Thursday, January 10, 2013

Wed Jan 9- Switching Gears

Michelle and I early during James' stay at Brackenridge's ICU.

Up until this point, I was in a state of, "Lots of broken bones. That's serious, but it's going to be ok."

I knew James had so much to recover from, that his body was in shock from the trauma, and that he would be in a ton of pain if he woke up. So I accepted the sedation as a generous blessing, if also "normal." The intubation for his breathing seemed normal for the circumstances as well, with the sedation and his sleep apnea. I watched the attempts to transfer via ambulance fail, so as extreme as an airlift was, it seemed appropriate for James' situation.

Then, on the 9th, when James failed to maintain his oxygen levels for his facial repair surgery, the nurse began talking about putting a feeding tube directly in his stomach, and changing out the intubation for a tracheotomy. She said he couldn't talk or eat when he woke up with a trach. She said that they liked to have a feeding tube in for a minimum of six weeks.

Six weeks seemed impossible. I was imagining that he would be home with casts on at that point. I had initially thought he would only be at the hospital for a week or so. Who stays at the hospital longer than that for some broken bones?!

I have to tell you.

So many people have asked me, "I would be a disaster if I were you. How are you staying so calm?" I'd like to say it was the Holy Spirit. But, no, it was experience. Not that we'd ever done this before- no. But James used to avoid stress or guilt by staying away from home. He would feel inadequate or mad at himself for not reaching a standard he had set; he'd feel overwhelmed. Many times he'd try to sleep to avoid his inner voices but the noise of our daily living would disturb him, so he'd run away from home.

So, many nights I'd be up late and wondering where he was. A few times in years past I actually hadn't seen nor heard from him in more than 2 nights, and would begin wondering how you find your loved one if they just never come home. Does someone call you- a cop, a nurse? Do they come to your house? What if his phone was dead, or he didn't have his wallet on him? How would they find me? How long would it take? I would begin daydreaming about how I'd spend his insurance money, and then he'd open the back door and be home.

So I've had some practice dealing with the scenario mentally. It was just a step further to have someone actually call me, take me to the hospital, and deposit me in a waiting room.

Anyway, on the 9th I had to switch gears. I had to start thinking this was going to be a longer road, and a bigger battle. I was shaken to think he couldn't eat, or couldn't talk when he woke up. What did all that have to do with broken bones?!

But it was the trauma to his system at this point, not the broken bones. Evidently the 6th cause of death worldwide, trauma is defined as

1. A serious injury or shock to the body, as from violence or an accident.
2. An emotional wound or shock that creates substantial, lasting damage to the psychological development of a person, often leading to neurosis.
3. An event or situation that causes great distress and disruption.
 Or, from this source,
In medicine, however, the words trauma patient usually refer to someone who has suffered serious and life-threatening physical injury potentially resulting in secondary complications such as shock, respiratory failure and death.
From Wikipedia:
The body responds to traumatic injury both systemically and locally at the injury site. This response attempts to protect vital organs such as the liver, to allow further cell duplication, and to heal the damage. Healing time depends on sex, age and severity of injury. Inflammation, common after injury, protects against further injury and starts the healing process. Runaway inflammation can, however, cause organ failure.
Much more serious than broken bones alone... which I didn't understand at first.
“Traumatic injury is a disease process unto itself. Biochemical changes occur throughout the body in response to the traumatic injuries, including in organs distant from, and seemingly unconnected to, the site of injury,” said Steven E. Ross, MD, Director of the Level I Trauma Center at Cooper University Hospital. For example, a patient with a fractured pelvis is at extremely high risk for developing a deep venous thrombosis, blood clots in the leg veins, which can result in pulmonary embolism – a clot that travels from the injured site to the main artery of the lung, which can result in sudden death.

It wasn't until they started talking about feeding tubes and tracheotomies that I really understood that he wasn't going to wake up and go start healing.

1 comment:

  1. He's truely a miracle, there's not any other explanation! No infections, clots , brain damage or spinal paralysis ... Unfortunately , the pain may never go away...