Monday, September 12, 2011

Failing the Standardized Test for Pooping and Peeing

Apparently there is a standardized test for pooping and peeing and Derek failed miserably.  He also learned to walk 13 years ago.  Yes, his math sucks.  And, the Mexicans are in the air and the Indians are supposed to help them.  Don't you see them?  I was supposed to have seen them, too.

I told that story to my friend Minnie whose husband is in CCU and who is Mexican and she told me to bring her in to Derek's room to show him that we saved her!  She was hoping that it would help Derek.

They changed his pain medications on Saturday.  After sleeping all day on Saturday and Sunday, he awoke this morning in full fledged delirium. 

Tonight, Krystina and I are exhausted.  We did not stop for a minute all day.  We could not take a break except to grab a quick bite to eat or a fast bathroom break.  It was "eyes on" with the nurse.  It was a two person job all day due to his active hands pulling on things and telling crazy stories.

This morning Derek told me the story of Dr. Perdue telling the kids on the night shift to turn the music down because all of the patients deserve respect.  He also was convinced that Krystina and I had to help him one night move all of his stuff from one room to another due to a black out.  He was oriented as to where he was, but thought things had happened that didn't.

Until he asked for his tan shirt and hat for formation.  After surgery, he asked the nurse if they had caught up to the platoon.

Derek wanted to know if my gun was hidden under my seat in my car.  I don't own a gun.  I never have.  He asked us many times if we cleaned the guns and if they were ready.

He was quite distressed about failing that standardized test for pooping and peeing.  I wasn't aware that there was one.  He said he passed it 13 years ago, when he learned to pee and poop on his own.  He also said it was the same time he learned to walk.  Yes, his math sucks.  Derek got through high school with a pen, a smile and his charm.  Which also explains why his spelling is so bad.

He wanted me to explain to the nurse about keeping the bicycles straight.  I tried to play along, but when I didn't explain it to the nurse, I finally had to tell him I wasn't aware of any bicycles and he became very upset and pointed at his leg and yelled, " the bicycles and the sandbags, mom!"  I got it.  We have to keep his leg straight by using sandbags because the muscles have started to constrict.

Derek told me that one of the wounds was hurting, but I explained that they took care of it in surgery, and that it was a blast wound.  He wanted to know if he should put neosporin on it.

Because the meds seem to be interacting with one another and causing havoc in his body, they removed all pain and sleep meds but the diluated (actual pain) and nuerontin (to block the phantom pain).  They decided to add one sleep med tonight (remeron) and will slowly add some meds back over the next couple of days to see what the trigger was for the delirium.  They think they know which one it was, but they want to make sure.  Dr. Dan felt terrible that the meds wreaked such havoc on his system and pinky promised me that he would get to the bottom of the problem. 

I do trust Dan.  He has been wonderful, and he promised we would all sit (his wife included) and have a beer at the "Humping Turtle" [after we "feed the peter (meter)"] when this is over.  It is actually the "Harp and Fiddle," but in my sleep deprived brain, I messed up the name.

Needless to say, graduation has been delayed.  If we will lose Dan, I don't know if I mind the delay.  I don't know if I want a new team of doctors and nurses.  I like the ones Derek has now.  Can I bring them with me?

But the good news is that surgery went better than good.  When I returned to the room at nine to wait for rounds, they were returning Derek from surgery!  The wound vacs were changed, arm was washed out, blast wounds (especially that one nasty ulcer on his butt) were debreaded and repacked, and the skin graft on one wound is scheduled for Wednesday if all continues to go well and if the white cell count gets its act together!

The white cell count went up slightly to 16.6 and Derek ran a slight temp of 100.1, but they attribute the temp to the OR and are trying to say the white cell could be nothing.  Not buying it until it goes back down, but I'm really more concerned about the medication problem.  Those pain docs better stop messing with this!

Our favorite OT, Sam, came by today and got Derek into his chair.  SO good to see him out of bed and Sam is always so upbeat and positive.  PT Mary Jean was also by and worked that leg.  She's a sweatheart, too.
Even though Derek was delirious, he had lucid moments when he was asking questions and wanting to know what was going on with the world, his family, etc.  He asked about his Papa, his brothers and sister, cousins, Kiki, Uncle Brian, and Krystina's family.  He asked to speak with his brother Mike on the phone, so we called him.  He also asked a lot about what has been happening since he was admitted.  Krystina did not hold back.  I tend to protect, but Derek and Krystina are brutally honest with one another, as they should be.  He wanted to know, and she told him.

We asked him what he remembered about the incident, in the way that Dr. West advised us to do.   He does not remember anything from three days prior to the event.  Dr. West gave us specific instructions as to what to say to him, and we are following his guidelines to help him remember the incident, hopefully without triggering a PTS event.  Only time with tell if we are successful.

Thankfully Derek has a nurse I trust tonight.  I've trusted most of them, but not knowing them when they first come on, I need to stay later until I get into that comfort zone.  Not the case tonight.  She is one from his first week at Bethesda, LTJG Priscilla Furher, so we were able to leave early.  It was a hectic and emotionally trying day. 

I am emotionally spent from seeing him upset, confused and in pain.  He could tell when he started getting off track.  Although I tried to keep my face passive, when I was unable to follow his story, or when Krystina would tell him that it was just a dream, he would back peddle and either say he was only joking, beg Krystina not to tell me, or try to laugh it off as a joke.  This was a rough day on everyone.

I am hopeful that we will be able to crash early tonight and start over tomorrow fresh.  Hopefully swallow study tomorrow!

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