Tuesday, September 20, 2011

Chocolate and Chuckles

Today was a pretty good day for Derek.  His spirits were up, he rocked it out in surgery #27, and he was visited by a congressman.

Congressman Rodney Frelinghuysen from the 11th district in NJ (our home district) came to chat.
Derek described some of his experiences in the hospital.  "They sit there and start screaming at me!  Like I cannot hear!  Or they come in in then middle of the night and say 'Derek, Derek!'"  He made his voice get very high when he said his name and with the valve it sounded so funny.  He had the nurse in stitches.  They talked about their experiences in the war, with Congressman Frelinghuysen discussing his time in Vietnam and how that affected him.

Derek also stated that before this incident, he had said that if he ever lost his legs, he would have just wanted to die.  But now that it happened, he is just happy to be alive.  His whole perspective has changed, and he said his priorities are different.  I love his attitude.

Congressman Frelinghuysen left us with bags of M&M that Derek immediately tore into.  After that, he had a chocolate donut.  He had chocolate all over his face and fingers!  Just like a little kid again!
It was a wonderful visit, and we were very happy to see Congressman Frelinghuysen.  What a nice man he was.

Surgery....  Washout of the arm, and it looks good.  On track for the flap next Monday.  Infections are getting under control, and they hope to stop all antibiotics in another two weeks.  Wound vacs were changed, incisions were checked, wounds were debreaded and closed a little more.  Also, Derek's trach was reduced from a size 8 to a size 6.  He said he can breathe better now, and it is easier to talk.  Although.... I heard all this from Dr. Gooddlet and the nurse NOT the surgeons as I would have done if we were still in the ICU.  The only team to come and talk to us was urology.

And.... we are off droplet!  Yay!!  No more masks!  *happy snoopy dance*  Yes, I'm a geek.
When Derek returned from the PACU (our first trip there), the first thing he said was to Krystina - "you look beautiful."  awwwwwwwwwwwwwwww

Dr. West came in and asked how things were going, and we relayed our little incident from Saturday with the RT and me kicking her out of the room.  He hung his head and shook it from side to side making Krystina lose it.  He will commit me before this over.  I will go quietly.... maybe.

Derek told Dr. West I was freaking out over something.  I joked with him later why he said that when I was just talking about it.  He said he was just kidding.  When I asked him what I was going to do with him, he mumbled, "you've got a year to figure it out."  He is starting to feel bad about Krystina and me being here and dropping everything at home.  He talked to Dr. West about it today, and Dr. West said it could be a year or more before he is through rehab.  I am not staying a year, and I tried to tell him that.  I told him I was only staying until his serious surgeries were over and he could manage better on his own.  Krystina will be with him after that.

But I couldn't leave him like one of the soldiers down the hall.  Someone from Derek's Platoon was in his room alone today.  He had had surgery this morning, and this afternoon,he was sitting there by himself.  He had come to visit Derek a couple of days ago, so I went in and sat with him for a while.  He is a nice kid.  I can't stand to see anyone go through this alone.

The disconnect of the flow of information between the patient and staff on the ward is still my biggest problem.  One example is I said yesterday I wanted to be there for Derek before he went to surgery and would be back by 06:30.  Well, while on the floor, first case leaves for PACU by 05:30.  If he hadn't been late, I would have missed him.  In ICU, they do not go to PACU either before or after.  No one told me of this change.

I am used to the easy flow of information from being in the ICU.  I have a team of doctors making decisions about Derek, and we have yet to meet them.  I know two of them, Dr. Bograd (resident) and Dr. Gooddlet (intern), both of whom were in the ICU, and Dr. Gooddlet was around today and Dr. Bograd yesterday, but I have not met the staff doctor, Dr. Carpenter, or the chief resident, Dr. Moore.  I hope to change that tomorrow.  I don't want doctors making decisions about Derek without meeting Derek and having a discussion with me.

They had intended on starting Derek back on the methodone today.  Had I not been in the PACU with him, that would have been done.  I understand that this is a big file; however, it was only one week ago when methodone and/or klonodine and/or a combination of the other meds sent him into the stratesphere.  It is WAY to soon to think about that, and no way am I going to allow that.  I do not like the way they just start him on meds without a conversation with me.  THAT will change with my conversation tomorrow.
I mentioned the Tylenol and my concern yesterday. I discussed it with Dr. Gooddlet today, and with Dr. Fiske, the infectious disease doctor.  Dr. Fiske is very against him getting Tylenol and did not even know about it.  She said it is very important not to mask the fevers since they are such an important diagnostic took.  Polytrauma patients are very tricky since there are so many teams balancing different injuries and concerns.

I was curled up on the chair in Derek's room today reading when a woman in a navy uniform popped her head in and said, "are you the nurse?"  Really?  If I was the nurse would I be curled up on the chair reading?
We had a dippiest RT today.  She asked Krystina to lift Derek so she could readjust the vest for his therapy. ???  Kystina is 5 feet tall and 100 lbs soaking wet.  She could barely lift Derek's arm (sorry, honey).  And this woman actually expected her to lift his entire torso without help?  Are you kidding?
Tonight's RT was the peppy one from the ICU who used to come in in the middle of the night using her outside voice.  She was SO excited to see Derek on the floor, talking and eating.  BIG improvement from the last time she saw him.

So, many more improvements today then set backs.  Those are good days.  We'll take them. 

Good night, and God bless.

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