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Updates: Early SCVMC
Rehab Updates (Read chronologically from bottom to top) May 20th,
2004 May 19th,
2004 May 18th,
2004 May 17th,
2004 May 17th,
2004 May 17th,
2004 May 15th,
2004 May 14th,
2004 May 12th,
2004 May 11th,
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
The hospital never had the correct combination of surgeon and O.R. last night for her to have the planned operation.... So, sometime around 2am they took her up to the ICU and did a bedside ventriculostomy. They did not remove her shunt. Her doctors will let us know what they are going to do about the shunt sometime later today.
Apparently the surgeon got pulled into some emergency operation of unknown duration and will not be able to perform Jill's procedure for a while. They said it could be very late in the evening before they get to her. The doc is on call 'till 6am so it could even be done some time very early in the morning. She has been pretty responsive today according to my dad (he came back down for the surgery).
Jill will have her surgery tomorrow sometime in the afternoon. The neurosurgeon has a long surgery scheduled right before hers so he couldn't give us a firm time. Despite the infection, she had a pretty full day of rehab work on Tuesday. She was in her chair for long periods of time and seemed to handle it fine. The resperatory therapist has started to deflate the cuff on her trach for long periods of time as well. This is a step towards teaching her body to breathe normally again. I was suprised because Jill was actually quite alert for most of the evening despite the day of hard work.
It looks like Jill will have to go through another surgery within the next few days to deal with this most recent round of infection. The doctors are tentatively planning to remove her shunt on Wednesday in exchange for a ventriculostomy drain. Apparently it is pretty common for a shunt to become infected (usually not this soon though) and, once it does, antibiotics are not an effective permanent solution. Jill seemed to be resting pretty comfortably tonight when I left.
Jill has an infection in her cerebrospinal fluid (csf). They found white blood cells and some bacteria (type unknown at this point) in the samples that they took last night. It doesn't appear to be extremely infected at this point (the csf is still nice and clear), but it probably does explain the fevers. On a brighter note, Jill's seems to be doing a little better this morning than last night. She is opening her eyes again (she wasn't last night) and doesn't seem as distressed. I am not sure what the prognosis is on this type of infection, but the doctors seemed confident that it can be controlled with antibiotics.
Jill had a really tough day today. All morning and early afternoon she looked like she was in pain. She had a fever most of the day and wasn't very responsive at all. Things just didn't seem right to us so eventually we got the attention of the doctors and they took a closer look. Throughout the afternoon and into the evening she got lots of blood work done, an ekg, and a CT scan or two (although it's tough to say at this point since the doctors at SCVMC don't have a picture of the scan taken a few days after the surgery). The CT scan showed that her ventricles are back to the pre-shunt size. The neurosurgeon seems concerned with her deterioration but feels that the shunt is probably working properly. He tapped into her shunt tube at around 11:00pm to have the csf cultured (after extracting it he was pleased to find that it looks nice and clear - this fact lowers the probability that it is infected). We won't know for sure until after the results come back which will be sometime in the next 2-3 days. He doesn't think that there is an immediate risk to her at this point. Tomorrow they will more closely scrutinize the scans and other information collected throughout the day. When we left Jill looked distressed and not too restful. Its been a very long day for all of us.
Jill had a pretty good day today. She was up in her wheel chair twice today for a total elapsed time of over two hours. Sitting up seems to keep her much more alert. For brief moments today she seemed to be able to communicate with us by nodding her head. In fact, her head has been moving around a great deal more today in general.
We apprecieate everyone's continued support. She is getting to the point where she can tolerate a few more visitors. It is really important that she gets to have her friends around in addition to the family. The best times to come are always earlier in the day - she will be less worn out and there is less chance of a crowd during these times. Also, weekdays are always better than weekends if you can swing it. At any time throughout the day there is a chance that she will be in therapy or busy, but the sessions don't usually last more that a half hour or so.
-Dan, Mom, Dad
Jill is beginning to get accustomed to her rehabilitation schedule these days. She has been "alert" for longer periods of time lately and her right arm is becoming a bit more mobile. She has been up in a wheelchair (with her back brace on) and has taken in some fresh air outside over the past few days. The doctors have started to let her breathe through her mouth for short periods of time (by deflating the trach cuff) - she seemed to deal with this just fine. This is the first step towards weening her off of her trach. My parents are thinking about heading home on Sunday. This will be the first time since the accident.
-Dan, Mom, Dad
She is all settled in now in her new place. Today a team of doctors did a thorough review of her injuries and current level of functionality. In the next few days they are going to set some short and long term goals for her recovery. The staff seems to be extremely knowledgeable and supportive.
Jill went through some of the same "mood" fluctuations today as she has in the past. She sleeps some, seems pretty alert some, and looks like she is in lots of pain/confusion some... The only difference lately is that all of these states seem to get a bit more pronounced as the days go by.
Jill made it safely down to SCVMC! They arrived about an hour ago (1:30pm). My mom got to ride in the ambulance to keep her company. This is a big step for Jill. She is now resting comfortably after the long trek down south.
Early SCVMC Rehab Updates (Read chronologically from bottom to top)