DAY 4: Hope Abides
No such luck on breakfast. Kevin didn't want to go. We ate at the cafeteria instead, using the food coupons given to us by the Rocky Mountain Church. The cafeteria food was good, better than I'd expected. We had warm tortillas, eggs, bacon, orange juice, and I had a cinnamon roll.
Mom made good progress today. The big event was another trip to the OR where they went back inside her stomach to change the packing, inspect for further damage, and see about closing her incision. The result was encouraging for a few reasons.
First, her blood pressure remained stable throughout the operation and afterward. They took her off all presses (blood pressure-increasing medications) and still she stayed at a normal pressure.
Second, they found some dead areas on her colon and were able to remove those sections before they expanded and caused serious impairment later. Sometimes, a hemorrhaging colon is fatal. She's safe from that, and should have normal bowel activity upon recovery. That's one less challenge to overcome down the road.
Third, she's cleaned up and ready for another 48 hours of recovery before they have to go in again. There are no signs of infection, which is particularly important now that she's missing her spleen.
By the way, I learned that the ability to leave an incision open for days on end is relatively new. In 1993, doctors discovered that human cells heal faster at sub-atmospheric pressure. They developed a system called a V.A.C. (vacuum assisted closure). A sponge goes into the incision, then a plastic wrap is sealed around the outside of the sponge and over the wound. A tiny hole is cut into the plastic, then a suction cup is stuck over the hole and hooked to a vacuum. It sucks the plastic and sponge down into the wound, pulls the sides of the skin together, and drains excess fluid through the vacuum tube all at the same time. It's amazing. The sucked-down plastic feels like the wrapper on a stick of beef jerky sold in a convenience store.
When Mom's body is not swollen anymore and the threat of compartment syndrome, where the pressure in the torso gets so strong that it constricts the lungs and damages other organs, recedes, they can finally stitch her belly closed. As it is now, when we pull back the sheet and pull up her gown, we can see the gaping incision and the packing material beneath. We cannot, however, as Kevin once claimed, "see her guts," much to Charlie's disappointment.
Another bit of unexpected good news happened a little before 10:00 this morning. Emily, Kevin, and I were with Mom when a team of nearly ten doctors, nurses, and other staff assembled at the foot of her bed to cover in great detail her condition. I didn't know it at the time, but I now know that this was morning rounds, and it would happen each morning between 9:00 and 10:00. Emily seemed annoyed at the intrusion -- it was loud -- and also because a nurse-in-training's lesson from the nurse-in-charge was long and too energetic and filled with the trainee's apparent inability to grasp anything. Plus, she kept confirming in nerd-like overkill what was self-evident to any lay person.
"When the buzzer sounds, you have to turn it off."
"Oh sure, sure. Yeah, any buzzer can't be left buzzing for too long. Got it. Got it."
"Here's where you adjust the swan tube to the heart."
"Oh, that's where? I would have thought it would have been up here more, but now that you point it out I can see that you're absolutely right. It's right there. That blue part. Mmm hmm. Gotcha. Right."
Em looked fit to be tied and threatened to "say something" if they kept it up. They did keep it up but, to my relief, Emily held her tongue.
In general, the staff have been great. We'd all like to see a little more seriousness around there, but the casual approach to what appears to outsiders like dire emergencies is par for the ER course in my experience. I've seen it in California and in Japan, too. We forget that our sudden catastrophe is just another day at work for them. It shows at times. They move too slowly for our tastes, joke too much about the daily news or other trivialities, and in general don't seem to change their routines much to accomodate the lives in the balance.
Yet, Mom is getting better, and when people talk to us they seem to know what's going on and take the time to fill us in.
I'm off track a bit. Back to that good news prior to 10:00. The main doctor leading the troop came to her bedside and said that her kidneys' ability to clean her blood up was a very good sign. It showed that her body is righting itself, even at that level, which is one they wouldn't necessarily expect it to be working on yet.
Noted, but not nearly as encouraging to us as Mom's gradual return to a normal color, especially around her eyes. The two horror holes I mentioned last night are now just a light lavender color and less swollen. At certain angles, she looks like herself. Although, admittedly, that was from outside the room and pretty far away as I was calling Dr. Dumont's office for the third time to try to get somebody to finally fax over her heart history. As of 11:30 p.m., still no sign of it. We're going to have a talk with those people.
