Wednesday, September 21, 2011

The House of Cards

Handing this on a daily basis is like building a house of cards.  Each team is holding a leg of the table and trying to keep it balanced so that the house of cards does not topple over as Derek tries to build the house as he gets better.  We have several different teams involved, some of them with more say then others.  We have the trauma team, the surgical team, the pain team, the infectious disease team, and me. 
Also involved are the orthopedic team, the urology team, the occupational therapists, the respiratory therapists, the physical therapists and the nurses who are handing Derek the cards and keeping him balanced.  I am holding a leg because I gave him the foundation to make him the man that he is and I know him like no one else, besides maybe Krystina.  I know how he acts when he is sick.  While I do not know the medical jargon, I can add something to the playing field by bring the human side of Derek in and reminding them of how certain medications affected Derek when used before.  The file and notes are already quite thick, and if they haven't read everything or are not aware of certain aspects, trust me, I will bring it up.

Case in point, the methadone they wanted to give him again this week.  We do not need La La Land Part Two, thank you very much.  Although it was a comedy, it was also a horror film.

It took me two days, but I was successful in convincing them to stop the Tylenol drip.  I understand the importance of weaning him off the narcotics.  I want that as well.....AFTER the infections are under control.  At this point, fevers are an important diagnostic tool (thank you, Dr. Dan).  Once I went through the infectious disease team, surgical team, trauma team and back to the pain team, they stopped the Tylenol drip for a couple of weeks.  Derek doesn't tend to run fevers as it is.  A 100 degree fever for him is serious.  Tylenol will mask that.  To tell me that if a fever is severe enough it will break though does not work for this kid.  Tylenol is just not a good move in this case.  Hence the importance of my leg in this house of cards.

Derek mentioned today that he felt bad that Krystina and I left our lives to be there for him.  The nurse was in the room when he said it.  Before Krystina and I could answer, she explained to him how important it was for his healing to have us there.  She explained that guys who had no one took longer to heal.  They didn't have anyone to go to bat for them in cases when medications were ordered when they maybe shouldn't have been, or when doctors walk in and patients are asleep, they just leave.  If a family member is there, they can actually get some information that helps the patient.

I took care of the flow of information problem today.  I got in touch with Dr. Moore.  Very nice.  And Dr. Perdue, who is my hero since he saved my son's life anyway, gave me his card with his email and blackberry number so I can call him anytime.  I will not abuse it.  I will only use it if I absolutely need to, like if I have not seen him and absolutely have to have information.

Sam, our favorite OT, made Derek a splint because one of his fingers was starting to claw.  She took the wrap off his right arm today, and it actually looked a lot better than I thought it would!  Derek was upset by it, but Krystina and I were relieved.  The doctors described it a lot worse than we actually saw it.  The "shark bite" was was a lot smaller than described.  He is also getting some movement back in his fingers.  The flap is scheduled for next Monday.

MJ, our favorite PT, got Derek into his chair and he drove around the ward!  Considering the last time he drove he crashed Mike's car into a parked car and ended up in some bushes, he did a lot better this time!
So Dr. West told us he is going to show up with his restraint team one of these days.... was he kidding?  We will see.

Dr. West is being evaluated tomorrow, and we told him to send them our way.  He walked away shaking his head and laughing.  Really?  Do we scare him that much?  We love Dr. West!  We would be very complimentary!  Just read my blog, Dr. West.

The hospital is in the process of being accredited.  Walter Reed and National Naval Medical Center were both re-accredited within the last year, in April and November, if I remember correctly.  But when they merged, they technically became a brand new hospital, so it has to be accredited as Walter Reed National Naval Medical Center Bethesda.  They need to do something about that acronym.  It's a mouthful.  But if the evaluators want info, talk to me!  Or read this blog.  I have a big mouth.....  I'm not shy!

Besides getting out to drive his wheelchair, Derek had a quiet day.  He slept a lot.  He is fighting something.  Although his white count is only 14.3 and he has no fever, Derek does not always run a fever.  He has been sweating a lot, which is what he does.  He was very pale, his eyes were black, he was very tired and he sweat a lot.  That to me says he was fighting something.

He also was very sick to his stomach, so they cut off his food and said liquids only.  He is still getting the tube feeds, so he is getting the calories, but he stomach is not ready for the food.  I walked in to find out he was sick overnight, and this morning was met with a good morning vomit.  He took it as a set back, but Dr. West was able to convince him that it wasn't.  Another reason we love Dr. West.

Krystina has been a real blessing through this journey.  Without her, I could not have done this and stayed so strong.  She makes me laugh, keeps me grounded, shows me what is important, and gives me an avenue to vent so I don't commit justifiable homicide (although I would get off for temporary insanity.  Yes, Dr. West... I know, "temporary?").

So, surgery tomorrow for a wash out, wound revision, dressing change, wound vac change, the usual.
Have a good night, everyone.  Thank you for your continued support, prayers and good wishes.

No comments:

Post a Comment