Wednesday, June 1, 2011

PT Day 10, by David

Some very small positives.  One of her physicians made a wise statement yesterday "bad things happen fast and good things happen slow". Any small positive we like. (TIGT _ that is a good thing).  She will be mad at me for telling everyone this (and that will make me happy because it means we are heading towards normal ;-),  she had a little poot yesterday (TIGT if you can believe it).  Let me explain.  With all of her trauma and medications particularly the narcotics for pain, her GI tract has not been working.  Not unusual.  Your stomach, small bowel and colon walls are primarily muscle.  It contracts rhythmically in waves (peristalsis) to propel everything through.  This has not been happening since day 1.  Tried early on to give her nutrition through her nasogastric (NG) tube (tube through the nose into the stomach) but she was not having any peristalsis so whatever was put in her stomach sat there.  This was stopped and TPN (total parenteral nutrition - fed her through her IV) was started.  When you see a doctor listen over the abdomen with their stethoscope they are usually listening for bowel sounds.  If there is no peristalsis then no bowel sounds.  Jan had some faint sounds recently so have tried again to give her nutrition through her NG tube.  Started with small volumes and so far the stomach has been emptying (TIGT).   If it goes in, something has to come out and the first sign is gas thus the poot (TIGT).  (Going through this really makes you appreciate the small things.  Don't forget to stop and smell the roses).  She continues to be on multiple antibiotics to quell any ongoing infection and prevent any new ones.  Her temperature goes up intermittently, only a little, but the nurses quickly jump on this with tylenol and cooling blankets.  She still remains heavily sedated and on a paralytic.  This keeps her comfortable and allows the ventilator to do its job efficiently while her body and lungs heal themselves. She was beat up badly and will take a lot of healing.  The concentration of oxygen being given is 60% (TIGT), oxygen concentrations higher than this can produce some damage to the lung tissue which is why getting her down to this level is important.  Next step to work towards is to get it to 40%, then try to start getting her off the paralytic, start decreasing the sedative and narcotic and work toward her breathing on her own off the ventilator.  I am hoping during this we will see those beautiful little eyes open with questions of what is going on.  Man I love that woman.

 I have to remind myself to be patient.  She is still not out of the woods yet.  I get to go in and see her five times every day,  I do not miss any of these visits.  We are allowed 30 minutes each visit.  Several people have asked me if I could not just camp out in the room.  Not a good idea.  The nurses have a job to do best done without my interference.  There is an excellent nursing staff in this CCU.  I do not know if My Little Darlin hears us but everyone who goes in to see her talks to her.  If she does hear she probably will not remember but it does me a lot of good.  I think I mentioned in an earlier post the knot I always have in the middle of my stomach.  It is always a bit more intense just before I walk into her room with each visit.  When I quickly look at her and scan all of the visible information on the monitors  and see no problems it eases.  It will not go away until we leave this hospital.  I love My Little Darlin.  What happened to her was almost my worst nightmare and it almost was my worst nightmare.  I am going to say over and over again,  do not forget what happened to My Little Darlin.  Get a mad on about this.  I have one.  Get yourself stirred up by closing your eyes and truly imagining this was someone dear to you such as your child or spouse.  Not all of you know Jan and I appreciate all reading whether you know her or not, but those who knew her can more easily visualize what she went through during the impact.  I want everyone to imagine this in a graphic way to keep it imprinted on your mind.  Otherwise we will become passive and forget about it.  Do what you can to not let this happen to anyone else.  Put that cell phone down.  Nothing is that important.  Give plenty of room to everybody vulnerable on the road or as I heard somebody who came by say protect them with your vehicle if they are in potential peril.

My friend, fellow cyclist and triathlete Jim Brown has taken the bull by the horn and gotten the ball rolling to get more signs up in Starkville and Oktibbeha county, If anyone in these areas knows of places they think a sign for share the road should be placed please let us know.  If your area does not have share the road signs up then get on it.  Talk to your city and county officials to get it done.  Another friend, Hillary Cassibry, is in the early stages of organizing a bike week  for Starkville similar to what Danielle Frerer (sister of John Paul Frerer who was tragically killed last year by an automobile while riding his bike, he was 18 years old.  DO NOT FORGET JOHN PAUL) did here in Tupelo two weeks ago.  There is an email circulating  by the League of American Bicyclists.  It asks for you to send a letter (all you have to do is sign and send) to your congressman about a bill that includes funding in a transportation bill to include bicycle and pedestrian projects.  Would someone out there more computer savvy than I am put a link on this page to that please?  Also get on your bike or put on your walking or running shoes and get out there and be seen.  The more of us there are the safer it is.  Also getting and staying healthy is what this is all about.  Jan would want you to get out there.

I love MY Little Darlin, Thank goodness for the small things,

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