The girls are still having a hard time, but all of us boys have already moved onto not worrying about death and just projecting times to recovery. It was great to see Charlie tonight. He seemed happy to see me, too, and I loved that. He wasn't too goofy to where it felt inappropriate, but just enough of a kid to bring some fun to the place.
Just before everybody left for home tonight, Mom gave us the best present of the day. She moved a lot. She turned her head toward me as I spoke and her left eye was pushed open a little from a hematoma and I could imagine that she was peeking out. She wasn't, but we'll take what we can get. It felt like she was turning to face me as I spoke and that was so thrilling. She lifted her feet and her hands, too. Emily and Karen were elated. Em asked her to wiggle her toes. She did. Karen asked her to squeeze her hand. She did. Then it looked like she lifted her foot to be scratched by Em. She scratched it, stopped, and then Mom lifted the other one like she was saying, "What are you stopping for? You're not done yet." We had a good laugh.
Earlier in the evening, Colleen melted down in the waiting room. It was nothing new, just a case of the situation weighing too heavily. Her fiance Dain consoled her, then Em came and the sight of Colleen sent her over the edge. Karen wasn't far behind them. We've seen the chain reaction cry wave enough to not get too worked up anymore. We just rubbed them and said that Mom was going to be OK.
I hugged Karen, who is surprisingly strong for her size, and when I got my breath back I said to her that Mom would be healthy and nagging her in no time. "Before you know it, you two will be back at each other's throats."
Later, Colleen and I were at Mom's bedside and she was talking to Mom, telling her all the thoughts that she'd just spilled in the waiting room. She said with a serious voice, "Mom, if I could ask you one question right now, it would be..."
I stood still, frozen in the moment, thinking in terms of movie scenes and how I was about to hear the long-standing mystery that had stood between those two over the years. "Why did you let my gerbil die when you knew it meant the world to me?" or "Why didn't you ever fill out the application I needed to go to beauty school?" or "Why did you hide the letters from the man I wanted to marry and let me go on believing that he'd abandoned me?"
She finished the sentence: "...are you OK?"
That's it? Come on! Why the dramatic lead-up? Everybody's asking that question. Give it another shot, I thought, but she never did. So we stood there wondering if Mom was OK. I never told her any of this. Her personality is so cute at times.
Emily and I took a walk around Sloan's Lake when Mom was in surgery. Kevin had returned home to pay his insurance and see a movie to take his mind off of things. The lake was a lot bigger than we'd expected, and beautiful. I'll take pictures of it later for Mom to see. It's behind the hospital, in a completely different world from the Colfax side where I'd had my memorable trip to 7/11. The lake and park are just what I need, and I plan to walk there often.
The turning leaves are still beautiful. Geese land and take off from the water with their honking and lovely splashing sounds. In the afternoon, the temperature was warm. People rode by on bikes. Mothers pushed babies in strollers. It was a slice of normal life that we needed, complete with the pungent smell of moist autumn grass.
A new family occupied the far end of the waiting room. We were there when the doctor told them that their female relative had only a 10% chance of surviving her car accident injuries. She's one room down from Mom's. The disbelief and typhoon of emotion washed over them visibly and audibly. They cried and hugged. Emily and I looked at each other. That phase was hauntingly familiar, but so far behind us in just the three days we'd been at this ICU game.
We speculated that some of them were feeling guilty. "Why didn't I return her call last Friday?" Some were feeling hope. "She's a fighter. We have enough people praying that God can't possibly ignore our pleas." Some were feeling relief. "I'm so glad we went to the market together on Sunday." Some weren't feeling at all. Mostly, though, we guessed that some version of each of those thoughts went through each of their minds in a kaleidescope of feelings, the tug-of-war between not wanting to be caught unprepared by the likely death, but not wanting to give up hope just yet. What's the right balance between preparing for the worst and hoping for the best? We all find it, as our family had done individually in the early days of this week.
When I left a little before midnight, the family was still there, surrounded by a buffet of chips, Pepsi, and sandwich ingredients, all of which had been graciously offered to our family as well. Their moods were higher, and so were her chances, now 30%. That's good progress from just a few hours earlier.
