Thursday, September 1, 2011

Getting Closer to the Edge of the Woods

I officially do not like September 1st.  That is the start of a new doctor's rotation.  We lost Dr. Obi Ugodikwo, who I absolutely love, Dr. Paolin of infectious disease, Dr. Mielke and others.  Dr. Mielke isn't leaving, he is moving to the pain service, but he will not be on the floor and giving Derek the same care.  I came to trust the team of doctors, and and then we were invaded by Walter Reed.  But then I got used to that team of doctors, and now they are leaving!  Ugh.  Oh well, we will will have to get used to all new doctors.  I am sure that they will be good, as well, but I will sure miss Dr. Ugo and Dr. Mielke the most.  I wish them good luck in their new adventures.

Dr. Perdue said he won't leave him through, so that's good.

Derek had the echocardiogram today.  We should have the results tomorrow.
Surgery went well today.  I was told it was "textbook."  The wound vacs were changed, and everything looked good.  The arm was washed out, and cultures were taken.  The legs are closed and look good, but cultures were taken to make sure they are not infected.

There are sacs of bacteria in the left leg, but they think the antibiotics will get it.  The abcesses in the abdomen are slightly worse, but they still think the antiobiotics will get them.  What I am not happy about is the almost defeatist way the doctors were talking about the abcesses and whether the antiobiotics will work or whether they will have to just go in after them, which is dangerous.  They were talking in front of Derek and it upset him.  His whole attitude changed after they were there, and he started with the, "what if I can't beat this" again.  I have to make sure each doctor knows that Derek is made aware of all information, but that it is told to him in a positive way.  If they are not up to this challenge, then they need to tell me so that I can tell him.  I think I will be making a sign for the door - "Only positive words and attitudes beyond this point or mama tigress will kick you ass!  This means YOU!"

There are three known sources of infection - in the soft tissue, the abcesses (even though they said maybe not), and the pneumonia in the lungs.  I was told that he did not have pneumonia, but one of the doctors tonight told me he definitely does and that whomever told that he does not was not being honest with me.  He would not have all of the fluid that he does without it.  I appreciate it when the doctors are straightforward and honest with me.  I can handle the truth.

His fevers hovered around 100 all day.  His white cell count was 28 overnight, but it was 24 in the morning, up from 22 yesterday.

His tube feeds through the J tube started today, and he tolerated them.

Dr. Mielky is trying to get him off the vent tonight.  Derek started at CPAP on 5/12 support today, and was at 5/7 at 8 p.m. tonight.  By 10 p.m. it was backed down to 5/4.  We will see what it is by the morning.  If he can be off it by tomorrow, maybe he can be on a speaking valve this weekend, which will really help his state of mind!

Unfortunately, it looks like the bacteria might be back in his blood.  Some of the cultures showed possible staph strains in his blood.  We will know more in the next few days.

We asked Derek how he felt today, and his response was "like shit."  If he could respond like that, he is coming back to himself.  He was a bit depressed tonight, and it was hard to see him so upset.  I calmed him and then I ran out to get something to eat and promised I would come right back.  I asked Dr. Mielke if there was something to help calm him down so he could sleep.  Dr. Mielke talked me me about it and gave him his regular night meds, as well as a little boost within proper guidelines, of course.  I do love Dr. Mielke and how honest and straightforward he has been with me.  I will miss him.

But as hard as it was on me to see him hurting, this is good, as explained to me by one of the nurses, Mary.  It is when these guys hold in their emotions, medicate themselves and refuse to feel that the healing doesn't happen.  The ones who go through this grief early are the ones who are healthier in the end.  Derek is strong man.  He is going to be fine.  As hard as a struggle as this is, he is climbing that mountain and will reach the top.  Climb to glory!

So, Derek is still in those woods, but getting closer and closer to the edge.  One of these days he will be close enough for me to reach in an grab him and pull him out.  I am praying for that day to come soon.  He is getting better, sometimes slowly, and sometimes he takes a few steps forward and a few steps back, but he looks so much better than he did last week.  Each week shows new progress. 

We have to concentrate on the progresses and not concentrate on the set backs.  If we concentrate on the set backs, we will go nuts.  There are going to be steps back as we continue on this journey, but as long as we continue to take steps forward, we can deal with those few steps back.

Thank you for all of your continued love, support and prayers.  It means so much.

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