Vicenta: Recovery Despite Complications

Vicenta, 86, was admitted to Balboa Naval Hospital on January 31 for abdominal pain.  Prior to this she was independent at home with her family. After a lap cholecystectomy, she could not be extubated.  She suffered multiple complications of surgery including a small bowel obstruction, pleural effusion and atrial fibrillation, and an irregular heart rhythm.  She was weaning from the ventilator for approximately two hours a day but was not progressing prior to admission to Kindred Hospital San Diego.

She was admitted to Kindred on February 16 for ventilator weaning and management of conditions complicating her hospitalization including diabetes mellitus, hypertension, diverticulitis, deconditioning and a sacral decubitus ulcer.

On February 28, she was placed on the weaning protocol. The speech-language pathologist started her with a Passy Muir valve in-line with the ventilator on March 2.

The next day, she was started on TTAV (trans-tracheal augmented ventilation), per the weaning protocol, so she could speak during her weaning sessions. She progressed steadily and gained strength with the addition of aggressive physical and occupational therapy and speech-language pathology for the next two weeks.

On March 15, Vicenta was weaned from the ventilator. On March 18, she was decannulated and her tracheostomy tube was removed.  She was discharged on March 23 to acute rehab with a plan for ultimately going home.  By this time she had made good functional gains in occupational therapy, was able to complete basic activities of daily living, was ambulating 60 feet, and was swallowing pureed foods.  

We look forward to a visit from Vicenta and her family in the near future.