Tuesday, April 7, 2009

Day 16

Forgive me for the delay in this post. I have been at the hospital all day but without the computer. Brad needs it for work and decided to stay home today to get some things done for club tonight. So, here is how today went...

I got to see three doctors today! The first doctor was a doctor that was in charge of making sure Mom is breathing just right. He said from his end (meaning what he is supposed to check out..) everything looked great. They decided to start the process of quitting the intubation on Mom. Mom would now be breathing on her own for several hours a day, eventually getting to the point where she is independent without the machine at all. Right now the machine is helping her if she fails to take a deep enough or frequent enough breath. She needs to be off sedation to be without the tube completely. This way she can help cough and expell the device and so any "leftovers" in her lungs do not choke her.

Doctor number 2 was Dr. Brown. He is the doctor that did the coiling procedure on Mom after her aneurism (or aneurysm) two weeks ago. His visit was quick, briefing us on the TCD numbers from today. They were down slightly with one artery still hovering at a higher than liked level. So, we would continue to watch.

Doctor number 3 was Dr. Greene. Today was my first incounter with her. She shared great information, listened to questions, offered explinations, and spoke about other examples of patients she had seen. Overall a very informative exam time. Here is the info she shared...

Mom's TCD numbers are holding steady, actually slightly down from prievious tests (as explained by Dr. Brown) However, the left middle cerebral artery is the artery that is still high. This is so close to the "real estate" in her brain we are wanting to preserve. It very scary to me to hear this sort of news. Dr. Greene explained that she is very focused on the patient and her observations of behavior changes from day to day (as well as the nurse's). She explained that sometimes numbers don't always mean the worst, but a change is a person's responses (extra sleepiness, staring, lack of movement...etc), is more likely to signal a problem. Since Mom's numbers were down, she would just observe. She also explained that we have no way of knowing where Mom's TCD numbers would have been on that artery before the aneurism. It may have always been weak due to desease or defect. (which by the way is a heretitory issue and family should also get checked out).

She checked Mom's pupils, movement, and grips on her hands. Mom had only movement on her right side when it was a reflex, a reaction to the place Dr. Greene pinched or poked. She had slight movement on her own with her left foot.

Dr. Greene is continuing to keep Mom sedated but for shorter and shorter amouts of times. Hopefully, we will get to a place where she sleeps when she wants to and not when encouraged with medicine. HHH therepy will continue. HHH therapy stands for hypervolemic-hypertensive-hemodilution therapy; basically this means keep the fluids (and therefore blood pressure or, more correctly, the mean arterial pressure) of a vasospasm patient up, and the concentration (or viscosity) of the patient's blood down. Together, this pattern of blood properties is associated with improved brain blood flow. She also started another med to make sure Mom retains more of the fluid that she is getting through IV. Right now she is 2 L ahead of where she needs to be and that is great for fighting the vasospasms.

There is a CT scan ordered for tomorrow morning. Remember a brain CAT scan in a patient suspected of having vasospasm may show new strokes in the distribution of the artery or arteries. We don't want any of those. She told us about some of the damage Mom already has which is damage to the frontal part of the brain. That part is personality and motivation. In the future (love those words) we could see her struggle in these two areas when in social situations or when trying to get her to move body parts. But, she encouraged us with a story of a lady that was just like Mom four years ago who is now walking and talking and living her life again!

She of course reitterated that things can change day to day. We have seen that with Mom. She was sitting up in bed beginning to talk again and feeding herself just a week ago before the vasospasm and strokes kicked in. So, we need to be aware... That said, she did say "I feel she'll pull through this."

So now, we will just keep on with day to day. I'll ride this bit of a good day and anticipate the next. Please know, this fight is continuing every minute. Thank you for all your prayers and petitions to Christ. Please continue to pray without ceasing!


  1. First of all I give you props for remembering all of this stuff that is said to you everyday on top of your stress!! Glad to hear we are moving forward!

    Thanks for the update.
    love ya

  2. We're continuing to keep your family and your mom in our prayers!

    Jen, Doug, and Drew Diggs

  3. Know we will always continue to pray without ceasing! Looking forward to the next update.

  4. We love you guys and are praying for sure. Thanks for the update. g gh h hg gf g gh gh g that was grayson sending his love. He did that all on his own :)