daddy daily volume 13

June 19, 2008 at 10:53 am 2 comments

Daddy had a second brain surgery Tuesday evening. Cat scans Monday afternoon late indicated a halo of fluid over the top of his brain. The original shunt has done it’s job well. Maybe too well.  It has gotten fluid away from the portion of the brain where it had collected. The ventricles which were enlarged are now considerably smaller. That was the goal. However, they were smaller even than the doctor had anticipated.  Therefore, fluid began to fill and area that was previously occupied by the swollen ventricles of his brain. So, the surgery done on Tuesday evening was to put in two drains via two “burr holes” drilled on either side of his skull so that the fluid over the top of his brain could drain off. Additionally, they decided to externalize the shunt lines for now so that they could actually see how much fluid is being drained off. So, they did that, too. The neurosurgeon ordered that the collection bag for the shunt lines be hung at a specific height so that it would provide “pressure against pressure”, causing the drains they put in to do their job better.  The nurses hung it at the physician-prescribed height when they brought him in after surgery. I stayed overnight after Tuesday’s evening surgery since we didn’t know really how he would behave, and we don’t have a hospital appointed sitter anymore.  He chattered all night long. (Nothing much I could comprehend…but he talked and laughed and smiled. And he also hallucinated. So, he was ducking and dodging unseen predators a lot. And he seemed to feel he was falling, too.)

 

Wednesday morning while nurses and pca’s were in the room they moved the original shunt line’s collection bag (now that the shunt lines have been externalized for now)…they moved the bag where it was hanging lower. I even said, “His neurosurgeon ordered that be hung it at that height to provide pressure against pressure.” Nothing had collected in the shunt line bags since the second brain surgery procedure. They moved the collection bag lower anyway, apparently as directed by a physician’s assistant with whom they had consulted. Two hours later, some fluid had drained into the bag. The neurosurgeon came in and immediately saw that the bag was in the wrong spot. I was able to tell him what time the staff had moved the bag down lower. He immediately walked over and re-established the collection bag at the height he had ordered originally. Minutes later nurses began appearing. And they had OBVIOUSLY been scolded for having moved the bag. I felt like they may have felt a little animosity towards me as a result of my having said something to the doctor about it. I knew I hadn’t done anything wrong, I’d just explained what had happened, and I’m glad I was able to do that for the doctor. Although I did feel bad for them because they’d been scolded by the physician, it is most important that what they’d done was against what the doctor had said.  And they shouldn’t have moved it!  But as tired as I was, I felt bad about the whole thing. From what I was able to gather from one nurse, the doctor may have indicated to them that he DID NOT WANT THAT MUCH FLUID to have drained off at this juncture, which is why he ordered the collection bag to be hung at that particular height. Anyway…apparently a physician’s assistant told the nurse to do it. WHATEVER. All I know is, I knew what the doctor said, and didn’t know if that decision had been overturned by the doctor when they did it, or what. But, I do know that I TOLD THEM that the doctor said for it to be at a certain height, and they moved it anyway. And then the doctor came and moved it back where he’d told them to put it. So, that whole thing kinda freaked me out.

 

Okay, so, I’m sure you can tell by how batty my wording is that I am clearly not firing on all my pistons. And, if you think THIS sounds disjointed, you should’ve heard me try to talk Wednesday morning after being there all night. Mama arrived, and we had a cup off coffee there. I relayed doctors’ visits stuff to her. Ohh, and I forgot to say to you that I tried to feed him a spoonful of grits but Daddy couldn’t concentrate enough to swallow. I thought I’d have to suction them out. But, he finally did swallow. I got him to swallow water easier. I told the neurosurgeon about that on Wednesday morning, and he said I was correct to stop when I did that they didn’t need to risk aspiration on food, nor food going into the windpipe where he could develop pneumonia. He said they may have to do a feeding tube for awhile. But, that was just a thought he had of what they MAY have to do, understand.

 

Then I drove home around 10:30am Wednesday.  Terry was at work, but I called him when I arrived to say I was home and that Jessye had an orthodontist appt later that afternoon. After attempting to unload and  recount all of the above to him, Terry very firmly told me to GO TO BED, and that should just sleep and NOT plan on singing at church last night as I do every other Wednesday. He was like, “Listen to me…YOU GO TO sleep. Go to sleep.”   So, I did.  Probably around noonish I was able to try to sleep.  And once I did fall asleep, it was a very deep sleep.  I didn’t even hear the phone ring right beside me. But, I see from caller id’s that it did. I did wake for a call around 5pm from my cousin who’s daddy is also in a bad way.  Then I fell back asleep after that call. And, Terry called me around 8pm to tell me I needed to get up for awhile so that I’d be able to sleep all night later, and not wake up and be wide awake in the middle of the night.