Hope is carrying the day for both of our families.
Mom made good progress today. The big event was another trip to the OR where they went back inside her stomach to change the packing, inspect for further damage, and see about closing her incision. The result was encouraging for a few reasons.
First, her blood pressure remained stable throughout the operation and afterward. They took her off all presses (blood pressure-increasing medications) and still she stayed at a normal pressure.
Second, they found some dead areas on her colon and were able to remove those sections before they expanded and caused serious impairment later. Sometimes, a hemorrhaging colon is fatal. She's safe from that, and should have normal bowel activity upon recovery. That's one less challenge to overcome down the road.
Third, she's cleaned up and ready for another 48 hours of recovery before they have to go in again. There are no signs of infection, which is particularly important now that she's missing her spleen.
By the way, I learned that the ability to leave an incision open for days on end is relatively new. In 1993, doctors discovered that human cells heal faster at sub-atmospheric pressure. They developed a system called a V.A.C. (vacuum assisted closure). A sponge goes into the incision, then a plastic wrap is sealed around the outside of the sponge and over the wound. A tiny hole is cut into the plastic, then a suction cup is stuck over the hole and hooked to a vacuum. It sucks the plastic and sponge down into the wound, pulls the sides of the skin together, and drains excess fluid through the vacuum tube all at the same time. It's amazing. The sucked-down plastic feels like the wrapper on a stick of beef jerky sold in a convenience store.
When Mom's body is not swollen anymore and the threat of compartment syndrome, where the pressure in the torso gets so strong that it constricts the lungs and damages other organs, recedes, they can finally stitch her belly closed. As it is now, when we pull back the sheet and pull up her gown, we can see the gaping incision and the packing material beneath. We cannot, however, as Kevin once claimed, "see her guts," much to Charlie's disappointment.
Another bit of unexpected good news happened a little before 10:00 this morning. Emily, Kevin, and I were with Mom when a team of nearly ten doctors, nurses, and other staff assembled at the foot of her bed to cover in great detail her condition. I didn't know it at the time, but I now know that this was morning rounds, and it would happen each morning between 9:00 and 10:00. Emily seemed annoyed at the intrusion -- it was loud -- and also because a nurse-in-training's lesson from the nurse-in-charge was long and too energetic and filled with the trainee's apparent inability to grasp anything. Plus, she kept confirming in nerd-like overkill what was self-evident to any lay person.
"When the buzzer sounds, you have to turn it off."
"Oh sure, sure. Yeah, any buzzer can't be left buzzing for too long. Got it. Got it."
"Here's where you adjust the swan tube to the heart."
"Oh, that's where? I would have thought it would have been up here more, but now that you point it out I can see that you're absolutely right. It's right there. That blue part. Mmm hmm. Gotcha. Right."
Em looked fit to be tied and threatened to "say something" if they kept it up. They did keep it up but, to my relief, Emily held her tongue.
In general, the staff have been great. We'd all like to see a little more seriousness around there, but the casual approach to what appears to outsiders like dire emergencies is par for the ER course in my experience. I've seen it in California and in Japan, too. We forget that our sudden catastrophe is just another day at work for them. It shows at times. They move too slowly for our tastes, joke too much about the daily news or other trivialities, and in general don't seem to change their routines much to accomodate the lives in the balance.
Yet, Mom is getting better, and when people talk to us they seem to know what's going on and take the time to fill us in.
I'm off track a bit. Back to that good news prior to 10:00. The main doctor leading the troop came to her bedside and said that her kidneys' ability to clean her blood up was a very good sign. It showed that her body is righting itself, even at that level, which is one they wouldn't necessarily expect it to be working on yet.
Noted, but not nearly as encouraging to us as Mom's gradual return to a normal color, especially around her eyes. The two horror holes I mentioned last night are now just a light lavender color and less swollen. At certain angles, she looks like herself. Although, admittedly, that was from outside the room and pretty far away as I was calling Dr. Dumont's office for the third time to try to get somebody to finally fax over her heart history. As of 11:30 p.m., still no sign of it. We're going to have a talk with those people.
