Thursday, November 19, 2009
I don't know how to describe yesterday, other than---wow! Joy has definitely overtaken hope and is ahead in the race.
Where to start?
At 2pm, Big Kid was transferred by ambulance to the acute care center. Hubby was at the hospital to watch over the "packing up" and Little Guy and I were at the center to meet the "delivery". They had given Big Kid an extra dose of the sedative so he wouldn't freak out on the ride, and the plan was to hook him back up to it when he arrived.
When he got there, he was flailing around the best he could (he was strapped down to the gurney) and the paramedics and nurses kept telling him everything was ok, and to calm down. After they got him settled in his room, and hooked back up to everything, we were allowed to go in and see him.
The first thing I noticed was that his legs were going again. Up and down, up and down. Slowly, but he was on the move. ;-) The second thing I noticed was that he wasn't restrained, and his hand was creeping up towards his trach. "Stop him!", I yelped, remembering all the tubes he tried to pull out before.
I guessed the sedative started kicking in, because the kid went still. Except for the feet.
The doctor and nurse on duty explained that unlike the ICU, they wouldn't be checking on him every ten minutes so that he could get some quality rest. The worried Mommy (which would be me) didn't like this a bit. What if he needed help? What if he flipped out again? He's in a private room without windows for staff to look in.
I told the doctor how important it was that Big Kid be restrained until we get the psychiatric issue sorted out. What if he came out of the sedation and nobody was around and he pulled things out? Sure at this point, all he has is the trach and the stomach tube and the pic line, but those are seriously implanted objects.
The doctor said he'd write the orders, and then laughed. "The nurses aren't going to like this."
I looked at the nurse. "We don't agree with using restraints."
I didn't say anything but kept looking at her. She started again. "Our patients are all adults. If they want to throw themselves out of bed, then that's their right. If he knocks out the vent tube, the alarms will go off."
Hubby could tell that I was building up a head of steam. "Honey," he said gently. I ignored him.
"Those patients can do whatever they like with themselves," I said to the nurse. "But my son has a mental illness. Unless you can be absolutely sure that he is in a rational frame of mind, you can't leave him alone unrestrained. Because if you do and he yanks out that stomach tube (which doesn't have an alarm)..." I let it hang with the obvious implication of "I will hold YOU responsible if his guts come out with it and he bleeds to death in here."
"Honey," Hubby said again. Softly. "Look at him. He hasn't been on the sedation for almost two hours."
Wha?? They didn't hook it back up?
The kid was laying still, watching us, and taking it all in. He wasn't flailing, or kicking, or trying to kick himself out of bed. He was totally calm. Groggy, but calm.
The Resperidone was working. Oh golly.
The doctor went over to him. "Big Kid? Can you show me your teeth?" The boy bared them in a grimace. "Can you show me your tongue?" Out it came.
"Can you move your right foot?" The kid moved his left foot.
"Can you move your other right foot?" He did. Deja vu. ;-)
"Can you take your right thumb and touch your right ear?" He tried to touch his left ear with his left thumb, but hey, in normal life, the boy would get the two mixed up from time to time anyway.
After the doctor left, I sat down next to Big Kid. "Sweetie, do you know where we are?" He shook his head. I explained to him briefly, and asked if he understood. He nodded. His hand came up to the trach, and he didn't try to pull it out, he just tried to feel the alien object stuck in his throat.
"Do you know what that is?" He shook his head. I told him that his lungs were very sick and it was a tube to help him breath. He wasn't to pull on it, did he understand? He nodded. I did the same with the stomach tube and the pic line. There were a few tears, but he seemed to understand.
Little Guy sat with him while we filled out paperwork with the case manager and nurse. "I'm here to comfort you," he announced. "I've been worried about you and I had to get a swine flu shot so I don't get germs. But I was brave." Big Kid reached out to hold his hand, and they sat there silently together.
Hubby, Kitty and I have worked out a schedule so that we will be with him almost around the clock for the next few days until we are sure the sedation is completely out of his system (it hangs around in whatever body fat there is and takes a little while to metabolize), and until we are sure that he knows how to use the call button. I know that sounds kind of silly, but we know him and how panicked he can get. I'm going to take the mornings, Kitty the afternoons, and Hubby the evenings until they give the kid something to sleep.
The treatment plan is an aggressive one. They're going to get Big Kid on his feet today, if they have to have 4 people hold him up, vent and all. Once he gets moving, it will be easier for his body to get all that crap in his lungs out.
Last night, Hubby stayed late with Big Kid and they watched South Park together, like they used to do when the boy lived at home. He said that the kid chuckled along although he couldn't see very well (no contacts). Hubby asked him if he remembered anything, and Big Kid shook his head. When Hubby explained about the H1N1 and all the resulting complications, he threw up his hands with a shocked "WTF" look on his face.
We didn't tell him it's been almost a month. We're going to call his neuropsych today to get advice on how and when to best deal with that. Apparently with some people, "losing time" can be a real issue and leave lasting trauma.
He's back. Our boy's back. He still has pneumonia in both lungs and is facing a long stay in rehab, but the corner has been turned.
I can't begin to tell you all how grateful we've been for all of your concern and support, my friends. Your continuing prayers and well wishes for healing are most appreciated.
Joy. Overwhelming joy.