Wednesday, February 09, 2005

Another good day

First off- let me apologize for whatever I did that made the first set of photos disappear... I can't seem to fix it. If you want all of them, let me know and I will email them. (In the end, I will probably print everything as a book with pictures for anyone who wants.) Also sorry about the delay in this post, just had to take last night for rest.

Now, to the real meat of the matter...

Yesterday morning when we went in, Mom seemed to be a bit better. The swelling was definitely down on her face and hands. The bruising is better and worse- as the swelling is down, the colors are changing and Mom now has the cheeky yellow mask of a raccoon (see photo below).

Yesterday morning,we lucked into being in the room when Mom's faculty attending came in for rounds with his students. He is a very nice man named Dr. Doucet and was very helpful to us. He explained that Mom had not failed weaning the vent the previous day because of lung issues but instead because they were concerned that she would tire too much from the pain from her rib fractures. He said they had decided to just let her rest overnight. That morning, while he was rounding the students, they did something called sprinting. Sprinting is where they take away all the ventilator support except a little leftover pressure assist to see how the patient does and if they wear out. Mom did GREAT on her sprints, as anticipated but was on 10 and 5 (for the criticalists reading the post) and they really like them to be at 5 and 5 before they extubate (remove the tube). He said probably not that day but maybe the next.

He also was able to give us some information on the ankle fracture. It is a nasty, complicated intraarticular (involving the joint) fracture called a Pilon fracture. This type of fracture ONLY can occur when severe vertical force drives the ankle bone into the shinbone (Thanks to Sarah for the internet search on the fracture type!). Given the anatomy of the ankle, this suggests that Mom was hit from behind with the force driving her ankle into itself as it sent her flying. Generally it is repaired with multiple plates. This type of fracture commonly leads to arthritis since it involves the joint but it only has about a 10% rate of arthrodesis (joint fusion). It is often an open fracture (bones sticking through the skin) which Mom's is not. Given the information we now know about the fracture, it is reasonable to except that Mom probably won't be able to run but she may be able to bike and will definitely be able to swim. It is something they will address in 'a bit' once she is a candidate for elective surgery. Whew! What a lot of medical talk!

Later in the day, we scored another special gift. Mom has a new critical care doctor, Dr. Brown. This doctor is not responsible for her primary care but is responsible for her critical care. His manner reminds me a little of Sydney Friedman (the psychiatrist from MASH), something Mom can appreciate. He is just wonderful and was a good questioner (What is she receiving through this line? Does she really need this line? Is she still at risk of X and if not, why is she still on this type of bed?). The upshot of this is that yesterday afternoon they pulled her central line (the catheter that is in her jugular vein at the level of her shoulder), replaced an old catheter, moved Mom to a more comfortable bed and sat her up 30 degrees! And he basically said that today (Wednesday) would probably be the day to try her off the vent. He also was able to give us information on the follow-up CT.

Mom seemed to like him as well. He had her open her eyes and track him, give him a thumbs up with each hand (it was weany but better than I expected) and wiggle her toes. She was very compliant- a big deal for Mom.

More to follow but I just realized a lot of you are probably waiting for something to read-

8 Comments:

Blogger David R. Linn said...

Jacqui, if you want me to do so, I can post the 1st set of pictures on a server at Vanderbilt. Roland or Kelly can get you my email address. Let me know ...

8:44 AM  
Blogger Beth Smith said...

Jacqui, having gone through a number of neuro issues with my husband, I want to tell you that this all sounds VERY GOOD!!! We will continue to pray and send all positive energy westward.

8:53 AM  
Blogger Ruth and Al Stith said...

Thank you so much for giving us updates (and especially with good news!) We've asked lots of people who don't even know Pam to pray for her, and it's good to be able to give them good news when they ask. I check this site every morning when I get to school, and hearing about improvements really brighten my day - I think and pray for you all often.

If there's anything we can do to help this time be more comfortable for you, please let us know.

It's good to see Roland smiling; give him lots of hugs for us!

p.s. "anybody want a peanut?" We love Princess Bride, too! :)

11:27 AM  
Blogger charlotte said...

It is so good to see Mr. Schneller smiling and enjoying himself (as best as is possible given the circumstances)!!! We missed him SO much at practice Monday night!! Keep more pictures coming of smiling faces. And I want to see all of these balloons and decorations!! It is such wonderful news to hear that she might get taken off the vent today. As soon as I read that she had breathed in rhythm to the music on the CD (yesterday?), I smiled and thought, "yep, that's my director!!!" She's always big on rhythm with us.

Tell her I love her!!
Charlotte

12:12 PM  
Blogger Barry Heard said...

It sounds like strides have been made in the last few days, and I find that heartening. I appreciate your admonitions for patience, and I know we all want Pam to rest and recover in the best manner possible. The community chorus met last night, and I had the privilege of being a part of and witness to a tremendous outpouring of support and love. The rehearsal time was strange, no doubt, but I'm so very glad we were all able to get together and sing. I found it difficult to hold a note in some songs without the voice cracking for tears. But the overall feeling was uplifting, and I hope you all know we're thinking of you and praying for you.

12:14 PM  
Blogger Fouad said...

Dear all,
This is Fouad Boulos. I used to sing with the community chorus until I got too busy at work. I just got an email from Barry about Pam's terrible accident. I don't know what to say except that Pam just knows how to bring people together, most often in songs and laughter, this time in tears and pain, yet always in everlasting hope and neverending love. Pam cannot but sing her way out of the hospital. My love and prayers go to all of you, and my thoughts are and will remain with you always.
Fouad

12:50 PM  
Blogger Carissa said...

Dear Friends and Family of Pam:

My name is Carissa B. Ray. I sang with the VCC for almost 3 years and came to know, love and admire Pam during that time. Words cannot express how overwhelmed I was when I heard about Pam's accident. So many wonderful memories flooded back to me; the times when she would try to tell a joke and a corny one at that!; all of the "shoulder massages"; and all of the wonderful and inspirational e-mails she would send to us after a long and gruelly rehearsal. She has forever touched and changed my life.

Please know that all of you; friends, family, and VCC choir members, are in my constant and vigilate prayers. I know Pam will recover and once again take hold of the baton and lead her choir(s) to glorious and heavenly heights.

Much love to all
Carissa

1:14 PM  
Blogger anne and ben said...

hey jacqui and roland! i miss you all a great deal. i've had a hard day today missing pam a great deal, but many people in the halls of the Divinity School stopped me to ask how my friend, Pam, was doing.Many said they were keeping all of y'all in their prayers. I might have to go wedding dress shopping this weekend without Pam and Kelly, an idea which is really upsetting to me. I hope that you tell Pam that I am having to possibly pick out a dress without her and that I just can't make decisions without her. I NEED HER HERE helping me! so selfish of me...
roland, we missed you at choir last night. i didn't miss a note and you missed it! the debussy is coming along and on the shenandoah piece, i imagined pam and what she looks like conducting us. it soothed me. i love y'all dearly.
let me know if you need glenn help - or micky help, for that matter. i'm here for anything. i love them both and would be glad to help y'all anyway i can. know that i'm thinking of you and praying for you. much love to you, anne
ps - tell pam again how much i love her and miss her, please.

5:39 PM  

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