Monday, December 6, 2010

Monday Dec. 6th's prognosis

Sunday evening I went home to Tamaqua, showered and threw some things for Nick and I in a bag. Then we headed back to Macungie to Barb's. Barb has been my best friend for nearly all the years of Nick's life. She's like a "pseudo-mom/sister" to me, always there when I need her and vice versa. We met through my ex, but while his and her friendship struggled and failed, hers and mine flourished. I don't know what I would have done through all of this without her help. She's truly my angel. Her door has always been open, and it was now as well. She said she was more than happy to have Nick, her "buddy", come stay as long as needed while I went back n forth from her house to the hospital. I made the decision to keep Nick out of school the coming week, and called them Monday and explained. They didn't sound pleased of course but said they understood and wished us well. Nick was upset about the accident, and very quiet...his sure sign of emotional stress...either that or acting like nothing at all is bothering him...only a mother can always tell.
I headed back to the hospital that night from Barb's and stayed.
Monday morning a team came in to do a doppler of Danny's arms and legs. They were concerned because his arms were swelling swiftly. The doppler of the legs was fine, and they commented on his "great" arteries and muscle tone. They did find a clot in his right upper arm though, and it wasn't possible to put him on blood thinners until they could be sure the brain bleeding had stopped. They said it was unlikely a clot in the arm would cause problems, but to me it was another worry on top of everything else. I was also worried about the fevers Danny was starting to spike.
Around 11am different doctors began trickling into Danny's room to talk with me. I introduced myself to each one and they showed no hesitation with sharing information with me, for which I was very grateful.
The ortho specialist told me about the broken left shoulder blade and right jaw, and cracked C6 and C7 in his neck. He explained that none of those areas can be casted and basically just stabilization of the parts as best as possible would be the treatment for now. The jaw would get wired, but no time soon...he was too critical. The Aspen collar would remain possibly 2 months.
The pulmonary specialist came in next, explaining that Danny had a collapsed lung on arrival and that there was severe bruising, some internal bleeding and significant fluid build-up in the chest cavity. My eyes followed the tubes coming from his left ribcage and emptying bloody liquid into a plastic measuring canister hung under the bed. He told me that the suctioning tubes going down his throat were threaded into his lungs for removal of fluid and mucus within them. He told me that the ventilator was necessary because they could not assume Danny was breathing on his own. It appeared he was attempting to initiate breaths, but certainly wasn't capable of carrying them through himself. They said he would be getting a tracheotomy inserted, probably later in the week. GOD! A trach...!!
The respiratory therapist had been in earlier and explained that as well. They were coming in often and suctioning him, especially when the tones on the vent monitor would alarm in a dramatic fashion. Nurses were suctioning him as well, and the reaction of pain on his face when they did so terrified me, but at least it was a reaction. It was the only reaction he was showing. They would induce cough, but he wasn't coughing voluntarily.
The most upsetting information came from the neuro team. Danny's injury was called diffuse axonal, which means the brain was violently shaken within the skull, tearing the neuron connectors all over his brain. The entire brain was involved, as opposed to a brain injury where a certain part is punctured or hit and the damage is focal. The doctor told me about the severity of this injury...the worst type to have. He told me Danny is young and strong and that that may help, but he had a "horrible horrible" injury from which some never recover. I remember feeling so sick when he said those words..."horrible horrible."  He mentioned the word "coma" and I realized that this was what Danny was in, but I asked just to be sure. Of course I asked for a prognosis, and was told for one of the first of many hundreds of times over the next year, that "no one knows...its a waiting game.  All we can do is wait and see,"... wait and see. He had a second CAT scan to compare to the one immediately after the accident, and it showed no worsening of the bruising or bleeding, and the cerebral pressure was staying in the above normal but not dangerous range. If the brain started swelling, which was very possible, almost expected, it would swell in the first 72 hours after the accident, and then a piece of skull would have to be removed to make room.
Neuro-checks were done every few hours around the clock. Flashlights were shone into his eyes to check for pupil reaction. There was some but it was very slow, especially on the left. Each new nurse would ask me about his two different colored eyes, one blue and one brown, and that always made me smile. Then they would shout his name a few times and say "open your eyes!" Nothing. Nothing either when they pressed hard and rolled a pencil on his finger or toenails. Each time it was time for neuro-checks I would watch with anticipation, but never a reaction. When I opened his clenched fingers and put my fingers inside, he would squeeze sometimes, and I was over-joyed. All the TV shows I'd seen like this where people said "OMG he squeezed my hand!", ran through my mind. But the nurses told me again it was just a reflex. The downward facing clenched hands were a typical posture of coma, and the squeezing an involuntary reaction to tactile stimulation. I quickly learned that the "buzz word" was the word "purposeful". When reactions and movements were purposeful, then we might be progressing. I was becoming increasingly worried because they turned down his sedation Sunday, and Monday morning, off all together. This was supposed to increase the chances of him being able to respond. Nothing was changed though by late Monday night. I left about 11pm to go back to Barb's, with a heavy heart.

