Tuesday, September 27, 2011

Back to SICU...

Tonight Derek is in the SICU, and not for the reason he thought he would be there.  We had expected to be in the SICU tonight because Derek was scheduled to receive his flap this morning and that requires a three day stay in the SICU.  After leaving Derek in PACU this morning, Yvette and I walked down to SICU to see where Derek was going to be and which wonderful SICU nurse was assigned to him.  We met Priscilla in the hallway and with a big smile she said she had him!

I later received a call from Dr. Martin advising that they were unable to do the flap due to blood pressure issues.  Derek has had an issue with a drop in his blood pressure under anesthesia.  So now what?  They are going to have a meeting with the plastics team, ortho team, anesthesia team and trauma team to discuss the best course of action for Derek.  This progressed over the course of the day.

It culminated in meeting with Dr. Martin in the hallway outside PACU.  He walked up and said I was a hard lady to find.  Really?  I have my cell phone, and I was sitting in PACU all day.  Is his first name Steve?  We discussed what happened in the surgery, and he finally told me what they gave him to try to even out his blood pressure.....  I was wondering why Derek was talking about kids in the hall, music playing too loud, things in the air, etc.....  They gave him ketamine.  Dr. Martin thought it was funny.  Seeing it from his perspective and thinking of it as a temporary fix, yes it was.  So after the meeting on Wednesday, we will try again on Friday... maybe.  We will see how the week progresses.

Anyway, that's the flap story.  Now to progress through the day and how he ended up in SICU....

On the way over to the hospital with Yvette for some puppy therapy, we ran into Dr. Purdue.  I filled him in on the events of the weekend and how close I came to calling him.  He said he would check things out and get back to me.  We then proceeded to Amy's office.  She is the Health Care Mediator and Mommy to Sgt Archie.  She had Bobbie and Laura Lee with her, so we had some puppy therapy while telling her what happened this weekend.  She said she would do all she could and try to find out what happened and get back to me.  Love her.

Down to PACU by 12:30.  Met with Dr. Perdue, Dr. Bograd, Dr. Gooddlet.

The good things about surgery, and the positive steps taken are Derek is now down to two wound vacs!  He has one on his right arm and one on his right hip.  They removed the x-fix from his right arm.  They did not place the piece in the fracture because it is stabilized by scar tissue.  They said they will wait for the flap.  The problem is his wrist has not moved in 9 weeks, so it will be hard to move and will need extensive therapy going forward.

Great news is his white count is down to 7!!!

Dr. Perdue evaluated Derek and discussed his breathing issues with me.  They were ready to send him back to the ward and Dr. Perdue asked for one more hour.  Within that hour, the SICU team came and evaluated him.  They did an ultrasound of his heart and lungs.  He still has a large amount of fluid behind his left lung.

The decision was made to transfer him to SICU at least for the night for increased monitoring and respiratory therapy.  He is having increased secretions, so they are giving him new meds.  They are continuing the Lasik for the fluid and also giving him another diuretic (sp? - too tired to look it up, sorry).
The difficulty with Derek's current status is that he is not quite an ICU patient but he is not yet a ward patient.  They really need a step down unit.  They cannot really justify keeping him in the ICU at his current status, but he is not ready for the ward, so they gave him a one-on-one corpsman.  The problem is when he is having the respiratory distress, the corpsman is not really qualified to deal with it, so that is when he should have been transferred back to the SICU but the resident did not make the right decision and overtaxed the nursing staff on the ward.  If this was just me being an oversensitive Mom, okay, but the charge nurse was upset.  I've seen the nurses calm, cool and collected.  It takes a lot to rattle them.  This one was rattled.

We will see what tomorrow brings for the SICU placement and getting him back to the ward.
As for his tummy issues, the doctors today say that no way was the J-tube in his stomach last week.  It could not possibly have flipped until Friday at the earliest.  If it had gone sooner, the tube feeds would have been coming out the G-tube.  They restarted the tube feeds tonight into the G-tube, so we will see how he tolerates them.  They had to place the J-tube on August 30th because he was not handling his tube feeds into his G-tube, but that was three weeks ago.  He might have improved enough now to tolerate it.  Let's give him a chance before putting him through that procedure.

What I am upset about is that he needs nutrition and calories in order for his body to heal.  For wound care and muscle tone and all over body health, he needs it.  He is not getting it.  They started the tube feeds, so now let's see if he tolerates it, and if he does, great.  If not, then let's act fast.

So, tonight Derek is in SICU after being with Priscilla for the evening but for a different reason than we thought (I surely did not miss the sounds of the SICU).  His nurses tonight are the awesome Tom Diggs and Leah Stanley.  I feel comfortable getting my five hours knowing that he is being contantly monitored.  I will be back at the hospital at 06:30 tomorrow morning to meet with the doctors (Dr. Dan - who finishes his SICU rotation this week), and find out what the next step is to get this kid better!  Enough is enough already!

An extra special thank you to Jessica Allen for coming out of her way to drop off a delish dinner to Krystina and me.  It is great having someone who has already been through this process to talk to and cheer me on.  This is exhausting and emotionally wretching.  I've held myself together pertty good for the last 59 days.  However, over the last two, I have found myself on the verge of breaking down more and more. 

I have had to walk away more than usual.  Talking to one of the doctors today, when he was giving me the PC answers when I was describing one of the screw ups from the weekend, I said, "Don't.  Just don't.  Don't go there.  Don't say that.  I do it to my clients when judges screw up orders or don't do what they are supposed to do.  I know what you are doing so just stop because I just cannot hear it right now."  I couldn't hear it.  I apologized to him and gave him a hug, and he showed me pictures of his adorable baby girl, so I know he forgives me.

For everyone who has been through this, you know.  You know the hell we are living.  For everyone looking in from the outside, this is the war on the homefront that is not publized.  Health issues with loved ones are awful.  I've lived them.  I've watched my children suffer through illness, some of it life threatening.  I sat with my grandmother through numerous injuries, illnesses and the end of the life.  I watched my mother battle cancer, pnuemonia, and made the call at the end not to code her.  Health issues are not new to me.

But it's even harder when it's your child, husband, brother who was full of life, healthy, in the best shape of his life seconds before being struck down by tragedy in the line of duty protecting the lifestyle and freedom that we all cherish....  AND most of America goes about their life never knowing about his daily fight to simply take his next breath.

For all those who are going to walk this road in the future, when that door to your old life closes, may God be with you and guide you through the hallway until you reach the safety of the next door to your new life.  That new life is a wonderful life full of promise and new beginnings.  It's this hallway that is pure hell. 
I hope Derek reaches the door soon.  My back hurts and Krystina's feet hurt.  I won't falter because I've got lots of love and support holding me up, and I've got God as my rear guard, but I'm getting tired.  I will continue to be strong and I will continue to keep fighting as long as Derek needs me.
Derek has a great attitude.  He is disappointed today due to not receiving the flap, and due to being back in SICU due to breathing issues.  I tried to reassure him as much as possible, and he said he will get through it, but he is tired.

So, here's to better days.  It's got to get better!

Good night, and God bless!

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