yesterday morning. She continues to use Dobutamine which is an ionotropic agent which improves the functionality of the heart muscle. The ICU team is continuing to reduce the dosage provided to her to test her heart functionality without the use of this medication.
Today Cassie will continue to undergo her occupational therapy to increase the strength throughout her body. She will also begin using “room oxygen” where she is completely removed from the ventilator to breathe on her own. Yesterday she was able to tolerate this for 30 minutes, and is looking to increase that amount of time today. Lastly, she will continue to be “tilted”, where the medical bed is moved upwards to simulate the sensation of standing. Thank you for the continual prayers and support, these words of kindness help give her strength to tackle the next obstacle that she faces on her road to recovery.
Cassie had a successful tracheostomy surgery yesterday evening. This morning she has been awake and very aware, even smirking at a few of the boys witty one-liners. She was even able to muster up her first words to the family saying “I love you too”. She is still too weak to have a speaking valve retrofitted, but she is beginning Occupational Therapy to increase her strength. They are getting her arms and head moving through a number of different exercises.
This morning she was also tilted upwards, where her hospital bed is able to move her entire body all the way up to a 60 degree angle to help stimulate the sensation of standing and move the fluid throughout her body. Both her left leg and right legs have pulses today, which the ICU team was unable to find earlier in the week. They are unsure what this means for her future functionality but will wait for her to be able to speak to the team to assess pain and movement. The goals of the team are to continue encouraging her to move her body and breathe on her own as she is looking to take significant steps in her recovery.
Additionally, Cassie has loved to receive videos and audio messages from her support group. If you have anything you would like to pass along to her, please send these directly to the family members so we can pass on your thoughts, motivation and prayers to her.
Cassie has just returned from a successful tracheostomy operation. Last evening she remained off the ventilator and continued to initiate her own breaths. Physical Therapy and Occupational Therapy observed her today and confirmed that she is ready to begin recovery activities tomorrow.
Vascular redressed her left leg and adjusted the wound vacs that are helping the fasciotomy wounds heal. The vascular team confirmed that she now has a pulse in all of her extremities. While this is promising, there is still concerns for the future functionality and the family has been informed that amputation is the most likely outcome.Vascular consulted dermatology to confirm if there is an infection of the skin in her left leg and right foot and are awaiting test results. Please continue to share your thoughts and prayers in the comment section below so the family can continue to share them as she becomes more aware.
The family would like to give a special thank you to Mennel Milling and Rowmark for the incredible support this week. It is incredible how after many years working together those people become more than colleagues, but family.
Cassie continues to remain stable. Overnight she had a CT scan that confirmed there was good brain activity and she continues to pass all neurological exams performed by the medical staff. She rested for most of the morning, but woke up and was able to communicate with the family this afternoon. She is still on standby for the tracheostomy surgery but is scheduled to have that performed today. In the coming days after the surgery is performed the medical staff will be able to give her a speaking valve where she can verbally communicate.
Cassie continues to remain on dialysis as it is helping to offload the fluid from her body. Her pacemaker wires were removed as she has not had to use them since she has been taken off ECMO. Please pass along your prayers to Cassie as she will be heading back into the OR tonight.
Cassie continued to remain stable. Today marks 19 days since her original valve replacement surgery. Overnight Cassie was able to get 8-9 hours of rest and reduce her blood presser medication. She continued to use the ventilator throughout the night to allow her body some rest. This morning she once again passed the Respiratory team’s “stress test” and the ventilator was turned off. She remains intubated but is continuing to breathe on her own. Three of the 6 chest tubes that remain in her will be removed today. This is because they are no longer taking out any liquid from her body. All 3 tubes on the left side of her chest will continue to stay in-tact until the fluid stops flowing from these as well.
Cassie is scheduled to take her 11th trip to the OR tomorrow where the ENT team is planning to perform a temporary tracheostomy. This surgery is required as she doesn’t have enough strength to protect her throat (e.g. coughing or clearing her throat). She continues to remain on dialysis to help cleanse her blood at a faster than normal rate. However, her kidney function has dramatically slowed down. Sonography confirmed that her kidneys are still functioning, but the ICU team has concern for her future state kidney functionality.
At this point the demarcation in her left leg has stopped, and there is no demarcation above her left knee. Cassie is also scheduled to take her 12th trip to the OR on Monday (5/5) to clean out the wounds in her left leg, ensure there is no infection, and redress the wound vacs.
ICU team’s goals for the day are to continue her fluid offload (targeting 1 liter of fluid offload per day), let her breathe without the support of the ventilator, increase the angle that she can sit up (45 degrees is as far as she’s gone), and monitor her usage of blood pressers. The family appreciates the continual thoughts and prayers as Cassie continues her fight.
Cassie has continued to remain stable. The Respiratory team evaluated her this morning to perform an extubation. However, she did not pass the final evaluation by the team and has remained intubated throughout the day. The ICU team requested a consult by the ENT team to assess her for a temporary tracheostomy. She will continue to be evaluated each day this week to perform an extubation, but if she is unable to pass the assessment the ENT team will conduct a tracheostomy. This morning she was very awake and aware meeting with the family and sitting at a 45 degree angle. Since her blood pressure has continued to be more stable the ICU team is sitting her more upright, which allows her to breathe easier.
Throughout the day her blood pressure continued to decline, which resulted in the ICU team having to increase the blood presser medication. She must continue to maintain a high blood pressure to ensure there is blood flow throughout her entire body. While her blood pressure dipped, her blood became more acidic. This is caused by her being unable to expel CO2 in her breaths. Cassie also had to be supported in a light setting by the ventilator to reduce this acid. Overnight the ICU team will look to reduce her use of blood pressers and take her back off the ventilator.
Lastly, rheumatology confirmed that she does not have Vasculitis and at this time are still unsure why her initial heart was unable to restart following her original valve replacement surgery.
