How High is High?


Yesterday I had the opportunity to go in and visit with my sister-in-law through the midday.  Usually I am in during the evening shift and there is not a lot of technical work being done.  When I was in yesterday I was able to observe one of the breathing exercises that they are conducting to prepare her for the removal of her tracheostomy.  It’s quite simple really, they remove the trach hose and loosely fit an oxygen mask over the trach opening to ensure oxygen flow.  She is then forced to breathe on her own while being monitored by the technician and the machines.  Although she did quite well and wasn’t in any obvious distress with respect to her breathing, I left the hospital feeling very uncomfortable with what I saw.

Going into the breathing exercise her resting blood pressure was around 160-170/100.  Her eyes were quite dark and she presented as being in some sort of discomfort.  During the actual exercise her blood pressure rose significantly, to a point where I didn’t think it was possible without all sorts of alarms going off.  I’m talking 250/120.  Can you imagine what her head must have felt like – it must have been like jackhammers pounding in there.  I finally had to speak to the nurse, no one seemed overly concerned at this potentially lethal blood pressure.  In discussion with the nurse, she advised that my sister-in-law had a headache earlier on and that she would administer some more Tylenol to help with that.  She also stated that it was time for some blood pressure medication and she would get that into her too.  The nurse also stated that these breathing exercises do tend to put my sister-in-law’s blood pressure up.  If they are aware of this can’t they do anything prior to commencing the exercises to ensure that she doesn’t face any additional unnecessary risk?

It was all very clinical and detached.  Too detached I’m afraid – it bothered me all night.  My sister-in-law cannot lobby for herself, she’s voiceless at this point in time.  I wonder what the protocols are for this type of situation?  Her son has the same worry as I do in this regard and was going to speak with the doctor this morning.   It seems to be pushing the boundaries a bit unnecessarily allowing her blood pressure to go so high.  We don’t need any more complications, she has been through too much already.

One comment on “How High is High?

  1. Jenny you have to relax about all this, you are stressing yourself out! They got her through the worst didn’t they, do you think they would do any less now? (I really feared for her at first but she has come through the worst very well). That particular reading was at that point in time, what were subsequent readings? Haven’t you ever had a stress test? Your body is continually adapting to its circumstances, BP and pulse reflect this. You would not believe how high your BP goes when you have a bowel movement, that is why most with cerebral aneurysms rupture while on the toilet. If they depress her BP to control it when she is stressed then she will bottom out when resting. I would be interested in her reading about 30 minutes after the respiratory tech was finished.

    Relax, you have enough to worry about…..stress depresses the immune system and lead to all sorts of problems, will you have them all get better and then you fall apart????

    I was going to start that blog about being a community health nurse but I am so pissed with the system and how it treats the elderly I don’t dare write a word yet, if I quit, look out though!!!

    GJB

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