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Updates: SCVMC ICU
Updates (Read chronologically from bottom to top) June 10,
2004 June 9,
2004 June 8,
2004 June 8,
2004 June 7,
2004 June 6,
2004 June 5,
2004 June 4,
2004 June 3,
2004 June 1,
2004 May 31,
2004 May 30,
2004 May 29,
2004 May 28,
2004 May 28,
2004 May 26,
2004 May 25,
2004 May 24,
2004 May 23,
2004 May 22,
2004 May 21th,
2004 May 21st,
Santa Rosa: April 11th - May 11th
Early SCVMC rehab: May 11th - May 20th
SCVMC ICU: May 21st - June 10th
SCVMC Rehab (round two): June 11th - September 14th
Home in GV: September 14th - April 11th 2005
Home in GV: April 11th 2005 - August 26th 2006
My new life
Jill had a pretty good day today considering that she had surgery yesterday. She was very alert the whole time that I was there tonight. The CT scan that they took this morning suggests that the new shunt is working correctly. Some good news...the rumor that we heard about her return to rehab was true. She will be moving back to the rehab unit at around 10am tomorrow morning. This is extremely encouraging news for us since we were told that she may not be able to go back there due to her low level of responsiveness a few weeks ago. So...another round of rehab begins tomorrow.
Everything went fine with the surgery. It was much longer than expected but she seems to have taken it pretty well. They will do a CT scan tomorrow to make sure that it's still working properly. She'll in the ICU for just a few more days recovering from this surgery and then they'll probably move her to the neuro unit for a while after that. The doctors are already taking about moving her back to rehab in the near future.
Jill is doing about the same as the last few days today. She still has pretty big fluctuations in her demeanor from minute to minute. She will have the shunt surgery tomorrow sometime in the afternoon. It should take around 2 hours for the neurosurgeons to take the old (external) shunt out and insert the new one. Please keep her (and her surgeons) in your thoughts tomorrow.
It has been decided that Jill will need a new (internal) shunt at some point in the near future. Apparently she actually did have a noticeable increase in ICP throughout the weekend which convinced the doctors to unclamp the shunt late Saturday night. The surgery will probably happen on either Wednesday or Friday of this week. The good news is that Jill seemed to feel a little bit better on Sunday and Monday after her shunt was opened back up. I'll probably post another update after I see her tonight.
Just a quick event plug... Some of Jill's SCU friends are holding a gathering in San Francisco this weekend for her. All friends, family and other supporters are encouraged to stop by. It will be at the Blue Light (1979 Union Street) on Saturday the 12th from 3:00-7:00pm. Email firstname.lastname@example.org for more information.
Jill had a fairly good day today. She wasn't as agitated as she has been lately and had a few brief moments of meaningful movent today. Late last night one of the neurosurgeon's unclipped her shunt as a precaution since her ICP was a bit high. Sometime this week they will decide what to do about it as a long term solution. Thanks for your continuing support for Jill's recovery.
-Dan, Mom, Dad
Jill was awake really early this morning so she seemed sort of tired and cranky today. It looked like she was uncomfortable all morning. In the evening, however, she was able to get some much needed rest. She was sleeping for the last 2 hours of our visit - looking extremely content and relaxed. We were pretty happy to see her in such a comfortable and peaceful mood for the first time in a while. Her ICP is still normal despite the shut-off shunt valve.
-Dan, Mom, Dad
Jill's CT scans and vitals are still stable. Her ventricles have not shown any additional swelling since the capping of the shunt. For the first time since I can remember her WBC counts are normal. She continues to track our movement, and occasionally responds to simple commands, but has not shown signs of increased awareness recently.
Jill's shunt was "shut off" yesterday afternoon. Her level of responsiveness stayed about the same as the past few days. The neurosurgeon was pleased that she seems to be handling her ventricle pressure effectively on her own so far. She will get a series of CT scans in the following 5 days before a final decision is made (regarding the shunt).
(I've gotten a few questions about the trust fund and where to send cards for Jill. I changed some of the information on the main page to address these issues if you are curious.)
It was a pretty good day for Jill today. She was a little bit more alert than she has been in the last few days. She cracked another quick smile and was able to open her mouth for the nurses. The neurosurgeon increased the pressure in her shunt (as expected) and she seemed to handle it without any visible difficulty. The doctors will continue to increase the pressure (while closely monitoring her ventricle size with CT scans) until either the shunt can be capped off or the ventricles swell. If the ventricles swell, she gets another internal shunt. If she does not show any additional swelling or deterioration, the shunt will be taken out for good.
There's not really a whole lot of news as of this evening. The hospital was pretty deserted today due to the holiday. Jill is doing about the same as yesterday. The doctors will most likely begin to check her dependence on the shunt tomorrow.
