06/2002 Blog

Author: carolarmstrong
Date Updates on Carol for JUNE
06.12.2002 The doctor talked to us about a radical procedure that can
be done to releave the pressure on her brain. They wanted to remove the
right portion of her skull and place it in her adomin to keep it alive.
That would allow the swelling part of the brain to expand through the hole
in her head and take some of the pressure off the good side of the brain.
The procedure took about 4 hours to complete. They did not have any complications
during surgery.
06.13.2002 Carol is doing much better today with the pressure releaved
some. They still have to drain some fluid from the left side every now and
then.
06.15.2002

The doctors came up right before the 1pm visiting hours
and asked to speak with me. They asked if I had seen a picture of Carol’s
cat scan yet. They showed them to me and explained that her brain was
still swelling and that the previous surgery to remove her skull was not
able to help anymore. They decided to open her head back up and remove
the dead (stroked) portion of her brain to stop the swelling. It is the
dead portion that swells because of the lack of blood flow. That would
allow the pressure that is being put on the rest of the brain to be releaved.
I gave my consent then they left to start on the operation.

The doctor came up at 3:30pm and said everything went well. The removed
all they could until they got to parts of the brain that started to bleed.
I was surprises at how fast they did the operation but I guess it was
because they did not have to remove her skull which was still off. I was
able to go and visit her at 5pm and she was very active. I think this
was the most I have seen her move around and hold hands. She was following
commands well.

06.16.2002 Went to see Carol at 9am. I was kind of concerned because
she was sleeping again. The nurse tried to get her to follow commands and
she was not responding very well. They called the doctor and ordered another
cat scan. At 11:30am the doctor came up and said the cat scan showed fluid
and air build up in the area where the brain was removed. They decided to
put a drain in on the right side. They said that they removed 80cc’s of
fluid and Carol immediatly raised her arm to feel what they were doing.
They left the drain open so that as the pressure builds up the fluid will
be drained automatically. She was doing better.
06.17.2002 By sunday night Carol started to run a temperature. It was
at 38.6 celsius (101.48) and rising. They took samples to have a culture
done to see what was causing the infection. She slept most of the day.
06.19.2002

Carol was sleeping most of the time. She is still fighting
the fever.

Carol’s temperature was still high at 39.2 celsius (102.56). She was
holding my hand and moving her right leg around. Sometimes she does not
want me to leave when visiting hours are over. I hate to go. I usually
rub her leg one more time on the way out the door.

06.20.2002

Carol was sleeping again this morning at 9am. She did
wake up for me before the 9 to 10 visiting hour ended. She held my hand
and felt my face. The nurse was busy this morning with other emergencies
so I did not talk to him much. The pharmasist was there looking over her
notes. He said he was treating Carol with two antibiotics to help get
rid of the infection of the spinal fluid. He saw in the notes that the
lab test from 6/17 came back negative, which is good. He asked how she
was doing. I informed him of all that had happened in the previous week
and that she is sleeping alot. She could be sleeping more because of the
fever that she is still fighting. The nurse turned the cooling blanket
on as he left to help lower her temperature but I noticed when I was talking
to the pharmasist that it was set for 37 degrees celsius. It was normally
set for 4 degrees celsius so I asked the pharmasist if that was right.
He tracked the nurse down and he said the thing must have reset during
a power bump and it was set wrong. I am glad I caught that mistake. Her
temperature was 38.2 celsius (100.76) at 9am. She started to play that
game with me where you hold hands and try to catch the other persons thumb.

I stayed home for the 1pm visit and Carol’s mom and sister went to see
her. They said she was doing much better. The physical therapist came
while they were there and worked with Carol for a while. Carol is starting
to nod her head now. Her temperature was at 36.9 celsius (98.42) and the
cooling blanket was still turned on. She was more active for them than
she was in the morning.

06.21.2002

Visited Carol at 9am. She was holding my hand but still
sleepy. She had the shivers again because the cooling blanket was on.
The blanket cools to 39 degrees. I asked the nurse about her breathing
pattern because it looked different. He said that they changed the ventilator
and she is breathing completely on her own now. They should be taking
the neck brace off today. They did xrays of her neck and everything looked
good.

1pm, The neck brace was off and she is able to nod her head. She was
awake when we went in to visit. I untied her right hand and she cleaned
her ear, scratched her head and felt around a little. We have been wondering
how much she can see out of her left eye. We know her right eye has problems,
she has not been able to open it yet. The doctor said there is a piece
of bone pushing / lodged in the optic nerve. I had my hand in front of
her face and open and closed my hand real fast. Carol then did the same
with her hand. I tried it again doing something different and she mimiced
me again. So it looks like she can see something out of her left eye.
She was shaking still because of her temperature. It was at 97 degrees
because of the cooling bed.

