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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