Dave is about the same today. They are taking him off of a drug today to allow a better mental state. He will stay on propythol but they're administering a pic line to better distribute antibiotics and the propythol. They are saying propythol can cause tissue deterioration if administered too long a period of time with the other method. CT scan is scheduled tomorrow and ortho is supposed to be out later for his leg. The Cpap will be done at some point in time today. So hope for progress today.
So as for the message earlier about an MRI for brain damage. So we've been on edge about that information because the terminology "brain damage" must be the nurses way of communicating. Anyway waited all day to get that result. Apparently their goal was to remove the neck brace but they decided against it. As well as his fracture at the base of his head he has ligament adema from the injuries. These will heal on their own. The MRI is a precaution before administering a blood thinner to prevent clotting. A small sign of pneumonia starting and a bad sinus infection. They're giving him a broad antibiotic until they do a culture to find the exact strain to treat. All is ok.
Dave had a CT scan for his brain around 2 ish in the morning. Results are not immediate for us until the trauma surgeon or neurologist reads it. No time as to his arrival. Depends on his schedule. He failed what they call a CPAC test to determine if he's ready to come of the breathing tube. At this point it's just time will tell when he's ready. It's based on his brain recovery, his will, his cooperation and of course prayers. So that's it so far today. Everyone have a safe holiday.
So he's on a psychotropic drug that they will increase slightly in an effort to reduce sedation. Good news...he does recognize his brother Gary and I. They did the test for oxygen. We were hopeful for the tube to come out. He needs more time but they will try again in the morning. All of this is routine apparently at the trauma unit. Great news but as I said before every day brings new challenges. CT scan shows a 2 more blood vessels with a small amount of bleeding. They will monitor these because his blood pressure going up is of concern to the bleed. Also a certain pain killer had to be reduced that could further complicate the bleeding. He did well with the nurse commands and did exactly what they asked. He really wants off that tube. I feel bad. However it wasn't a pass on the test because of his oxygen levels and blood pressure raise. Doesn't mean he won't make it tomorrow. 5 to 6 am it may happen. Blood clots are a real concern so tubing with a screen to catch any clots that may move to the lungs may be put in also. We have to still be careful about his brain stimulation. He is anxious and that creates a blood pressure rise as well as the excruciatingly painful coughs that he has to so once in a while. I was at the hospital all day..tired.
Apologize for the time difference and whenever these messages arrive to all of you that are working. Called this morning to check on Dave. His night was somewhat restful. Vitals are good. A positive sign for me was he squeezed the nurses hand and wiggled his toes. I'm so happy hearing this. They will discuss the breathing tube coming out today. So I sort of allowed myself to breath a sigh of relief. Prayers are working guys♡♡♡♡♡♡
OK I'm here now waiting for the trauma surgeon. He is showing a minimum
response by squeezing his fingers and moving his toes, however a new set
of issues will make his recovery longer. He may have a little more
complications in the lungs. They have to remove mucous, flem???, they
haven't said exactly from the lungs. Possibly from the bruising and
broken ribs. I feel like pneumonia is lurking but they aren't confirming
this. Other injuries are still of concern.
They came in to suction his lungs and give him blood thinners, stool
softeners, Pepsid, suppositories so i said hi. I think he's coming back.
He knew it was it was me. He did squeeze my hand!!! Omg he is so
fortunate. Still risky. They're going to try again with the breathing
Well Gd only knows what lies for my poor husbands world today. I took an hour extra at home this morning and I was uneasy to fly back to this hospital. Had to cancel my markets with the business today. It would have been great income but.......
The nurse immediately stopped me and said do not stimulate,talk or wake him in any way. He kicked his leg almost over his head and became highly aggressive. So their fear is for his and their safety. Remember everyone...he can't help it. His brain injury is severe. He also wakes up scared, tubes are in his mouth so he doesnt even have a voice now. They do tests to lower the help given for his breathing so they can give his body the chance to fight on its own. Remember, the lungs have to work, he needs oxygen, organs have to function, etc. But the most critical is the brain injury. Any way, I just got word that the trauma surgeon will not remove the breathing tube today. Being cautious, he feels he's not ready. So today's goal is to for low brain activity. Rest for those blood vessels, so hopefully less of a fight. His vitals are good now. Nothing much can be expected until the weekend is over. I am here in his room being as quiet as possible. I can't touch him for fear of waking him. So.....pray some more everyone. I hope he's in there. The nurse said she thinks yes he is.
