Sunday, October 26, 2008

Water, Water Everywhere and Nobody Will Give Me One Measly Drop

I'm not kidding when I tell you this: I have NEVER been as thirsty in my life as I was in the Surgical Intensive Care Unit after my transplant operation.

For what seemed like an eternity I wasn't allowed a sip of water, a sliver of ice, nothing - except for some laughably inadequate miniature, flavored sponges that had been dipped in water and placed in my mouth so the moisture could re-hydrate the Sahara-like landscape that used to be my tongue and gums. Talk about your "drop of water in the desert!" The sponges were pitifully insufficient and I was desperately miserable.

I wasn't able to consume any liquids because keeping my stomach empty would help reduce chances of nausea (and vomiting after major surgery would be spectacular painful and unpleasant). Additionally, if I experienced complications that required more surgery, I had to be ready to go at a moment's notice and surgery must be done on an empty stomach. [As it turned out, I went back to surgery the day after my transplant AND again the day after that.]

My poor husband, to whom I pleaded for water or ice, was alarmed when he tried the suck-on-a-sponge technique. Instructed by the nurse to use the sponge to swab the inside of my mouth, Gene jumped when I clamped down on it and "sucked it dry in seconds," before he could attempt to swab. I couldn't help it - I was just so damn thirsty! What made me cry, though, was when I begged a dear friend - someone whom I could always count on, a partner in crime, no less - to bring me ginger ale and she didn't, telling me that it was extremely dangerous and all that other doctor-like blather. If she wasn't going to rescue me, I knew no one would.

Since that time, I've often wondered if there weren't some product, some better way, to relieve the dry mouth and thirst of post-op patients like me. Several months after the transplant my dentist introduced me to Biotene products to help offset the dry mouth I experienced as a side-effect of medication and they worked pretty well. And recently, physicians allowed us to bring a similar product (Oasis) to the hospital to give to my Mom after she had surgery (she wasn't in ICU, however). Neither product requires a prescription and can be purchased at a drug store or pharmacy.

So are these kinds of products being used in ICU? Can they be used? While digging around for data about oral moisturizers I learned that oral health is especially important for critically ill patients and people with breathing tubes (such as moi) because bacteria that grows in your mouth can dislodge and potentially cause infection. According to Dr. John R. Ashford Ph.D., CCC-SP of Tennessee State University and Vanderbilt University School of Medicine:

Intensive care nursing is now using toothbrushes with suction tubes attached to catch secretions while brushing and to help prevent dislodging and swallowing of bacteria by patients. The results have been very good. Some other findings have been that the green sponges often used in oral care are essentially worthless and may do more harm than good. Likewise, lemon-glycerin swabs. The glycerin swabs alone appear to moisten the mouth and do not clean it, but the lemon additive may, in fact, act to dry out the mucosa of the mouth - the opposite of what is desired. dated 1/1/2007

I honestly don't recall what my ICU nurses used. Yet I don't recall my doc telling me anything about this. But I'll be certain to raise the question if I'm ever in that position again.

And so, as I told my family and friends after this experience, and with apologies to Scarlett O'Hara, "I'll never go thirsty again." And you can take that to the bank!

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