Saturday, October 15, 2011


Yesterday, after several weeks of heart wretching battles, a pregnant, young wife and mother made the worst decision of her life.  At only 20 years old, when she should have been celebrating and anticipating the birth of her second child, she had to face a medical nightmare brought on by a bullet wound to the head of her beloved 23 year old husband in Afghanistan where he was serving with the United States Air Force.  It took her weeks to analyze the maze of medical data and satisfy herself that nothing more could be done to save her beloved Jerome.  The ventilator was turned off, and Jerome's heart stopped beating.
RIP.  A hero who served his country well.  Gone but never forgotten.

Darkness fell over all of us today.  Derek had a rough day, too.  He was third case, which meant no food or anything to drink (NPO) all day.  As a result, he was nauseous and vomited this morning.  Late surgeries are always rough.  And Derek's mood was really dark today.

He did get his dental mold done so they can finally make his pop-in!  He'll have teeth again!  Thank you Dr. Stasio for arranging to have Dr. Hammer (love the name!) come and finally get these teeth done.  Until he is able to get his implants, this will give him something.

Before heading to PACU, someone came by and mentioned that the notes from ortho said something different than what dead Dr. G had told me yesterday.  Oh the communication issues.

The orthopedic issue....

Derek would have surgery, and no one would give me an update.  I asked Dr. Bograd or Perdue what happened, and it's not their area.  Not right.  I've been complaining to them for weeks.

They send for x-rays without telling me why.  Then they do not come to discuss them.

Then this week, I ask for someone to come and talk to me, and they send a resident without answers.  I send him away to get answers, and no one returns until I call for them.  They send Dr. G in, and he is not on that rotation.  Dr G had all the answers, but that is not the point.

I asked to speak to someone in a staff position, who will actually be doing the surgery, and who will actually have the answers I need.  I said I did not want a resident or an intern, and that I would wait for the staff doctor at his convenience, even if it was sometime next week.  They sent Dr. Tracey, who I happen to like, a lot, but he is a resident.  He had all the answers, and he cleared up the confusion, but it wasn't what I asked for, and I will still wait to talk to the staff doctor.

On to PACU and the OR for the day.  Bumper cars with the bed!  Patient transport ran the bed into the wall a dozen times and almost every person we passed!  Even Krystina was yelling at them and she is quiet!  When we got to PACU, I vented to the anesthesiologist about them, and he said it might be the steering mechanism.  When he took the bed to the OR, he turned back to me and said, "Hate to break this to you, Mom.  It's not the steering mechanism.  It steers just fine."  Great.  Derek got bounced around for nothing.
Then the procedure took a long time.  It was supposed to be a quick dressing change on the flap and a check on the wound that re-opened, both to take no more than an hour.  Three hours later....

Breathing is a problem.  It wasn't quite as bad as when he ended up in the ICU, though, but it still went in peaks and valleys.  They did a breathing treatment in the OR to help break up the mucus plugs, and Dr. Bograd was already planning a chest x-ray.  I asked him to do it while Derek was still sedated, so he planned it for the OR.  Love him! 

The x-ray showed that the fluid is greatly reduced, but not yet gone.  They did a broncoscopy, and they found a lot of mucus plugs.  Mucimist was reordered for three days, instead of PRN, so the decanulation is on hold.  He had a guardian angel on his shoulder the day he was without oxygen and monitoring! 
When Derek returned to PACU, Dr. B led the bed.  He could steer it fine. 

Dr. Bograd is off to Fort Belvoir at the end of the month and the rumor of who is his replacement has me very excited.  I won't say it for fear of jinxing us!  Oh!  I hope it is true!  I do not want to lose Benji, but if we have to, this one replacement would be okay.

One wound reopened and the A cell did not work.  Dr. Howard checked out the wound and although it had regressed, he thinks another dose of A cell should work.  A wound vac was placed on it to aid in healing.
The "pimple" on the hip had developed a second "pimple."  Dr. B made an incision in them to help drain them faster.  Because the incision had introduced a potentially harmful "foreign body," a wound vac was placed on them as well. 

When preparing Derek for discharge, the nurse called upstairs to the ward to give the report and heard that Derek was to go to CT tonight.  Derek got very upset.  With that, Dr. G walked in.  I grabbed him and DC'd the CT for tonight.  He had been pulled about enough, and I had had enough.  No food or drink or all, pulled and prodded and in pain, Derek needed to rest tonight.  Also, the last CT was such a battle getting him into the tube because of his arm.  I'm out of fight tonight.  I need a little rest before going back to battle.  And I like his night nurse, but she's not LT Bennett and I don't think she will battle the way she did so I will have to do it.

I'm whipped tonight.  Between Jerome and Derek's latest difficulties and the recent medevacs, I'm overwhelmed.  This is tiring.  Tonight marks 11 weeks, 77 days since we arrived in Bethesda.  I'm tired.

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