PT Day 22, by David

It is Sunday evening.  They have again started backing down on My Precious Little Darlins sedation.  I can not keep the lump out of my throat, the quiver out of my voice or the tears out of my eyes.  I am as afraid now as I was when this first happened.  She and I both believe in quality of life. The reality of her brain injury will start becoming more apparent now.  I am so afraid that she will not recover to live the quality of life she loves living and it is tearing me up.  At the moment she will open her eyes but is totally unaware.  I hope and pray this is the drugs.  There are other subtle neurologic signs that bother me.  Many of my friends who have a combined massive medical knowledge and experience have reenforced that what I am seeing is at least partly related to the level and duration of sedation she has been given but Jan is my life and I can not help but fear the worst.  I still know how severe the impact of that car hitting her was and can not get that out of my mind.  There have been prayers said for her by a Methodist Minister, Catholic Priest, My Father, innumerable churches and most everyone who knows Jan and knows of Jan.   I have prayed and I have also questioned my faith because of this.  I feel totally helpless.  She is here because of a stupid senseless act.  The sad thing is there is no doubt the same stupid senseless act will be repeated and another life will be wasted or ruined.   This is an almost unbearable hurt.  I just want my solemate back.

Morning, PT day 22.  Her body body functions continue to do well.  Her blood gases are very good on 30% O2.  The next step will be to see how she does with less pressure the ventilator uses to help her breath.  Getting her off the ventilator is a slow weaning process.  Her sedative has been decreased.  Now it is at half the rate it was the past few weeks.  Last night it was at 1/3 the rate but needed to be increased because she was getting agitated.  The way she shows agitation is by breathing faster and less efficently.  Her tube feeding rate is where it is needed so I expect the IV nutrition will be tapered off and stopped in the near future.  Her GI tract is active.  She is still having fever up to 102 F.  Still do not know why.  Her WBC (white blood count) remains normal.  She is well covered on antibiotics.  Her bilirubin (liver function) continues to improve.

Her neuro status weighs very heavily on my mind, as if you could not tell by the note I wrote last night.  I  discussed my concerns with her neurosurgeon this morning.  I have a very high respect for and confidence in this man.  Her recovery from this will be months if not years.  The subtle neuro  changes are not surprising given the severity of the head trauma.  She is to get an MRI today.  As I suspested and he also suspects she likely had some degree of shear injury to her brain that can not be seen on CT.  The MRI should not change what is currently being done but will give a better idea of the extent of her brain injury than the CT and will give a better idea of expected long term recovery. 

There was a front page article about the danger of cycling on the road in the Jackson Clarion Ledger yesterday.  The newspaper blog for this article generated the most comments of all.  Many of these were written by thoughtful intelligent people.  Most reflected why Mississippi remains at or near the bottom in education, health and intolerance to being from different from their way of doing things.   Jan and I have traveled the world and have found that no matter where you are, what language you speak, what religion you practice or what color your skin is the overwhelming majority of all are kind, compassionate and caring people.  That includes Mississippi.  There are a very few who are not this way in all societies.  This was painfully apparent by the blog comments.  These few are an embarrassment  and danger to us all.

My former Mentor and Chairman of the Radiology department where I did my training sent me an interesting link , http://www.cellular-news.com/car_bans/ listing the number of countries that ban cell phone (52) use while driving.  He told me two of his Grandchildren who live in Germany were visiting last summer and were astounded that people use their cell phones while driving.  How many more people are going to have to lose their life before this is changed in this state and or country.  Is it worth the inconvenience to you before or after this happens to you or your family.  Think about it!!!

Jan was always joking that she wanted a bicycle that would allow her to go fast without sweating or breathing hard.  She also wanted to write a book with the title "How to do an Ironman Triathlon on a Ding Dong Diet".  I would give anything for her to ask me to go get her a Ding Dong and to see her on a bike again.  I do not know if either will ever happen.

PUT YOUR CELL PHONE AWAY WHILE DRIVING
SHARE THE ROAD, THAT IS A HUMAN BEING ON THAT BIKE
GET OFF THE COUCH

I Love My Little Darlin more than anything, She is my Solemate.  Unless you have lived it, this hurts worse than anything you can imagine.
David