My heart bleeds as I receive these messages from my aunt. This is not going to happen. I believe in miracles and damn it I declare an intervention, the unexplained, a medical miracle that cannot be explained.
We received a message through a friend that knows brain functions as he is a surgeon and these were his words.
Take to heart: combative behavior is a high level form of function. Contrast that with wondering if there will be signs of any "presence" in there at all, yelling into an ear and asking him to blink or show two fingers. Trust me... combative behavior needs to be looked at in that perspective. For a lot of people with traumatic brain injury, it's more than they can muster.
In order to be combative, you have to think and feel, want (and not want), initiate movement and then have the hookups for nerve and muscle to execute on that drive. Combative is good.
In my experience, combative behavior is often seen in people with brain contusions that are manifested as "salt and pepper" hemorrhages in the frontal lobes as seen on CT scan. Injury in this region of brain can make people volatile, regressive, and sometimes moody or even violent. It's sometimes referred to as "frontal dis-inhibition". It can disable the self-reflective governing function that we (at least most of us) exert when we DON'T act on every impulsive thought we have. Sometimes there are complete recoveries, sometimes there are lingering effects of this but it's pretty hard to measure. Recovery from these kinds of changes can play out over many months and he may or may not remember a lot of what's going on now, when he gets through it. If not, good! Who wants to remember months of languishing in the healthcare system?
Before Surgery: He is going into surgery today. I talked to the anesthesiologist and the orthopedic doctors. Dave's son is on his way from Illinois. With Dave's children and everyone's love and input, we feel OK with our very difficult decision. Our fear and reasoning for the anesthesia mixed with the new need for surgery and his mental condition was real. The anesthesiologist definitely confirmed this. But we don't have a choice and it is a matter of choosing which risk is the one that is the least damaging. They have to keep him in a state of sedation because of his mental condition. There is a risk for not coming out of sedation. So many scales to balance and the rest is in Gds hands. That's where we left it. We will be forever grateful to each and every one of our friends, family and people who don't even know us.
After Surgery: Scared now but have to take this hour by hour. Trauma surgeon just delivered a message that makes me apprehensive about a full mental recovery. The broken body is dependent on the trauma team getting him off the breathing ventilator to breath on his own. Highly likely pneumonia has started with the amount of days he can't walk. The mentation is dependent on the ability of the broken body the get moving to eliminate and rid itself of toxins so his brain has the opportunity to heal. The brain ability to heal is oxygen so he has to be able to use his lungs. All this has to work for his recovery. At first, I couldn't help but feel the surgeon delivered this message with hospital liability in mind. Then after viewing how upset it got me, he said "to ease your mind please know that we have done these types of treatments many times. There is nothing that we can't treat here."
He may have thought that made me feel better but he never said we can treat him and he will come out of it with a sound mind. Omg. What has happened? I have to take this hour by hour. I can't go further.
So the news is subjective. He made it through surgery and his leg looks
fine. Not sure if a good looking leg is good news when the brain is in
trouble. There's no good answer yet in my eyes. Hour by hour will tell.
They are working to get him off the ventilator primary so he can breath
on his own. That is the first step to a sound mind opportunity. I will
be here for couple hours yet to observe the ups and downs for my poor
5:00 am and I am heading out to the hospital now. I called the nurses at 2:30 am and
they have Dave on the surgery schedule so I need to get there to access
his condition with my own eyes and hear how the night went for him. His daughter may be able to be there as well, she will let me know. I'll post soon.
5:30 am and I just arrived at the hospital. I was asked to wait 15 minutes because he had kicked his urinary device off. I hope this was an accident and not aggressiveness or agitation. This behavior makes me concerned about his brain injuries. It was probably an accident and it's easy to do with all the crap he's hooked up to. He's a kicker when he sleeps anyway.