 

About 8pm or so last night I called Mama to see what all had happened during the day Wednesday.  She said another CT scan was done yesterday during the day,  and the neurosurgeon as well as another neurologist both confirm that the results are IMPROVED from the previous cat scan done yesterday! So, that’s encouraging. They think the second surgery has already done some good.  We haven’t really seen language improvements at this point, though. But, they did say it could be six or seven days IF we see anything improved there at all.

 

Yesterday during the day the doctor ordered no food by mouth for now. Only medicines by mouth still. He began receiving glucose and nutrients intraveinously effective last night. And the neurosurgeon himself has come and lowered the collection bag for the original shunt lines a little now. But, it’s still not as low as the nurse had inadvisedly moved the bag Wednesday morning. There has been a sign posted by the nursing staff above his bed that says that the neurosurgeon has ordered this shunt line’s bag to be hung at X height. Susan said after the neurosurgeon moved the bag a little lower that a new sign was being made (by nursing staff) to post up there so that no further collection bag mismanagement occurs. Clearly the nursing staff took a chewing from our neurosurgeon Wednesday morning.

 

All right. So, all that said, the nurse staff is jumpin’ now, very attentive.  Watching Daddy very closely. Mama went home last night at nurses suggestion, although they made it clear that they are not allowed to make that suggestion to her officially. But, they assured her that they will be watching him very, very closely and that they’d call her if there was anything they needed her to know. And, based on what I saw while I was in there awake with him all Tuesday night, overnight, combined with the butt-chewing they got Wednesday morning, I believe that is true. Susan went to the hospital Wednesday afternoon and stayed ‘til after nine pm Wednesday night. He had been good and asleep for fifteen minutes when she went home.

 

Then the hospital phoned us this morning (Thursday) about 1:30am to say that Daddy is highly agitated and combative, and that it would be very good if one of us could come back. The nurse had phoned the doctor on call from the neurosurgeon’s group to see if she could give him something to calm him down, but they said no.  They don’t want him to be sedated right now. So, Mama and I conferred on the phone and we determined that I would drive her to the hospital and drop her off, that way she would be safely inside and not have to walk from the parking garage to the hospital which is a pretty good jaunt) in the dark at two o’clock in the morning.

 

So, Mama’s there now with Daddy. I called this morning and asked how things are, to which she responded, “LOUD.”  He is STILL highly agitated. He obviously is still doing some hallucinating and startles such that it appears he must think he is falling sometimes.  He has used some words that can be understood, as he usually does when he’s really mad.  Mama said he’s said things like, “Get outa here!”,  “Don’t touch me!” and,  “You get that one! I’m sitting on this one!”, and “I missed that one!”  Again, we think he must think there something or things trying to get him.  He ducks and dodges in his bed.

 

The nurses have wrapped Daddy’s hands in gauze so that it will be more difficult for him to snatch at the shunt lines and I.Vs.  But he is still able to get his gown off. He keeps throwing his pillows and sheets in the floor.  Mama has covered him again and again all night long. She said she thinks about 14,000 times.  And I’m sure that’s how many it times it must feel like.  

 

So now Mama’s had about three hours sleep after having been up there all day long Wednesday, and then back up there since 2am…. And she will be up there all day today, too.  She’s going to have to sleep tonight.  So Susan or I will likely stay with him all night tonight so that Mama can go sleep. So, anyway, we’ll figure something out on all the logistics of the situation. But, unless something changes dramatically, somebody is going to HAVE to stay around the clock with him so that he doesn’t yank anything loose that’s attached to his brain.

 

I’m trying to think if there’s anything else I know to tell. But, I don’t think there is anything more right now.

 

God is still on His throne.

Thank you for your prayers.

-tracey

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Entry filed under: daddy daily, pray for....

new paintings daddy daily volume 14

2 Comments Add your own

  • 1. Billy McCord  |  June 19, 2008 at 11:39 am

    Thanks for the detailed summary. I know all of you are worn out and I certainly understand. May God continue to be with James and all of you this this ordeal. We will continuing praying and thinking of you all.

    Like

  • 2. annette clark  |  June 19, 2008 at 12:48 pm

    tracey, jack or I can sit with him. when jack was so sick the doctor told me, “you must sleep when he sleeps, even if it is just a few minutes” so he stopped all company and kept the room dark and it seemed to help jack and I. please call us if we can help out. Annette

    Like

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