Tuesday, August 30, 2011

Broken Bed and a Broken Heart

This morning the white cell count was 24.5, down a little.  Fever was 100.7.  CPAP was set at 10 and 5.  After surgery he was back at VC-AC, but they put him back on CPAP at 12 and 5 a few hours after surgery.  We are hoping to get him off CPAP and back breathing completely on his own in a couple of days.  Those infections are still in his lungs, but the secretions are getting less.  They have to suction him less and less from down the trach.

This morning I got so excited and started dancing around the room when Derek moved his thumb and forefinger on his right hand!!!  The nurse asked him to move it and he did!  This was her first time working with him, so she didn't understand my excitement.  When I explained it, and when she saw how excited his night nurse Trista was when I told her, she got it.  This is big!  It means the nerves, tendons and muscles are starting to repair themselves!  Go, Derek!

Surgery 18 went well.  The left leg was swollen and red and there is fluid on it, but no infection was found.  There might be bacteria on it, but it is not infected.  They washed out the left leg, for the first time in a while, the right leg and replaced the antibiotic beads and the right arm.  They also checked all of his other wounds and said they looked good and were healing nice.  The wounds on his back and butt are still causing him problems.

The fixator on his pelvis will be there a while yet, because the pelvis is not healed.  But the jaw looks good and he is opening his mouth wider every day.  We have to force him to do his jaw exercises, because he says he is too tired.

His stomach/intestines/gut has not been processing his tube feeds or any of his oral medications, which stinks because his nuerontin for the phantoms pains and the tylenol are both oral.  To find out if there was a blockage, and to see if the fluid was infected, they did another CT scan.  They did one last week, but with only oral contrast.  This time they tried oral contrast, but it didn't work, but they also did IV contrast.
There is a lot of fluid around the lungs, the lower part of the lungs have collapsed, there is a lot of fluid in the lower abdomen but it does not look to be the source of infection, and they believe that the newest medication (methylneltrexone) will get the GI tract moving again.  The lungs they believe will re-inflate and be okay once they get the infections and the attendent secretions out of them.

And tomorrow they are going to do a procedure to help with the tube feedings and GI tract.  Right now he has a gastro-tube for feeding, but he is going to have a gastrojejunal (GJ) tube.  This placement is a minimally invasive, image guided technique in which a special soft feeding catheter is placed through an existing hole in the stomach (gastrostomy) into the small bowel (jejunum).

The worst part of the day for Derek was his damn bed.  Derek has a special bed because his wounds weep and he had been sitting in a soaking wet bed.  4 - 5 times each shift the nurses would have to change him.  Those changes would effect his blood pressure, heart rate, breathing, etc.  When he was septic and/or otherwise unstable, they would be unable to change him, so he would be forced to lie in a soaking wet bed.  This caused the wounds on his back and butt to deteriorate further.  He had two stage 3 and one stage 2 wounds, or so I was told before he got his new bed on August 19th.  The new bed allowed air flow below him which kept him dry.  It allowed the sores to heal so that they are now stage 1 and 2.

The rep from the bed company came today and fooled with it and broke it!  Right after surgery!  She touched something and it deflated.  When she tried to reinflate it, it started rotating.  Then she had the nerve to say that when it was deflated that he was okay because there was a pad under it and he was lying on the pad.  I checked.... he was lying on hard, cold metal.  I told her so.  His nurse from the other day, Pete with the bright orange laces checked and snapped his fingers to get the new bed in there immediately!
My heart broke as I watched them pull him to move him over to the new bed.  He was in so much pain.
Then the witch said to me that the bed would need to be taken back and checked out and that we should have it back in about a week.  I went through with her what I just said above about the wounds, the wet bed, the stats, etc. and the reasons Derek needed that bed and why he could not stay in the replacement bed he was on for more than an hour or two.  I told her that she better find him another exactly like the one he had within a few hours or else.

They found one.  I was told it would be down in CT scan for when he came out of the machine.  But then the brainiacs brought it to his room.  Why?  This poor kid, on surgery day, had to be moved from the deflated bed to the other bed to the CT table to the other bed to the new bed all because they didn't bring the bed to the CT room.  Dumbasses.  But at least they replaced it right away.

And special prayers are needed tonight for a young woman at Bethesda facing an unspeakable horror. Her husband was shot and is on life support. There is little to no hope. She has a 2 yr old and is pregnant. His family is threatening to sue her if she makes the decision to end efforts. His father who was not involved in his life wants to sue the army for this tragedy. My heart breaks for her.

I can understand the anger and frustration of this.  I remember the mother who wanted to sue when her son was killed in Iraq.  My political beliefs are well known by my family and friends.  This is not the place to air them, but I want to make it clear that I neither hold this administration nor the last one responsible for what has happened to Derek. 

I knew that this was a possibility when he joined the military, and I knew that injuries could occur.  I did not realize that it was this bad, because the media does not let us know that this is going on.  But I knew that he could be hurt, or, God forbid, killed.  I begged him not to join the infantry, but he was gung ho.  He wanted to be a warrior.  I was so proud of my son's bravery and determination. 

I knew when I last saw him on March 19, 2011 at 3:00 a.m. and watched him march down the street with his platoon that I might never see him again.  I hugged him and said, "see you later," because I could not say, "good-bye."  Every time I chatted with him on facebook or had the occasional phone call, I ended it with "love you, miss you, be safe."  His attitude was that he was fine, and nothing would happen to him.  But I knew better.  I am lucky that he is still alive.

I still have him able to communicate with me.  I still have hope that he can fight these infections.  Amanda is facing the ultimate decision.  Please remember her and her adorable little girl in your prayers. 
God bless you all.

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