No new medical information today (which sort of feels like a good thing). In addition to the fact that she has been doing a bit better lately, it is probably due to the fact that it is the Sunday of a 3-day weekend. Jill had a fairly good morning, but appeared to be more uncomfortable in the afternoon. The highlight of the day was when she smiled for Grammy...
-Dan, Dad, Mom
Jill is doing a little better today. She is tracking people in the room with her eyes and lifts her head off of the bed occasionally. We think that this is similar to her level of responsiveness early on in rehab (before the big infected shunt ordeal). We know that her condition will probably continue to fluctuate from day to day, but let's hope that the general trend stays positive...
-Dan, Dad, Mom
Jill seems to have deteriorated a bit again. She isn't having any issues with her vital signs, but her responsiveness is way down. Over the next week the doctors will evaluate the need for another (internal) shunt. Any future move will be dependent upon her regaining at least her previous level of consciousness and, of course, her continued stability. Please keep Jill in your thoughts and prayers.
-Dan, Dad, Mom
The doctors didn't see anything that they were particularly concerned about in the EEG. Jill has been doing pretty much the same lately. The nurses confirmed my thoughts about her sleeping patters improving. Apparently she has been sleeping for pretty big chunks of the past few nights. She got a fiberglass cast on her left-arm fracture. It is definitely healing, but they want to make sure that it stays protected. My parents and I are meeting with the doctors this afternoon to chat about the overall status of Jill's care and recovery. At this point, we think that she'll be ready to leave the Surgical ICU within the next week or so.
Jill had some more small hints of improvement today. She appears to be slightly more relaxed at times and is really tracking our movements within her room now. Also, I think that she is back to getting some real sleep again. She is back up to the rate of feeding that she got in rehab. Jill got an EEG this afternoon to check out her brain activity. We should know more about the data that was collected tomorrow sometime.
Today brought some more brief moments where Jill seemed to show evidence of improvement. Jill, at one point today, turned her head and focused her eyes in the direction of her doctor during an exam (it is nice when the doctors get to see little signs of improvement so that we know that we're not just going nuts/imagining things...). Also, the docs were finally able to tap into the fluid around her liver. It turned out to be a relatively small volume, but looked infected. They saved a sample to culture so that they can be sure that her current antibiotics will address whatever is in there. No fevers or BP/HR issues today, but her white cell count is still ~double what it should be.
It is tough to say, but it almost seems like Jill got a tiny bit better today. It appears that her visual tracking is starting to come back for brief moments. She is still not responding to any verbal commands, however, and her upper body is extremely tense. There has been no change in the status of her swollen ventricles.
The swelling in Jill's brain is not decreasing despite the external shunt that the doctors put in. We are very concerned due to her lack of responsiveness over the past few days. She was a bit better today than on Saturday, but overall she has deteriorated a great deal since her early progress in rehab. She does not seem to respond to our voices or make eye contact very much these days. She is on 3 antibiotics for a few different infections throughout her body and she still battles fevers on a daily basis. Thank you all for the support, kind words, and thoughts/prayers for Jill.
Jill was still having a pretty hard time today. She is not really responding to our presence much these days. The CT scan showed that her ventricles are still swollen, but that the external shunt is functioning correctly. The doctors think that her recent deterioration is probably due to some combination of her various infections and the swollen ventricles. They are hopeful that, once these two issues are dealt with, her level of response will recover back to what we have seen in the last few weeks. In addition, they found a small area of excess fluid in her abdomen which will probably be extracted and cultured tomorrow.
-Dan, Dad, Mom
Jill was not very responsive for most of the day today. She has been showing some of the same spells of high blood pressure and HR that have given her trouble at times in the past. She is on lots of antibiotics, pain medication, and bp/hr regulation medication. They isolated the bacteria that is in her CSF and they are targeting it specifically at this time. No new infections seem to be appearing at this time and her white cell count has been reduced over the last few days (down from 28k to 11k - normal is ~5k). The tension in her facial expressions and in her body was pretty intense today. She is scheduled for a CT scan tonight to verify that the external shunt is working correctly. We hope that she is resting comfortably and will feel better tomorrow.
-Dan, Dad, Mom
To clarify what happened early yesterday morning - the original plan had been to take Jill to the OR to remove the infected shunt and put in a temporary shunt (the ventriculostomy). The OR wasn't available so the surgeon did the procedure in the ICU under local anesthetic after Jill had been given some short acting sedation. The surgeon he left in the valve in her ventricle (from the old shunt) and connected it to an external catheter which can drain fluid when the pressure in Jill's brain gets too high. There will not be another surgery until they feel the infection has cleared; probably 10 to 14 days, and then a new shunt will be placed.
Jill is restricted to bed rest these days due to the external shunt. This will last until she has the external shunt put in (about 2 weeks). She definitely doesn't seem to enjoy lying down all of the time.
-Dan and Paula (Jill's aunt)
SCVMC ICU Updates (Read chronologically from bottom to top)