Thursday, January 3, 2013

Thurs Jan 3- Wake Up Day

This video is from 1/8/13, but he did this all the time since the accident.
You can see he has a full beard still, and is intubated- the white tape is holding it in place.

At 9:52 pm last night, I put this on FB:
James had a quiet day of recovering. He has a slight fever (99) now. They are planning to take him off his sedatives (on since 7 pm Mon) for a moment in the morning to check his responses. This will be hard for him but they are leaving his pain meds on (thank God). He has the 4 bones of his eye socket broken, and got stitches all around his eye this morning. 

James was scheduled for his pelvis and clavicle repair today. They were going to come get him for surgery about 10. At 8:45, the nurse comes in- a black guy named Chris. He says they're going to turn off the sedation medicine so James can wake up. Chris is a calm quiet-spoken dude.

They turn off the sedation meds. They say it only takes 12 seconds for the meds to travel through the tubing to his system, so they expect him to wake up rather quickly. My heart begins to race.

Nothing happens. He has been moving his right hand up and down a little ever since he's been in the hospital. He does this a little more frequently, and is turning his head back and forth a little. I wonder why there's even a neck brace on and I learn he has cracked the lowest bone of his head- above the first vertebrae.

Nothing happens for so long that Chris asks if James drinks. "What?"

"If he drank alcohol the sedative would work out of his system like that!" he says, snapping his fingers. So I'm left to think, do I want him to have been an alcoholic so he'd wake up faster?! What kind of a question is that.

Nothing happens, and it's getting on towards time for surgery, so they put the sedative back on and give up, for now.

He comes back from surgery and they said that they didn't repair the clavicle, because he had a neck brace on. What?! Had they not noticed that when they scheduled him?! The neurosurgeon and the big-picture DR both say that they don't need him to be intubated and that for their purposes, it can be taken out. I remind them again that he has bad sleep apnea and that if he's sedated he won't breathe on his own.

At 2:20 pm they turn off the sedatives. All the way. This time he is struggling to come up from not only his regular sedation but also from the anesthesia from his pelvis repair, and also a paralytic they give him during the surgery. So I expect even less wake-up, less movement, an even slower reaction than this morning, because there are so many different sedatives working in his system. And (evidently, unfortunately?!) he's not an alcoholic who can metabolize it out of his system instantaneously.

He does the right-hand-lift thing, and turns his head intermittently. I pick glass shards from his chest hair. There are shiny dust particles of glass on the sheet under him. The shards in his chest hair are all irregularly shaped and it's hard to extract them from the maze of hair. I know his body, this chest I've laid my head on. It's strange that he's almost inanimate, alive but so disconnected.

By 3:30 his heart rate has increased to 175/80. I am sitting on the guest bed/couch with my friends, talking, waiting for a reaction or movement from James. He moves his right leg, bending it and pressing his hips left-right into the bed. When he makes a big movement, I jump up and take a position on his right side so if he wakes up he can see me. I tell him that he's okay, that he's in the hospital, that they're taking great care of him, that I am right here. He is shifting his weight more, and turning his head much faster and more frequently. I am hot and nervous.

I motion for Chris through the window. I don't see him, I send my handler out to find him. He comes in right away and politely asks to "Get in where you are," so I switch to the other side. I'm petting James' head gently, and talking to him, and watching the numbers all at the same time. He is "coming up" more and more. He is thrashing, he is moving his leg. He is sliding crooked on the bed. His left arm is silent beside him but his other arm is up and down. Chris is struggling to do something with the PICC line on that arm.

My handlers has disappeared from my consciousness. More nurses appear, but I just know, I don't really see them. I see James' face moving back and forth. I fear he won't see me when he wakes up.

Chris is suddenly a much louder man. "JAMES" he says, with perfect enunciation. I've always noticed that the word "James" is not quite one syllable, not quite two. Jaym-s. It's too long for one, but it doesn't break in half neatly. "JAMES" Chris says again. "JAMES can you squeeze my hand." He holds James' hand and there is an infinite pause while he waits for a reaction, but it is also just a brief instant. My little speech, my comforting comments, seem more and more useless. I almost tell him "Look at mommy." I feel like a fool- he obviously doesn't register my voice.

James' eye opens. It is so strange to see him moving, so alarming instead of comforting. He turns his head right and upward, where Chris' bold voice is coming from. The entire time I am trying to comfort James and be a familiar, calming noise for him to center on. His eye is open- his good eye- and it is swollen- the actual eyeball. The iris is recessed in a little well made by the swollen white part. This is horrifying- I hate jacked-up eyes. (I don't watch in movies when they have robots climb in or out of eyes- I could watch live surgery all day unless it's an eye- I want Lasik but can't handle the thought of the clamps and the laser.) That is his good eye?! With all of my being I don't want to look horrified if James looks at me. I try to calm my voice. His eye isn't seeing anything, much less me or my facial expression. He is crooked on the bed- I'm afraid he is going to slide off the bed, he's moving his right leg so much. I am pained, imagining his newly set bones grinding and getting pressed onto the mattress. He arches his back and pushes the top of his head into the mattress.

I'm so alarmed by his eye being swollen that my voice cracks. That is not what I want to offer him as he wakes up. How long is this going to go on?! Has it been a minute? Has it been five? I have no concept of who is in the room or how long it's been. Chris is at James' side- doing what? messing with his PICC? I suddenly see that James' ears are leaking a clear fluid. I don't want to alarm James even more by saying this out loud, if he can hear, and I try to stroke his head, but it is too much. I can't talk at all. I am choked around the throat by tears that aren't even in my eyes. My voice is tiny and broken and weak and I tell Chris- "His ears- they're leaking" The pressure from his struggling is making fluid leak out of his ears... is his eye going to explode all over me?! I am right there on a razor's edge, I can't control my voice.

Suddenly a hand is on James' right thigh, and a calm, peaceful voice says "Jesus. You are here."

I am struck. I swallow. I and step back to my post at James' left side. I stroke his head.

"Jesus. You are here." It's a friend, a nurse, from church.She had stopped by when he was still under, and had been there the whole time.

Chris decides to put James back under. He hasn't reacted to any of the things we've said- not to Chris' requests or my soothing noises. Twelve seconds, just like they said, and he is under. Quiet resumes.

The nurses straighten him on the bed. Chris tells me it's ok, that everyone reacts differently to coming up, that this reaction is not a "failure." I'm shaky. I see my other friend, the kids' main handler and scheduler, who had just stopped by for a moment, was still there. She's shorter than I am, and when I turn I see that her eyes are filled with tears. Somehow I feel like a failure that James couldn't hear me.

I don't remember the timing- it was still daylight-the nurses trickled out, all their tasks done- and I remember sinking into a chair near the foot of James' bed. He was quiet and inert again. I asked a question- I made a statement- my two friends stood before me. I just caved in. I cried and sobbed. I was really letting go, letting it all go, when I looked up for a second- utterly horrified, I saw my father, totally stricken, miserable, standing before me.

I pulled it together again. I made small talk. I kissed James and touched his hand and when out of the room for a minute.

At midnight, after two hours sleep, I posted this on FB:
If I didn't have this perfect fat sleeping infant beside me resting his dimpled warm hand on my arm, I'd be up walking in circles picking things up and putting them down again. I thought I slept thru the night but it was less than 2 hrs. It just occurred to me to thank God that James even survived the collision. Pray for me to stay calm when they try to wake James again sometime tomorrow a.m.

1 comment:

  1. That's how I remember it. I'm so glad you are documenting it.