Facebook on Tuesday, December 7, 2010 at 12:49am
There have been no improvements really in Dannys condition. The sedation is off 24hrs now and he still is only responding to pain like when they suction him. His pupils are reactive but sluggish. The second cat scan shows no worsening at least. He has a clot in upper right arm but they said theres little or no chance of that causing problems. Cant put him on heparin cuz of the other bleeding places. Arteries in legs are excellent and they said he has wonderful blood flow and muscle tone. Lung sounds are a bit coarse but no wheezing and are mostly clear. Oral surgeon says the jaw will be just wired and should build new bone on its own to heal...that wont be done til hes more stable. The bruising on brain is severe. Theyve seen patients like this wake in a few days, months, and some just dont. Still too early to know degree of damage. It upsets me that he hasnt shown much reaction at all, but i asked if they did an eeg and they said they dont have too because they are sure there is brain activity and hes not brain dead. They also said he looks to be initiating breaths but its just not enough to do on his own. So the vent has to stay in. Hes running high fevers, and has edema in both arms. Im going back tomorrow in the morning sometime. Im at my friend Barbs down here in Macungie. Bayada has been wonderful and has given me time off til Friday and more if i need it, and im keepin nick outta school all week. I dont wanna do that, but i want to be with Danny every moment i can at least this first week. Only figuring things out one day at a time. Thank you for all your prayers and concern. My heart is really breaking......Kathy

Sherry Peletsky Thank you for everything you are doing Kathy!!! Stay strong, we are all praying. I will talk to you later.
December 7, 2010 at 6:10am

Deanne Peletsky Colna ditto, what Sherry said.
December 7, 2010 at 7:00am

Dan Siracusa Wow, Just when you think all is going well for you.
You know that you guys are in my prayers.
Just keep us posted.
How and where did this car crash happen ???
I tried to look at the paper, on line. But nothing was found.
December 7, 2010 at 7:21am

Carol Terry thinking and praying for you guys...
December 7, 2010 at 7:56am

Robin Kinsey Keppley Keep having faith that god will heal him! All things ARE possible;) be strong and patient... Things like this take time. I will keep praying;)
December 7, 2010 at 8:02am

Lorrie L Leickel- Koch Ive been thinking of the two you every moment of the day.. Wish there was something I could do for both of you.. Love you!
December 7, 2010 at 8:35am

Sarah Hottenstein i'm still praying for you and danny. please keep thinking positive kathy and believe that god is listening to everyones prayers.
December 7, 2010 at 9:28am

Troy Heiland sending good vibes your way, Kathy ..... keep thinking the best
December 7, 2010 at 10:18am

off to the hospital soon. Hoping something is looking better. I hate waking up in the morning and realizing Danny is lieing in that bed instead of with his arms around me like it should be.

Sittin here with danny. Content just to have his hand in mine
Facebook on December 7, 2010 at 5:35pm

Eric Waksmunski How is he and how are you doing?
December 7, 2010 at 5:47pm

Rhonda Bigham Moats You are a wonderful woman Kath. He knows you're there. :) My thoughts and prayers are with you both. ((Hugs))
December 7, 2010 at 5:47pm

Lesley Murlo Thinking of you guys :)
December 7, 2010 at 5:57pm

Patrick Sherman Kathy we hope that Danny has a speedy recovery.Stay strong alot of people love and are praying for the two of you.. Dasiy sends her love and misses her friends.
December 8, 2010 at 5:45am