Saturday, July 16, 2005

Saturday July 16, 2005 When I arrived at 6:30 AM today Scott told me Zack had been unresponsive all night. He had worked with Zack all night trying to get him to follow commands. Scott was very depressed because they would assess him during morning rounds and we hoped to get the tube pulled from his mouth. He had run a fever of 101.5 most of the night and at 1:45 AM they obtained blood, urine and sputum cultures. His white count is back up to 11.8 so he is fighting infection somewhere. They need to identify it to know what type of antibiotic to use. They had done another CAT scan at 3:00 AM and there was no change, which is good. At 7:00 AM Dr Harpring (Neuro Surgeon) arrives to explains that Zack probably has pneumonia and they would keep him on the tube through the weekend and Trach him Monday. The good news is that we have an explanation now for his lack of response. He doesn’t feel well. He doesn’t want to do anything, which is natural considering how bad he feels. Once they Trach him it will be a lot easier to suction him and he will start feeling better and be more responsive. Once we get over the pneumonia and his fever is gone they will remove the tube from his nose and give him a feeding tube into his stomach. They will start giving him 2000 calories a day and he will be more mobile. He also cannot be moved to Frazier Rehab until the feeding tube is out of his nose and that is the ultimate goal…to start rehab. Zack got a bath and a shave before being moved to his chair at 10:00. He was on TP in the chair and for another 2 hours in bed. I had 10 of his friends together for a group visit when Rita told me that Scott wanted to spend time alone with Zack before the kids went in. He is feeling guilty for pressuring Zack throughout the night to follow verbal commands only to find out this morning that he has pneumonia. He wanted to apologize to him alone so we went back downstairs to wait. About 10 minutes Rita comes running downstairs saying they were removing the tube. I ran upstairs very confused because the Neuro Team said they would Trach him on Monday. I told Dr. Lenhardt (Anest.)that I was confused that they were doing it now after what Neuro told me this morning. Kelly is our nurse today and she is also surprised. He reminded me that this was what I had wanted yesterday but Zack wasn’t ready and today he is. At 2:00 he was extibated and Scott and I were both there. Everything went smoothly and he was immediately put on an oxygen mask. Now we need him to cough and swallow. He needs to be able to maintain his airway and move that fluid. Not we have new numbers to focus on and it is his respirtory rate. They want it under 30 with the ideal being 12 but mid twenties is OK. Zack is hanging around 18 – 23. We are elated that there is no longer a tube in his mouth. He looks much more like himself except for his big swollen lip. When they tried to suction some mucus from the back of his throat he clamped down on his teeth. There was no way he was letting anyone put anything back into his mouth. Unfortunately he got his lip in of the way and he bit it until blood was running down his chin. I think we are seeing a little of the old stubborn teenager we knew before. It seems like we’ve been here much longer than 9 days. Our world is so confined to these walls that I don’t watch the news, read any magazines or even listen to the radio in my car. I don’t want to think that the world carries on without him. The time flies when I am at the hospital. We have to live in the day and not think much beyond tomorrow because we don’t know what the future holds. I have faith that God will completely heal Zack but I know it will be in His timing and sometimes that doesn’t seem to move fast enough. Just when I am frustrated the right person shows up. They will pray with us or listen to my never-ending explanations of what has happened during the day. I want to thank all of those who visit us and pray for us. Now we pray that Zack coughs and swallows and he is strong enough to fight pneumonia. I pray for peace for Scott who struggles now with having to leave the hospital in order to work a few hours. We pray for all the kids out there that just haven’t gotten the message yet and hope that their parents aren’t sitting here someday.