Saturday, June 4, 2011

PT Day 13, by David

As everyone reading these posts has figured out when it come to My Little Darlin's condition I have been on a roller coaster ride like never before.  The extreme lows have outnumbered the highs by a large margin.  The highs are only a relative term never actually having a high just  less anxiety.  Admittedly I grasp at the tiny changes that give me encouragement.  On the other side I despair with only the slightest negative.  Remember good changes happen slowly.  This is still going to be slow.  I do not want to sound too optimistic because Jan certainly is not out of the woods but today I feel more relief than I have in almost two weeks.  Maybe it helps that I got almost 6 hours of sleep last night but there are subtle changes that have me encouraged.  Her blood gases (oxygen and carbon dioxide concentrations in the blood and blood ph) were better than I have seen in a while.  This test is done each day and the results are used to help the pulmonologist change her ventilator settings.  They decreased the oxygen being given to her this morning to 50% (TIGT).  Also were able to decrease the rate (number of times the ventilator gives her a breath each minute, TIGT).  While sitting here writing her Neurosurgeon came by and told me the plan is to stop the paralytic today and let her start breathing on her own (TIGT).  This will allow him to do a neurological examination which means he will take the intracranial monitor out on Monday (TIGT).  We were starting to get paranoid about how long it had been in.  The longer it is in the higher the risk such as infection becomes.  Her Hg/Hct (blood count) have remained stable for two days (TIGT).  This had dropped several times over the past two weeks requiring blood transfusions.  Her weight is down a little(TIGT)  Remember I said previously her whole body is swollen.  She is probably more than 40 pounds over her normal weight (do not tell her I said she was 40# overweight, I would pay for that) from all of the extra fluid in her tissues.  Decreasing weight suggests she is starting to mobilize this fluid.  Her tube feedings were stopped yesterday.  Her GI tract is still not working.  I think this is just a matter of time.  Overall I am encouraged and feel she is moving in the right direction but we can not get too excited just yet.  She still has a long hard road ahead of her.  At the moment she remains heavily sedated and paralyzed,  swollen with broken bones all over, brain injury that we have no good idea what the long term effects will be,  damaged lungs and a GI tract that does not work yet.  But by some miracle that beautiful Little Darlin of mine is still here so she can get better.  I do not want to think about the alternative.

There are more good things that are happening because of this.  Jan will be proud.  One of my partners (My partners are not only extremely good docs but extremely good guys and friends, they are also my family) called me last night.     He knows how Jan and I feel about being physically active, trying to do the eating right thing and how we wish everybody would so that they could stay away from people like us (physicians).  Jan has inspired him and hopefully others.  He has begun the early stages of getting a rails to trails built from Columbus to Greenville.  This would be a safe trail that everyone could use and hopefully would encourage more people to get off the couch (TIGT).  Ironically the proposed abandoned railway runs very close to where My Little Darlin was injured.  He also had his bike and the rest of his families bikes tuned up for riding, he was going to check out the railway today on his bicycle !!! (TIGT)   We are one of the most obese, unhealthiest states in the nation and this is mostly preventable.  Jan and I would love nothing more than to see anyone and everyone out there biking, running, walking, swimming anything to keep yourself healthy and active.  When this happened Jan was training for her second Ironman Triathlon (2.4 mile swim, 112 mile bike, 26.2 mile run) at age 57.   I plan on doing this kind of activity with my Little Darlin until we are old (older) and gray (grayer).  You do not have to get old and feeble,  you should just want to get old. 

As far as the investigation of this incident,  the Clay County prosecuting attorney is looking into it.  I will post on this when I have more information.



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