• Thomas: From Apprehension to Progress

    Thomas, 51, was admitted to a short-term acute care hospital July 30, experiencing numbness and tingling of extremities and shortness of breath. Following respiratory failure and intubation, Thomas was trached shortly after admission and diagnosed with Guillain-Barré Syndrome.

    Pulmonary complications included multiple infections, recurrent pneumonia, and mucous plugging. He was treated with two full courses of IVIG, a plasma protein replacement therapy. Other complications included hypotension, diabetes mellitus and obesity.

    After stabilizing his condition, Thomas’ doctors at the short-term acute care hospital realized his recovery would be slow and that he would need extended acute care. He was transferred to Kindred Hospital San Diego for ventilator weaning, rehabilitation and stabilization of diabetes.

    Thomas was admitted to Kindred Hospital San Diego on August 25. The Kindred San Diego weaning protocol was initiated on the second day of admission after assessment by our pulmonologist. The next day a Passy-Muir speaking valve was initiated in-line on the ventilator by Speech and Respiratory Care. Chest percussion was initiated using vest therapy to break up the mucus caused by his respiratory infections.

    The first phase of weaning, transitioning from full ventilatory support to CPAP and pressure support, went slowly. Thomas was anxious and sometimes refused to participate. His Pulmonologist and family members encouraged Thomas and were able to dissipate his anxiety.

    Thomas’ strength began improving quickly. He progressed through the weaning protocol without stumble. Thomas was able to use the Passy Muir speaking valve most of the day. By September 13, Thomas was completely off the ventilator for 24 hours.

    Rehabilitation therapies were also initiated upon admission for Thomas. Kindred’s physical, speech and occupational therapists began working diligently with Thomas in their individual areas five times per week.

    On admission he required a feeding tube, total assistance for bed mobility and was weak in all extremities. By September 13 he was swallowing a soft diet and liquids and using adaptive equipment to brush his own teeth. He was also able to sit on the edge of bed for 20 minutes with standby assistance and was recovering active movement in his lower extremities.

    The interdisciplinary care Kindred Hospital provided coupled with Thomas’ willingness to work and his family’s support allowed him to make immense progress. No longer requiring the high-intensity care Kindred Hospital provides, Thomas discharged to an acute rehab facility for continued therapy.

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