5pm, Carol’s sister and mom went to visit while I kept the boys. They
said she was doing some weird hand signals and they did not know what
she was trying to say. My mom told my later that when my sister was leaving
she turned and waved goodbye to Carol and she waved back.

9pm, Carol was sleeping. She would wake up a little when she coughed
and squeeze my hand. The nurse told me they are going to try to take out
the breathing tube tomorrow. Maybe she will be able to talk then.

06.22.2002

9am, Carol was sleeping. She would wake up a little then
go back to sleep. The had to turn the respirator back on because she was
having apnea (breathing would stop every now and then). The looked like
she was dreaming some because her arm would jerk some. She would also
move her left foot a little. We still don’t know the extent of the damage
to the right side of the brain and the left side of her body.

1pm, Carol just slept the whole time. The nurse said they had just cleaned
her up and changed all of the sheets. I was looking at some of the notes
and the plastic surgeon wanted to try to get started the week of July
1st but needs to wait for an ok from the neurologist.

9pm, Carol was still sleeping. She must have had a busy night. They wake
her up every hour to make sure she can still respond to commands.

06.23.2002

9am, Carol was sleeping when I went in but woke up towards
the end of visiting hours. I untied her hand and she rubbed the back of
her neck some. Her temperature was at 99.6 degrees. The nurse said the
cooling blanket had not been on since she came in at 7am. That is good
because that means her fever is finally going away. They had just taken
samples today to test for the infection she has had. They are trying to
get her of the respirator again today. They have it turned down to a minimum
of 10 breaths per minute. She can breath as fast as she wants but if it
drops below 10 the respirator will kick in.

1pm, Carol was awake when we went in. She had the suction hose and was
cleaning out her mouth by herself (she is still sluggish in her movements).
She held my hand and felt my face. I asked her a few questions and she
would answer by nodding her head. We had to leave early because they had
scheduled another cat scan because the white cell count was up. The cat
scan showed that there are some pockets of infection left on the brain.
The options are to keep treating with antibiotics or to do surgery and
flush the area to get rid of it. The doctor decided to wait and see if
the new antibiotics would help. She has been on two since last week but
they just added two more for a total of four. We were able to get back
in and see her at 2:30. She was still awake so I held her and for awhile
and gave her some leg and neck rubs.

5pm, Carol was sleeping so we left her alone. I only stayed for 30 minutes.
Being awake for a few hours earlier must of wore her out. Her temperature
was going up again. They also had her back on the respirator because she
was not getting rid of enough carbon dioxide. Her oxygen level was fine.

9pm, Carol woke up for a little bit while we were there. I untied her
hand (they keep it tied so she wont pull out and cables) and she cleaned
her right ear, rubbed her neck and scratched her head where the incision/staples
are. She held my hand for awhile then went back to sleep.

06.24.2002

9am, Carol was sleeping. I started back at work today.
I visit Carol at 9am then go to work and visit her again at 1pm. I will
be skipping the 5pm visit so I can pick up my boys but will see her again
at 9pm.

1pm, Carol was awake and we held hands. The nurse told be someone from
infectious disease was going to come and examine Carol. She still has
an infection and they are trying everything they can to get rid of it.
The doctor did come while I was there and she looked over all of her incisions
for signs of infection. She is also going to look over all notes and tests
to see if there is anything that was missed. Carol was rubbing and scratching
her head so the nurse gave her a wet wash cloth to rub her face with.
She seemed to like it. I put it on her forehead and right side of her
face. She liked that alot.

5pm, My mom, sister and friend went to visit. She was awake. The infectious
disease doctors were there looking over some things.

9pm, Carol was wide awake. The nurse said they changed her antibiotics.
When I untied her and she started to scratch her head and rub her face
and neck. I got a wash cloth for her and she wiped down her face and cleaned
her nose. She indicated her head was hurting so she got a little shot
to take the pain away. She held my hand and also put her hand down the
back of my neck and rubbed / held my neck. She motioned that she wanted
her teeth brushed so I did that for her. I asked her is she wanted a kiss
and she stuck her tongue out at me. She smiled a few times. It was a good
visit.

06.25.2002

9am, Carol was sleeping. The nurse said she was up all
night. They stopped feeding her yesterday just in case they had to do
surgery again.

