Category Archives: Surgical room 19

Update/Upswing

Today brings some sunshine. Wethinks the end is in sight. Of the hospital stay, that is.

If you’re new to this storyline, my husband was in an accident on July 22. The unfolding is here.

Meds

On Wednesday, we got Roger off the pain med Fentanyl. What was gained from this?

  • Because delivering Fentanyl requires 2 tubes going into the IV and an additional control cord, as well as a stand that needed to go everywhere with him, the presence of this contraption meant that any movement, like simply putting on a gown, was a complicated project that practically required a spreadsheet to coordinate. Mobility has been regained.
  • The narcotic had been taking him away (think Calgon meets Quaaludes). Although he was lucid and able to talk, he was flat. The only way I can describe it is that he wasn’t there. Now his personality was regained.
  • No more headaches and nausea.

What was lost? His ability to have pain relief delivered at the touch of the magic green button. A worthwhile trade-off.

Chest tube

It’s still in. The problem is two-fold. First, until this morning, the top of the lung was separating from the pleura, meaning the vacuum seal that makes the lungs work was compromised, there was air in the chest cavity and the lung was still just a little collapsed. Today’s xray showed improvement.

Secondly, while the color of the draining fluid is now very light pink (which is good) the tube will stay in until the volume of the fluid is near 100 ml a day. The most recent check was 400 ml.

Prognosis

If tomorrow’s xray shows a lifted lung, and if tomorrow’s drainage shows not too much more than 100 ml, the docs will clamp the tube for several hours (simulating the absence of the tube, without taking it out yet) to see how Roger’s body responds. Will his body reabsorb the fluid? Or will it begin collecting in the lung?

If the latter, he keeps the tube in another day.

If the former, they’ll pull out the tube (they say it’s painless), play Wait & See for a few hours, and then pack up all the stuff the room has accumulated and come home. With a lot of Percocet.

And maybe something for Roger, too.

Roger just gave himself a sponge bath — guess I’ve been fired. He took a Percocet in anticipation of his first foray off the ward — we are having a date in the cafeteria. He looks very handsome in his gown and nearly full beard, and he’s carrying his own lung bucket. I am wearing the shirt Lollipop Goldstein sent me from BlogHer09 that says, Born To (front) Blog (back).

One of our more memorable Date Nights.

Show & Tell: What a Difference A Week Makes

My family last week at the Southwick Zoo near Boston:

Reed in the foreground, Tessa in orange, and Roger’s legs.

My view this week:

Roger is just out of sight, to the left. This is the self-medicator, the oxygen tank, the commode.

Tessa and Reed are in Park City, UT, enjoying the company of the rest of my family at my parents’ 50th anniversary celebration. They are all having a good time and missing Roger and me (and us them). It’s such a godsend that the kids are well taken are of and properly diverted.

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The bright spot of this past week is the astounding support that’s been directed at us, both online and IRL. It is, at times, almost unbearable (in a good way). A post is brewing on that.

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Brief update: Doc is fairly certain there are no neuro issues — I feel like she heard me and addressed my concerns. Changing up the pain meds to address the headaches/nausea. Roger is a “lightweight when it comes to narcotics,” in the words of the trauma surgeon. Chest x-ray looks better today, but he’s still having difficulty inhaling. Will start heparin shots in belly to avoid clotting in legs. But we also need to avoid bleeding in the lung. Changed the IV –they’re good for 4 days (I didn’t know that). He walked around the ward twice this morning, then I gave him a sponge bath and cap-shampoo. He’s been sleeping for several hours.

Thanks to all my medical friends and those who are well-versed in Hospital for such great advice. I felt emboldened this morning to speak up.

An while I am reading all of your comments, I am giving myself a pass on responding to each one. Please know I appreciate all your care, concern, advice and love.

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See what my classmates are showing and telling at Mel’s Show & Tell. And show something yourself (if you’re not already IN the class, you can join — we’re a very nice group).

Report from Surgical Room 19

It’s been a few days since my last Roger update, so here goes another.

Summarizing the last two days in two words? This sucks.

Roger was making incredible progress through the weekend. His voice was strong, he entertained a series of visitors, and he was up and around often. It seemed like the worst was behind us, and that he wouldn’t need the epidural after all — his lung was getting stronger and he was utilizing more capacity without more extensive pain treatment.

Turns out his clotting factor never did right itself enough to allow the epidural, which was no big deal.

Monday was a slight decline, which I attributed to all the activity on Sunday.

Today, Tuesday, things are Not Good. But I can’t put my finger on why. He has slept all day, is resigned and doesn’t seem to care about anything — walking, eating, talking, even watching the Red Sox. He feels nauseous (a side-effect of the narcotics) and gets frequent headaches (also a side effect). But the latest ick, he says, is pressure behind his left eye.

The current nurse and CNA are pretty responsive. There are times, before I get here in the morning, when he’ll sit for more than an hour waiting for someone to stop the alarm on one machine or another, for help getting untangled from all the cords going into his body so he can get to the bathroom, or for someone to address the nausea/headache.

The nurse says the eye/head pain is probably nothing.

I feel like something besides the obvious is wrong. All the professionals here look at just one piece of Roger: the orthopedist comes in daily to check the collarbone. The trauma surgeon checks in daily to see how the chest tube is draining (he had to go back on wall suction, as the xray shows blood pooling in the lung again — waiting on results from the more detailed CT scan). The nurses address his pain, and the CNAs take care of his bodily functions.

But no one looks at him as a whole, as a person. Probably the headache on just one side of his head is nothing, but SOMEthing is not right. And I don’t know what to do, how to advocate, to whom to speak.

This sucks.