Friday, the 18th of June

The best news we got this morning is that he's been breathing on his own since last night. The machine gives a tiny assist to overcome the resistance from the long tubes, but each breath is initiated by him. His mobility is greatly increased. We just got kicked out for his physical therapy session. And we're still waiting for the tube to get pulled out. Oh, and the hospital has a strict "no pictures" policy for the ICU. :-(

At 1:30 one of his doctors showed up to verify that he passed the parameters for getting his tube out. Flying colors. They pulled the tube and now they'll just monitor his breathing by checking blood gasses every few hours. Dad likes making sound now. We were asked to go easy on talking to him for a few hours.

I moved his arm around to get one of the monitor alarms to shut up and got his first words: "Thanks, Don."

Thursday, the 17th of June

Moments after we entered Dad's room we could tell he was more alert. His eyes were open and he was scanning the room. Mom had called earlier this morning and found that the nurse had gotten Dad to respond to yes/no questions by blinking. We asked him if this was true and he nodded his head. Show off. He then proceeded to lift each arm about an inch and wiggle his legs a bit. He's turned his head a little also.

They changed a setting on the vent so he could breathe on his own for a while. I could see that tired him out a lot. Once in a while I'd have to remind him to breathe deep. After that they did tests to see if it was time to pull the tube. Not yet. They'll try again tomorrow morning. He looked pooped after that so we told him to nap and snuck down to the cafeteria to eat and update.

Evening visit yeilds nothing new. He still has his humor, though. I started singing a lullabye and he bugged his eyes out. He also looked ticked when we said we had to go. Hopefully the tube comes out tomorrow.

Wednesday, the 16th of June

We visited a little later today because we knew Dad was having a CT scan this morning. It will be a while before we hear the results. Everything looks much the same as yesterday except...he opened an eye! I thought maybe it was just open a crack from the last time someone was hitting him with a flashlight. But no! He closed it and reopened it a few minutes later. Mom likes to get real close and chat with him and try to get him up. We use words like Camaro and salami. At least twice he has scrunched up his eyes and moved his lips. So far it's only been the one eye, and it's just a sliver, but it's a start.

The nurse came in to reset some lines, get his food going, and turn him. Dad's really coughing when he gets his mouth vacuumed out. His doc is supposed to pop in around 2 so we're going to lunch so we can be back by then.

At three the doctor still hasn't been by. But the nurse just hollered at Dad to look to his right and he turned his head about an inch. Somebody's home now, baby!

The doc showed up just after 4:00. He kicked us out for a while and removed the bolt and staples from Dad's head. He put in a few new staples and put on new bandages. Dad now sports a cool beanie just like a newborn. The doc said his CT's look better and better every time. Mom was worried that Dad's taking so long but he said there is no reason to believe he won't wake up fully. That's what I wanted to hear! We went back in and caught Dad making yucky faces. Seriously, he looked like Justin did at two days old. He almost constantly has both eyes open now. He looks at different things in the room, but he doesn't track or seem to focus. We finally ended our morning visit at 6 p.m.

Tuesday, the 15th of June

We walk in and notice the EEG is basically going crazy! His brain is active enough that the EEG tech has to come in and change the impedance on the leads to basically change the scale of movement. To us, that just meant the bumps got a lot smaller, but on a new scale. General swelling is way down, even in the left arm. If you didn't know him, he would pass for normal. The nurse says he sometimes coughs when they are messing around with his vent tubes. Good sign. The doc is leaving the bolt in until Dad wakes up more so he can see that the pressure isn't inhibiting normal functions.

During the evening visit, nothing changes. The nurse says they're going to run cultures on everything to verify there are no infections. He's had a slightly high white blood cell count, but that's normal for the steroids he's on.

This is where I realize I could save Mom several hours a day on the phone by posting all this stuff in a blog and passing out the address. She likes talking to people, but 10 or 12 want updates every day, and that's a little too much. She's skipping her naps and that's just not right!

Monday, the 14th of June

We walk in to notice that there is substantially more brain activity on the EEG. What had been tiny squiggly lines are now bumpy lines. We try to see if he responds to words like bacon, but to no avail. His ICP is back up to 20, but they expected it to rise when they took him off the pheno. They have dialed back the ventilator from 19 to 16 breaths per minute to normalize his blood gasses. He no longer looks like he's panting. He's also beginning to create small amount of back pressure on the ventilator which is a tiny precursor to breathing on his own. Again, the puffiness has decreased, except maybe in his left arm.

Nothing new on the evening visit except we bump into his doctor. He's pleased with the progress so far. He plans on maybe removing the bolt (pressure meter) maybe tomorrow or the next day. Dad's pupils were responsive to light.

Sunday, the 13 of June

It turns out that when a doctor says three days he means after three days not including the day of surgery. On our Sunday morning visit the first thing we noticed was that Dad's ICP was down to 8! This was after three days of hovering around with really no downward trend. At 11 a.m. they stopped his phenobarbital to begin the waking process. Apparently, pheno has a half life of around 40 hours, so they aren't expecting him to get up and dance any time soon. In addition, they gave him some drugs to increase his pee output and dialed back his fluids so he could dry out some. Kidney function had returned to normal range a few days ago and he seemed quite willing to help out. At this point he's hooked up to an EEG for constant monitoring.

By Sunday evening only two things look different: his ICP is back up to 12, and he's noticeably less puffy.

The Coma

For the next three days we visited twice a day to see how things were going and to generally get in the way. We learned that Dad's ICP may have been in the 40's for "some time" before and during the surgery. Normal is 10 (mm Hg) while lying down. While asleep he's on several meds, including one to keep his blood pressure artificially high. This allows more blood profussion to the brain. In addition he is given extra fluids for basically the same reason. This extra fluid, as well as laying around in bed, causes his body (hands, feet, and face esp) to get pretty swollen. I begin calling him Sta-Puff. During these three days his ICP is around 25. He also has a clot in the vein of his left arm. The unusual thing is that is extends almost from the shoulder to his wrist. This may have happened while he layed in surgery for an extended period of time. The normal procedure would be to give him anti-coagulants, but that is out for the time being. Turns out that's not a good thing to give a guy just out of surgery. The decision is to just wait it out.