1pm, Carol was awake when I got there. I untied her hand and she immediately
started to scratch her head. I have to keep her from scratching the incision
no matter how hard she tried because we can’t let it get infected. I held
her hand and rubbed her feet and legs. She started to cough which can
be scary at times. Her eye opens really wide and she looks like she is
in pain or really scared. She settles down after awhile. She indicated
she was cold and I asked the nurse if the cooling blanket could be turned
off for awhile so she could warm up a bit. The test of the fluid drained
from her head showed another rise in the white cell count. They are still
worried about the bacterial infection she has in her head. The pharmacologist
was there looking at her notes again. I talked to him and they are looking
for other antibiotics that can be used. They had already increased the
dosage of the current antibiotics she is one. I asked the nurse if the
doctor was around so I could talk to him. He came by and basically told
me that they are still trying to get rid of the infection. They are going
to continue treating with antibiotics as long as they can. He does not
want to do surgery to clean out the places in her head unless they have
to. I told Carol I loved her and she mouthed back ‘I love you too’.

I just got home and had a letter from the court. The defendant has requested
a new bond hearing, it is set for July 3rd. He previously received no
bond for the armed robbery charge and 200,000 for the assault charge.

5pm, Mom, Doug and Rachel went to visit. They gave Carol a good massage.
Carol was doing good.

9pm, Carol was awake. The nurse paged the doctor because he wanted to
talk to me. I brought a picture of the boys and taped it to the ceiling
for Carol to look at. The doctor came and said they want to operate on
Carol tomorrow in the afternoon. They need to open her head back up and
clean out the infection that is not going away. We had a few visitors
tonight. The cold bed was turned on again so I made sure the nurse would
turn it off for awhile after I left to give Carol a break.

06.26.2002

9am, Went to see Carol and the head neurosurgeon was waiting
to see me. He told me what they were going to do and said it would probably
be around 12 when they started. Carol was awake and I told her what they
were going to do. Her right sholder hurts her alittle so she tries to stretch
it. I called work to let them know I was going to take the day off. I was
originally going to go to work then come back at 1pm because lastnight they
told me they would be doing the procedure around 2pm.

12pm, The nurse called me and let me know they would be taking Carol soon
and I could come back and visit for a few minutes. Carol was awake and I
let her know I would be waiting to see her when they were done. Carol’s
mom and sister came back today. They got in about 1:30pm. I was in the waiting
room when my sister and dad showed up. They tried to go see her but the
room was empty. They did not know she was already in surgery. The doctor
finally came in around 3pm and let us know the procedure went well. He said
it was a good thing they went ahead and did it because there was alot of
infection and puss building up. They cleaned and flushed out the area where
the right stroked brain had been taked out. He did say that this was potentially
a life threatening situation with the infection.

5pm, We went back to see Carol. She was still recovering. She was awake
enough to sqeeze my hand at first. She woke up alittle more and waved hello
to her sister. We did not stay long so she could get some rest.

9pm, Carol was awake. She had a fever of 103. The nurse was taking blood
and other samples to have some cultures done. Some times patients get a
fever after surgery. She was a little tired. They had given her a few doses
of medicine and Dilantin. She has another tube in her head that is draining
alot. I think the doctor said it was one that was on the surface between
the scalp and bone to help drain off fluid.

06.27.2002

9am, Well it seems when it rains, it pours. Carol was very
sleepy this morning. She is running a fever of 102 now. It looks like
the place in her abdomen where they put the piece of bone from here head
is now infected. They had a bandage on it and it was soaked with reddish
puss. The nurse cleaned it up and put a wash cloth down to help. It was
already covered again before I left. The doctor was not able to get in
to see me before I left so I will talk to him at 1pm. The nurse said it
was good that it was draining and they will probably clean it out bedside.
The Infectious Disease doctor was there looking at her notes again. I
asked her to look at it also.

1pm, When they called to see if we could go see Carol we were told we
had to wait. I figured they were working on the infection in her abdomen.
The doctor called back and said I could come back. He explained what they
did. They reopened the infected area and cleaned it out good. They then
packed it with gauze and left the incision open putting gauze and tape
on to hold it closed. There is about a one inch opening. They will keep
checking and changing the packing to keep it clean. The doctor told me
Carol would be out for awhile because they gave her a load of medication.
We discussed the infection and he agreed that it was probably from the
same source and the one in her head. It probably came from the first operation
where they took the piece of bone out (part of the skull) to releave the
pressure and put it in her abdomen to keep it alive. The infection probably
got in her head and on the bone at the same time.

5pm, Just got an update from Carol’s sister. She was sleeping. The doctors
said they gave her a lot of morphine. Her blood pressure alarm went off
but they did not seem too concerned. It was somewhere around 60/40. The
infectious disease doctor was there and he said that the infection on
her brain was the worst case he had seen. He was not too concerned with
the infection in the abdomen.

