Thursday Update

November 24, 2005
Thanksgiving Day Indeed

Another very good day in Macon.

First thing this morning Shea came off the “oscillating” ventilator and went onto a conventional ventilator. That enabled them to take her for a CT scan (more on that in a moment). They have taken her off the paralysis medication. When she was on the “oscillating” unit, they didn’t want her to fight the vent, so they gave her the paralysis meds. Now they want her to breathe with the unit.

The Dr. showed us the morning’s chest x-ray and said the lung image was “awesome.”

She is off all blood pressure meds. This happened faster than we imagined.

The left drain in her chest is out. The Dr said that all lines and tubes into the body are potential infections spots, so they remove any lines and tubes as soon as they can be jettisoned. She still has two drains on her right side.

The feeding tube that was put in on Tuesday has moved into place perfectly. They snaked it as far as they could and then let the body take over—the parastaltic motion of the stomach and intestines eventually pull the tube through the sphincter valve at the bottom of the stomach and into the small intestine—right where they want it. Now that it’s in place, they are upping the nutrition flow 10 cc’s an hour. She is handling the intake of food well. As I type this, Susan tells me that she moved her bowels tonight. This is really quite good. The body systems—which can sometimes take a long time to resume normalcy after trauma—are just coming nicely on line.

At the end of the day, her temp was up slightly. They have done numerous cultures at all the sites where infection is likely. Have started her on antibiotics. If the cultures come back negative, they’ll discontinue the antibiotics.

The big news of the day came around 5:00. The CT scan showed that the brain looked normal and showed no sign of damage from loss of oxygen. As we reported yesterday, this is a very good sign, but there may yet be small areas that do not show on the scan (and the MRI will be a better picture, when that is possible). Nevertheless, this is a great sign. We breathed a great sigh of joy and relief.

Other positive neurological signs: Shea partially opened her eyes on command—and following a command is the best sign of brain function. She also was able to “localize pain.” When they stuck her with a needle in trying to put in an IV she tried to push it away. This is a sign that, more than just a general response to pain, she is able to “localize pain”—able, that is, to sense that someone is sticking her in the right wrist and to withdraw from that specific pain. This, combined with the good brain scan gives us ample reason to hope. We need still to remember that Shea has sustained head trauma and that even in the best scenario there will be a road back to full recovery. She is not out of the woods.

The CT scan, however, also showed a problem. There is an air pocket in her abdomen.
This indicates that the air system has a leak, and it’s collecting in her abdomen. Since she has the two drains in her chest cavity, this is not a serious problem at the moment—the pressure is being bled off. They thought it might be a tear in the esophogas of the bronchial tubes, but (and this was after the conference call at 8:00 pm tonight) they scoped her trachea and upper lungs—the bronchial tubes—and found nothing. They couldn’t see the bottom of the lungs and there could be a hole there. But they think that perhaps there is a small hole, and the pressure of the ventilator (to say nothing of all Shea’s lung have endured) may be putting an unusually high pressure in the system, and that when she begins to breathe on her own it may just heal of itself. So—the plan now is just to watch this.

We had Thanksgiving Dinner at the Ronald McDonald House. It was a lovely spread, with turkey and a groaning board of side dishes. I sat next to Lauren Nicole and we talked weddingweddingwedding. Fun. CJ and Sarah joined us and it was great to meet them. Luke and Jesse were in good shape today. There is grace here. I will always remember this Thanksgiving as the most memorable in my life.

David Anderson