7:28 am and I am waiting for his daughter and the nurse to arrive. They said this morning was he had an episode of confusion and delirium. He popped straight up after he kicked his feet on the end of the bed. They had to place him down and then the catheter got pulled out. He called out for his brother Gary and his Mommy. Specifically get my Mommy. They said that all of this occurred after lowering his pain medication to not over medicate. So they slightly upped it again and now he is asleep. They are not hurrying us about the surgery but I explained my concern about not seeing any mental improvement. One point the nurses made is the longer he stays the more crazy he feels not being able to start moving.
His daughter arrived and is here and we talked and thought passing the day for as much rest as possible an maybe letting the surgery occur either this afternoon or tomorrow morning.
7:54 am I will ask about the pain management but I'm thinking at this point it's the juggling of pain medication to manage his pain. And they actually restrained his arms today and he is not responsive to conversation but he did tell the nurse "ouch" when the catheter was inserted. The consensus is from his children and myself that we will monitor his condition today up until as late as we can go until surgery. If it appears as though he can get through the surgery, it's yes to this afternoon. I will have apprehension if he becomes combative or overly aggressive as the day progresses. But if he is agitated but lucid I would say yes for this afternoon. Otherwise the morning seems to be the latest we want delay so the leg healing is not compromised.
9:33 am Surgery is scheduled for tomorrow. There's nothing else medically they can say to deny the surgery. He had a sonogram for blood clots and the radiologist will let us know as soon as they read it. The neurologist came in and said his frontal brain injury is severe and it changes personality, agitation, ambition, etc. So this made me decide to say those horrible words...will he have brain damage? He said they won't know for a while what the extent of his abilities will be. I WANTED TO CRY AND NEVER STOP! I am so hurt. Omg. I just pray that he will be mentally sound. That hit me hard just now. So it's covered for the neurologist because if the anesthesia caused him complications we wouldn't know where the damage came from. My heart is crushed. So it's tomorrow. Pray.
Last night was extremely difficult for Dave and everyone around him. He was very uncomfortable and insanely uncooperative. The nurse discovered that his leg was turning inward and it needed surgery this morning. I stayed with him all day and his son and daughter in law were there too. Most of the time he seemed unaware of the severity of his injuries, which was a change in behavior. His agitation was through the roof. He was pulling off his neck brace which could have caused more brain bleeding, pulling off the arm cast then feeling so much pain. Finally we all left him thinking the nurses could get a grip over his behavior. This was not the case. Dave didn't sleep all night and continued to decline mentally. He was pulling out the oxygen tube which in turn gave him loss of oxygen and his ribs hurt trying to take deep breaths so he didn't want to breath deep. This morning in speaking with the ortho surgeon's and nurses we expressed the concern of surgery too soon on the leg because due to the fact he would need to be anesthetized, this led to discomfort with the brain not working well last night and today. We decided to put the brakes on surgery after speaking to the ortho. He has a week before the leg becomes a problem so the doctor thought priority should be to pay attention to the brain first. So no surgery today (THANK GOD) and medication is being dripped into IV as opposed to being administered all at one time. So blessings to everyone for their contributions whether it's prayer, financial, thoughts or whatever! It is APPRECIATED by me and my POOR husband. Prayers are still needed. He's not out of the woods yet. Thank you everyone.
So the past updates were from my aunt and her experiences with my uncle in the hospital. I received a private message from a gentleman on our neighborhood website by the name of Justin and this is what he wrote me:
Hi Stephanie-is his name David Turner? What hospital is he at? We came up the hill and were there before emergency services got there. I held his hand and tried to be a bit of a comfort until paramedics arrived.
God sent his angels to be with him while we were afar.
I'm in here and they are changing the dressing on his leg. The nurse had a small concern about his leg rotating inward so the assistant Ortho ordered another CT scan as I am sitting here. The concern is that the screws and leg are aligned. As I am writing this the nurse informed me that there is a possibility of going back in for surgery AGAIN to align the foot! Oh no my poor baby! I can't even tell him because he is sleeping the current pain off. So so sad but it's better to do this now so there is not a walking issue. I'm so upset about this but has to be done if the CT scan shows an issue. Makes me sick. I'm just praying hard for him. Surgery is now scheduled for Tuesday morning.