My Little Darlin, PT day 23, by David

No matter what I say about Jan's progress this is going to be a very long and difficult road to recovery.  I have to keep reminding myself no matter if it is one of my down / depressed days or one of my up, things are bright days (mood swings more closely patterned to between visit intervals) that she does have a road and things could be worse.  I would like to say that I think these mood swings must be the way it feels to be a teenage girl ;).  Now for a TIGT.  Derek (Jan's oldest son and also a radiologist) and I have seen her MRI done last night and have talked to her Neurosurgeon who gave his opinion.  The MRI is better than I expected.  Do not get me wrong, it is not normal.  She has the fairly large area of hemorrhage in the right temporal lobe that we knew about.  This will continue to improve but will take time.  She has the small contusion in the right frontal lobe that is a known finding. This should not cause any significant problem.  No other significant findings are seen(TI VERY GT).  I fully expected other areas of injury in critical regions of the brain but did not see any.  Only time will tell but this suggest she could have significant recovery neurologically.

She also had a good night.  Her oxygen is at 30%, the ventilator rate was at 12 and PEEP (pressure the ventilator keeps on her lungs) is at 6.  She did very well with this and her rate has been decreased to 6 (TIGT).  She is still on a fairly large dose of sedative but this is being decreased gradually.  It will take some time to get her off the vent and sedative but her team is working towards that.  She is in training.  Her labs all looked very good this morning.  Did not check a bilirubin level this morning but her jaundice color is clearly improving indicating improving liver function.  She is totally off the IV nutrition now getting it all through her PEG into her well functioning GI tract (TIGT).  For an unknown reason her blood pressure has been going up and down without an explanation but not critically.  She is still having temperature spikes also without a clear explanation.

There has been one other time in Jan's and my past that I had a very brief fear for her life.  Several years ago we decided to do a white water rafting trip.  This is still one of my all time favorite trips.  This was a week long trip on the middle fork of the Salmon river in Idaho.  Just getting to the start was an ordeal. We flew into Boise then caught a small single engine airplane to Stanley, Idaho.  From there we took an even smaller plane to the start point.  This was interesting since we were flying between the mountains when the pilot did a quick u-turn and dove down to a small dirt landing strip in a deep valley.  For the next seven days there was no easy way out.  We were in a pristine designated wilderness area.  The river was clear and cold from the snow melt.  There were innumerable rapids many of which had to be scouted by the guides before we could go through them.  Between the rapids there were long spans of calm water where we would see river otters playing and big horn sheep on the river edge drinking.  We could swim as we floated or fish for trout.  At night we would camp on the river bank.  We had tents but some of us preferred to sleep out.  One night Derek and I were laying in our sleeping bags watching the stars when this extremely bright light slowly began coming over the mountain. It turned out to be the brightest moon we have ever seen. 
On the river we had several, all inflatable boats.  There was an oar boat that carried the gear.  You could ride on this and let the guide do all of the work.  The six man paddle boat where everyone had to work as a team to get through the rapids without flipping.  And there were several inflatable kayaks.  These always followed the paddle boat when taking the rapids under the watchful eye of the guide.  Before the start of the trip we had a lecture on taking care of the environment (you take it in you take it out, you see any even tiny piece of trash you pick it up, too bad people can not do this all over).  The best safety tip (we found out later) was if you suddenly find your self wet all over and dark all around the boat has flipped and you are under it.  Just go with the flow and feel your way out.  We also were taught about what to do if the boat lodged sideways against a rock.  When this happens the boat is stuck, held by the tons of flowing water force and pressing it against the rock.  When this happens you are supposed to lean towards the rock otherwise you can be pulled under the boat.  Well one day I was in the paddle boat with 5 others.  Jan and a few others were in the one man kayaks.  The river guide instructed the kayakers to wait until told before they took on the section of rapids we were approaching.  We took the raft down first but just before getting through we became wedged on a rock.  We were stable but not going anywhere.  My Little aggressive kayaker Darlin had started her run behind us too soon and hit our raft that was effectively a rock.  She leaned correctly toward us but the edge of her kayak was caught by the current and pulled under our raft.  Everyone that could put a hand on her was grabbing to pull her in our boat but the current was too strong and pulled her under the raft with the kayak.  I was on the back watching this.  I knew she was usually cool in a crises and had listened to the safety talk.  Can not say I was not feeling panicked, I was, but I turned to the downstream side of the boat.  After what seemed like an hour but probably  only a few seconds there she was, face up feeling her way calmly out from under the boat.  The speed and force I used to yank her out of the water probably scared her more than being pulled under.  She tells me my face was white with fear when I saw her and I do not doubt that.  Later that night she let on just how much it had scared her and cried herself to sleep in my arms.   I love My Little Darlin.

I am going to say again and again,  I feel strongly cell phone usage in a vehicle should be outlawed.  It is a luxury not a right and in a car they are as dangerous as a drunk.  Until it is outlawed, and it will be if I have anything to do with it,  put your cell phone away when you drive.  I do not know if this was the cause of Jan's horrible tragedy but this is one act that certainly puts one at risk and is easily prevented.  If you hit someone their life will be severely compromised or ended and your life as you know it will be forever altered in a very bad way and it should be!  You do not want to live through what Jan and I are going through.  Sadly what happened to Jan will happen again to someone else but we have an obligation to do what we can to decrease this risk.  We also need to continue to actively make people aware of all exposed (bikers, runners, walkers, workers etc) and on the roads.  Auto versus person, person always loses and usually in a very bad way.  People who ride a bike, run or walk should be encouraged to do so not discouraged.  I tell people everyday that if they would do things (exercise, eat right, do not smoke) to help themselves and improve their health they would not need people like me (physicians) and TIGT.

SHARE THE ROAD,  IT IS A LIFE
DON'T DRIVE AND CELL
GET OFF THE COUCH, LIFE IS FOR DOING STUFF

I Love My Little Darlin, she is my Solemate and I miss her BAD,
David