Wednesday, August 31, 2011

Moving Forward

 
Several steps forward, and only a few steps back.  As long as we keep moving forward, I am A-OK with that!  As the 10th Mountain says - Climb to glory!!!  Hoo ah!

The best news today was that the bacteria is out of the blood!  (doing happy snoopy dance) (picking dignity up off the floor and smoothing it out)  Okay, I'm calm.

Derek's white cell count is down slightly to 22.  It has been slowly declining since the jump up on Friday, but he had a fever overnight.  It seems when his white count goes down, the fever goes up and vice versa.
They read the films from the CT scan and said that there are several abscesses in the abdomen.  They are in very dangerous areas, so they do not want to go after them.  To insert a needle and extract them could potentially puncture the bowel or one of the blood vessels.  They do not want to open his stomach because of all of the abdomnal surgery he had down range.  So they are going to hope the antibiotics work.  If they do not, they will have to reassess the risks involved with going after them.  I am going to trust that they know what they are doing and leave it in their capable hands.

Last night Derek's heart developed an arrhythmia.  Dr. Mielky explained that sometimes even healthy guys have them, so it might be nothing to worry about, but because Derek is so sick, they will have cardiology look at him.  They didn't get to him today, so they will be there tomorrow.

Dr. Mielky saw me listening to rounds and took me aside afterwards and asked if I heard it all, understood everything or had any questions.  Wonderful of him.

And today was "line change Tuesday!"  The central line had to be changed.  It was starting to look a little funky (great medical term, huh?), so Dixson, his "big ugly guy" nurse (his description not mine!) called for it to be changed.  They have changed it every week to avoid infection.  Sometimes they have been the cause of infection.  I found out today that one of the lines a couple of weeks ago had been placed wrong!  It was accidentally put in an artery!

Dixson is about six and a half feet tall with spiky blond hair and dances around the room.  He is a Navy nurse and sings "big guy in a little space," and other strange tunes out of no where.  He tells Derek the most insane stories as he works on the lines, moves him, gives him his medicines, and places his "Pillow of Destiny," one of Dixson's own creations.  The Pillow of Destiny is a pillow full of ice cubes that goes behind the head, neck and shoulders and keeps Derek cool and comfortable.

Derek also received his JG tube for feedings.  What should have been a 10 minute, easy procedure took over two hours.  His stomach kept spitting it out and saying, "No!  I don't want it!" like a spoiled little two year old.  Because of his birth defect, his gut is not wired like the rest of us.  He is special in more ways than one.  They couldn't seem to get the tube in.  Finally, they got a shorter tube in place.  It isn't what they would have liked, and they will have to watch it more closely, but it is there.  Hopefully now they can re-start the tube feedings and get his gut working again!  The TPN lady (nutritionist) kept saying he was fine on TPN alone, but his gut needs to work!  He needs real food!

The methylneltrexone that was supposed to start yesterday and help counter the effects of the narcotics to get his gut working was not started due to the pharmacy not sending it up until today.
Today Derek asked for ice chips.  His nurse, a very sweet, very pretty young woman, went and got him ice chips.  When she tried to give them up him, he shut his mouth tight and shook his head.  He then pointed at Krytina.

He also asked Krystina to take him to lunch.  She asked him how, and he said in a wheelchair... to McDonalds... where he wanted McNuggets, a wrap and a Coke.  It has been over five weeks since he has had anything to eat or drink.

The worst news of the day is that Dr. Obi Ugo is leaving us!!!  NOOOO!!!!  I love Dr. Obi.  When he walks down the hall, I sigh in relief.  I know Derek is well taken care of when he walks in.  But his rotation is over and he has to go to Fort Belvoir.  Our horrible loss is Belvoir's awesome gain.  I told him that I was going to kidnap him and shackle him in the basement and only let him out to care for Derek!  I didn't realize that he was only a resident.  I thought he was a full fledge doc already... he is THAT good.  He will be missed, and I wish him the best of luck in all that he does.

Derek had OT and PT today.  His OT, Sam, is very sweet and upbeat.  This was his first day of PT, and Mary Jean was very nice, too.  She had him moving his right leg for the first time.  She also talked to him about getting his wheelchair, and he was all for it.  He wants out of that bed and moving!  Five weeks is a long time to be stationary, even if you don't remember it all.

We found out today that Derek received nine units of Battle Buddy Blood.  When the guys are down range and need blood, they do not have time to test the blood when it is donated, and they do not have a lot of blood stored, so the guys in the platoon donate blood for the wounded.  Unfortunately, if they have contracted a disease since the time that they deployed, there isn't time to test the blood.  So they test the wounded warrior after he returns, every three months for a year.  The alternative is not to give him the blood that he needs to save to his life.  I am grateful that he received nine units of his buddies' platelets down range. 

That's about it for the Derek update.  He is doing well, and we seem to be moving in right direction finally.  Positive thinking, prayers, an awesome medical team and Derek's fighting spirit and never give up attitude will help him fight his polytrauma, including all of those nasty bugs!  Thank you for your continued support.  It means the world to me.

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