The Roller Coaster Ride Continues

Last night and today have been quite the roller coaster ride with Dad. It all started last night when Dad was in obvious pain in his stomach area. He kept pointing to his stomach and then nodding when asked if he was in pain.  He also started shaking all over.  When he started coughing up blood (a significant amount) and his oxygen level dipped, the trauma team was alarmed enough that they felt he needed to be back in ICU for closer monitoring and testing. This was of course alarming to the family as well and Dale ended up staying at the hospital all night with Dad (Jeff also stayed most of the night). The main issues were getting to the bottom of why he was coughing up blood and finding the cause of his pain. He continued coughing up blood through the night (although it started getting darker which indicated that it was old blood). 

The first concern was pneumonia. Dad's lungs hadn't looked great on the last chest x-ray.  His morning x-ray today showed his lungs looking "stable" but he does still appear to have pneumonia brewing.  He had 3 of the 5 indicators needed before they consider it full-fledged pneumonia. As a result, they have changed the mix of antibiotics they are giving him.  But pneumonia did not appear to be the cause of bleeding. 

With the bleeding issue, first they told us that he had been improperly suctioned out, which had caused the bleeding.  Then they were concerned that the tracheotomy itself was causing the bleeding (Dad's is located very close to a main artery, which they were looking at).  After they did a CT scan of his neck and chest they ruled out that theory.  So they were still assuming that the blood was caused by improper suctioning of his trach (someone had used the wrong tool) and they were very apologetic to our family. 

They finally got to the bottom of the bleeding issue tonight when Dr Leyngold (the Dr. who performed the facial surgery) came in to check up on Dad post-surgery.  He was shocked to find Dad in ICU and asked why.  When he was told about the bleeding he indicated that it was most definitely drainage from the surgery Dad had just had, and nothing to be alarmed over.  The amount of blood Dad had coughed up was not excessive for the surgery he had had.  The blood had not been aspirated into the lungs but had merely drained into the mouth/throat and upper airway.  This had clogged up his trach a bit and was also the cause of his oxygen level dip. 

A cause was also found for the intense stomach pain Dad had been having along with the "shakes".  I won't go into much detail,  but since the catheter had been removed from Dad, he apparently had not been voiding as he should.  In the ICU they re-catheterized him and they drained 1300cc from him.   The normal bladder only holds 300-400cc.  A bladder that is as full as Dad's was can cause intense pain, delusion, shakes, and other problems.  They are going to be leaving the catheter in for a while now, as his bladder will need time to shrink back down so that the bladder muscles can work properly again. 

The entire ICU return trip appears to have been somewhat of a false alarm.  However, we would much rather have them being overly cautious than not cautious enough.   They expect to move Dad back out of ICU and to the Trauma floor sometime tonight or tomorrow.  As a family we are so relieved that Dad's problems last night did not end up being more serious.  We know that prayers and blessings are working!

Other notes from the day,  Dad's face is not as swollen as expected after surgery.  He is recovering well from that.  The Dr. did indicate that during surgery he found Dad's eyeball to be lodged in with the broken bones and scar tissue, making it immobile.  He freed it and the eyeball should now start moving again.  However, there was no way to assess the nerve damage to the nerves that control the movement of Dad's eyeball, the eyelid, and facial movement. Each of these areas are controlled by separate nerves and there is no way to know which are damaged, and if so, how much.  They will wait for 6 months to reevaluate and then will try some surgical repairs if necessary.

Dad was extra sleepy and calm today and slept peacefully most of the day (I'm sure he felt so much better after getting rid of his stomach pain).  The Occupational Therapist and Physical Therapist did make him wake up for some therapy this afternoon.  Today Dad was able to walk down most of a hallway and back (with 2 helpers)!   At the end of therapy they had him sit up in a recliner for an hour. It is better for his lungs to have him upright.

 The therapists also worked on his cognitive skills.  They again today asked him to write answers to questions.  When they asked him  what month and year he thought it was, he wrote "March 1908".  When they explained that it was May 2012, he wrote "May 1212".  When they asked if he knew where he was he could not answer.  They asked if he was "home" and he nodded yes.  When they explained where he really was, he nodded as if he understood.  They also asked him to look at a clock and write down the time.  It was 2:30 and he wrote 2:300 PM.   I share these things with all of you not with the intent to embarrass or exploit Dad, but to show everyone just how seriously his brain was injured, and to let you all see the gains he is making.  He will continue to make progress and will hopefully eventually regain full ability after some time.  His brain is still very injured, and information is still quite "scrambled" for him (like the most terrible concussion).  That all should improve and one of the major goals of therapy will be to help him regain full cognitive function. 

Dad's blood pressure, temperature, and heart rate were all great today. They are working on moving Dad to rehab on Monday.

Thank you again to all of you for your prayers, thoughts, and support.  The experiences we are having with Dad are reaffirming and strengthening our faith in the power of prayer.