9pm, Carol was awake a little bit. She would hold and sqeeze my hand
some. Her blood pressure was up, the nurse said they had to give her an
IV to help with it. He said they took the bone out of the abdomen to have
it cleaned and sterilized. They are also going to make a plaster cast
of it just in case they will not be able to use the bone. They can make
a replacement for it out of some other material. The person that checks
her medication and blood results came down and said the CSF or something
like that was down and that was good. They have to keep cleaning out the
infected area in her abdomen. The cooling blanket had been turned off
for three hours and her temperature was still at 100. It was not rising
as fast as it had been.

06.28.2002

9am, Carol was sleeping. She would squeeze my hand some.
Her temperature was 101. They took the dressing off of her head. They
also removed the drain from her head. They had to give her two units of
blood. He said it could be from some bleeding from the surgery or from
the new problem they had. When they put the new port on her left shoulder
for blood/iv/medicine they punctured her lung. The nurse said it was not
uncommon because the vein runs across the top of the lung. They had to
put in a chest tube that creates a vacuum too keep the lung inflated.
It should heal in a few days.

1pm, Carol was sleeping. Would wake up enough to held my hand some. Did
not open her eyes any. We did have a scare while we were there. Carol
coughed and I heard some fluid gurgle in the ventilator. Alarms started
to go off then I noticed she had stopped breathing. I had to go and get
a nurse to come in and look at her. The ventilator tube was blocked and
she could not breath. The nurse connected the manual respirator and was
using that for a minute then suctioned out the blocked tube. They kept
giving her air manually until things sounded ok. Once they connected the
ventilator back she started breathing again.

5pm, Not much to report except she was sleeping.

9pm, Carol is sleeping really good. She looks confortable. She would
wake up enough to hold my hand or rub my arm then go back to sleep. The
nurse said there have not been any problems. The dressing on the abdomen
opening is staying pretty dry so the infection is going away there. She
still has a slight fever of 100.7

06.29.2002

9am, Carol was awake. She held my hand and rubbed my face.
I untied her hand and she went straight for her head. She likes to scratch
and rub it. I told her she could not scratch the incision so I gave her
a towel that she could rub it with. I cleaned her mouth with mouthwash
and wiped her face. She seemed to have a headache and the right side of
her face hurts because of the broken bones. I put a cold washcloth on
her head to keep it cool. Her vital signs looked good and the nurse said
her temperature seems to be getting more stable. The white cell count
is still down and there does not seem to be any liquid draining from the
infections. They tried to let her breath on her own and she still had
periods where she would stop breathing so they put it back to assist mode.
The nurse gave her some Tylenol for her headache.

1pm, Carol was doing good. She still is not opening her eyes. She does
wake up enough to squeeze our hands. The infection disease doctors came
in to check on her chart. The white cell count is still down. They did
say that they identified a third bacteria that was present. It was the
staph bacteria. I think she is trying to indicate that her chest / or
throat hurts where the tube is.

5pm, She is doing about the same as 1pm.

9pm, Carol was resting. She held our hands then would go back to sleep.
She woke up enough to rub her face and eyes. I asked the nurse if he could
give her some more Tylenol because she indicated her head and eyes were
still hurting. They are going to try to see if she can breath on her own
in the morning.

06.30.2002

9am, Carol was resting. Woke up but did not open her eyes.
She will nod her head ‘yes’ if you ask her questions. She said her head
hurt a little but not as much as yesterday. The neuro surgeon came and
looked at her incisions. They looked ok. I asked about taking out the
ventilator tube and do a Tracheotomy. They are going to look at that because
it has been three weeks and they usually don’t like to leave the ventilator
tube in that long. She seemed to be resting well. Her temperature was
at almost 101. They had the cooling blanket on at 47 degrees.

1pm, Carol was doing about the same as this morning. Resting with her
eyes closed but will acknowledge your presents and hold your hand. Waved
goodbye to her sister and mother.

5pm, Carol was a little better. She was awake for about 30 minutes then
fell sound asleep. They are going to keep her on antibiotics for another
week. She opened her left eye today for a few minutes. She rubbed her
face with a wet washcloth. She waved bye to the nurse like she wanted
her to leave then pointed at me. The nurse told me that at 1pm she pinched
Carol on the chest to wake her up and Carol reached her arm up and grabbed
the nurses arm and tried to pull it away.

9pm, Carol’s mom and sister went to visit because I am not feeling well.
They say she was awake a little. She was cold. Doing about the same as
1pm.