Friday, July 15, 2005

Friday July 15, 2005 Zack has a fever this morning of 100.1, which means his body is fighting something. He is less responsive today than yesterday. The Critical Care Team will come around and assess him during rounds to determine whether they can exurbate him (remove the tube in his mouth). At 4:00 AM they put him on T-Piece (TP). This is a smaller tube that gives him humidified oxygen as he breathes. He remains on TP for 2 hours and then returns to Cpap (this provides only pressure to encourage him to take a breath). We are preparing him for his 7:00 AM exam because he has to perform well for the doctors in order for the tube to be pulled. Zack does not do well. He will not give thumbs up or even wiggle his toes and Dr. Lenhardt says he is not ready. I am very disappointed because last night I kept promising Zack we would get that tube out. I get Dr. Lenhardt to agree to come back later in the morning justifying Zack’s lack of responses to his rough night sleeping. After some pitiful pleading the team agrees to reevaluate him later. My spirits are low and I am very emotional. We have been so blessed with how fast he has been recovering that we expect new progress everyday. Zack looks tired but his eyes are open more and he seems to be watching the golf game on TV. At 11:00 the team returns but Zack does no better. Dr Lenhardt is very cautious and doesn’t want to remove the tube yet. He explains that the important thing is that Zack is off the ventilator and breathing on his own. I explain that the important thing to me is that Zack does not like the tube down his throat so we want it out. It is hard to go from Dr Lenhardt’s cautious approach when we have gotten use to Dr Densler’s aggressive one. He agrees to give Zack one more chance today so Kim Myre (the nurse practitioner for the Neuro Team) discusses with Tom and Christy (our day nurses) putting him in a chair. They feel he will be more alert in a chair and they will also put him back on TP. I go in to talk with Zack and for the first time I am frustrated with him. I feel like he is being stubborn and after much coaxing he gives me a small thumbs up. At 2:00 PM they put his helmet on and put him in the chair (this is a special type of stretcher that adjusts into a chair). Dr Densler and Dr Munchnick (Nuero Team) come by as they are moving him to the chair and see how upset I am. They come in and discuss options. They request his blood gases be checked. They will look to see how his body is processing carbon dioxide, which is an indictor of how well he will do off the tube. Dr Densler reminds me that a Trach could be the next step and it is not a bad thing. At 2:30 I bring a group of 11 of Zack’s friends into his room. We close the door and they talk with him. It is so critical to his recovery that he has his friends around. They are able to get a thumb wiggle out of him, which heightens all our spirits. Throughout the day Zack remains inconsistent in following verbal command. He still localizes to pain (brings his hand up to where they pinch him) but he’s just not moving around as much. I am an emotional wreck waiting for miracles that don’t come. God is giving me lessons in patience because it is not one of my virtues. At 6:00 PM coach Woods (one of Zack’s baseball coaches) comes to see him. As he talks to him it appears Zack is listening intently. He keeps giving him baseball signals and Zack responds to the “wipe off” sign.
He moves his arms several times and we are encouraged that he’s still in there. Scott is staying tonight so that I can get a little sleep and take the edge off of my emotions. We have set up Zack to have no visitors after 9:00 PM tonight so that he can get some rest and be ready for his assessment in the morning. We will try to get the tube removed if Zack will start responding again to verbal commands. He looks so tired. I ask for prayers that Zack will be giving the thumbs up again and he will fight off infection. I ask for specific prayers that I will get my peace back and not be so restless. I thank all of those people who faithfully come to the hospital and wait with us, giving encouragement. Our God is so powerful but sometimes he needs to slow things down so we can hear His whispers and feel His healing touch. Keep praying.