The girls are still having a hard time, but all of us boys have already moved onto not worrying about death and just projecting times to recovery. It was great to see Charlie tonight. He seemed happy to see me, too, and I loved that. He wasn't too goofy to where it felt inappropriate, but just enough of a kid to bring some fun to the place.
Just before everybody left for home tonight, Mom gave us the best present of the day. She moved a lot. She turned her head toward me as I spoke and her left eye was pushed open a little from a hematoma and I could imagine that she was peeking out. She wasn't, but we'll take what we can get. It felt like she was turning to face me as I spoke and that was so thrilling. She lifted her feet and her hands, too. Emily and Karen were elated. Em asked her to wiggle her toes. She did. Karen asked her to squeeze her hand. She did. Then it looked like she lifted her foot to be scratched by Em. She scratched it, stopped, and then Mom lifted the other one like she was saying, "What are you stopping for? You're not done yet." We had a good laugh.
Earlier in the evening, Colleen melted down in the waiting room. It was nothing new, just a case of the situation weighing too heavily. Her fiance Dain consoled her, then Em came and the sight of Colleen sent her over the edge. Karen wasn't far behind them. We've seen the chain reaction cry wave enough to not get too worked up anymore. We just rubbed them and said that Mom was going to be OK.
I hugged Karen, who is surprisingly strong for her size, and when I got my breath back I said to her that Mom would be healthy and nagging her in no time. "Before you know it, you two will be back at each other's throats."
Later, Colleen and I were at Mom's bedside and she was talking to Mom, telling her all the thoughts that she'd just spilled in the waiting room. She said with a serious voice, "Mom, if I could ask you one question right now, it would be..."
I stood still, frozen in the moment, thinking in terms of movie scenes and how I was about to hear the long-standing mystery that had stood between those two over the years. "Why did you let my gerbil die when you knew it meant the world to me?" or "Why didn't you ever fill out the application I needed to go to beauty school?" or "Why did you hide the letters from the man I wanted to marry and let me go on believing that he'd abandoned me?"
She finished the sentence: "...are you OK?"
That's it? Come on! Why the dramatic lead-up? Everybody's asking that question. Give it another shot, I thought, but she never did. So we stood there wondering if Mom was OK. I never told her any of this. Her personality is so cute at times.
Emily and I took a walk around Sloan's Lake when Mom was in surgery. Kevin had returned home to pay his insurance and see a movie to take his mind off of things. The lake was a lot bigger than we'd expected, and beautiful. I'll take pictures of it later for Mom to see. It's behind the hospital, in a completely different world from the Colfax side where I'd had my memorable trip to 7/11. The lake and park are just what I need, and I plan to walk there often.
The turning leaves are still beautiful. Geese land and take off from the water with their honking and lovely splashing sounds. In the afternoon, the temperature was warm. People rode by on bikes. Mothers pushed babies in strollers. It was a slice of normal life that we needed, complete with the pungent smell of moist autumn grass.
A new family occupied the far end of the waiting room. We were there when the doctor told them that their female relative had only a 10% chance of surviving her car accident injuries. She's one room down from Mom's. The disbelief and typhoon of emotion washed over them visibly and audibly. They cried and hugged. Emily and I looked at each other. That phase was hauntingly familiar, but so far behind us in just the three days we'd been at this ICU game.
We speculated that some of them were feeling guilty. "Why didn't I return her call last Friday?" Some were feeling hope. "She's a fighter. We have enough people praying that God can't possibly ignore our pleas." Some were feeling relief. "I'm so glad we went to the market together on Sunday." Some weren't feeling at all. Mostly, though, we guessed that some version of each of those thoughts went through each of their minds in a kaleidescope of feelings, the tug-of-war between not wanting to be caught unprepared by the likely death, but not wanting to give up hope just yet. What's the right balance between preparing for the worst and hoping for the best? We all find it, as our family had done individually in the early days of this week.
When I left a little before midnight, the family was still there, surrounded by a buffet of chips, Pepsi, and sandwich ingredients, all of which had been graciously offered to our family as well. Their moods were higher, and so were her chances, now 30%. That's good progress from just a few hours earlier.
Hope is carrying the day for both of our families.
Posted by Jason Kelly | 11:45 PM
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