Monday, January 11, 2016

A new year

2016 has not started off anywhere near the way I assumed it would begin. In the first 10 days of this year, I have had a crash course in medical school. My Google search history looks like it might belong to a first semester med student. Ischemic stroke, mechanical thrombectomy, IVC filter, trach and peg, stroke prognosis...it's not a pretty sight.

New Year's Day started off like any random Friday that Kate was out of school and Nick was off work. We woke up whenever we wanted. Kate was already up and watching cartoons when I rolled out of bed. Around 10:45 am my Dad called, as he usually does on holidays and I assumed that I was going to get some new year's wishes and a lecture about eating black-eyed peas. We were scheduled to have lunch at Yiayia's house, complete with all the standard menu items for the new year - ham, cornbread, and of course the aforementioned black-eyed peas which I hate with a passion but I eat because it makes the old men in my life happy. But instead of a calm hello and happy new year, I was met with my father's panicked voice.

"They think Pam has had a stroke. The ambulance is here now."

It has always scared me when my daddy is scared. Daddies are always supposed to be brave and strong, confident. They always have the answers. I still and will continue to call my Dad when I need advice or have a question about some grown-up something that I assume he would know. That's his job. Now the roles were reversing.

At first he wasn't sure where they were taking her - it started off as one hospital but they were full so the ambulance was re-routed. Once they arrived in Rockwall, a test was done to determine the type of stroke she had. Was it ischemic or hemorrhagic? Treatment would change depending on the type. We didn't immediately head to Rockwall because there was a good chance they would air lift her to another hospital depending on the type of stroke, so we had to wait until we knew exactly where we were going.

The Medical Center of Plano became our target as they care-flighted Pam to a waiting team of doctors. The side of one of the buildings proclaims them as "The Brain and Spine Hospital" so I felt fairly confident in their ability to treat the situation. Jason and Heather made arrangements for the kids and they were heading towards us. Nick and I arrived just as one of the neurosurgeons was talking with Dad about a mechanical thrombectomy. This procedure would allow them to break up the clots in her brain, and she was a candidate. Not everyone is...and it was her only chance. Dad signed consent forms as I stood beside him in a tiny room where major decisions are made every day.

We waited.

A few hours passed. They told us to expect it to be around a 4 hour procedure. It didn't take them quite that long, and they successfully broke up the clots. They showed us scans of her brain. They showed us damage and restored blood flow. They told us we don't know if it was enough, or if it was even going to help. All they could guarantee is that we had long road ahead of us - stroke recovery is very much a wait and see type of situation.

Over the next few days we drifted between playing the waiting game at the hospital, greeting visitors and meeting new nurses each day, answering text messages and emails with updates, waiting some more, and trying to accomplish work and some sort of normal life in between it all. We found ways to pass time at the hospital, we found ways to pass time at home. Wait, wait, wait.
It is now January 10th. Pam is still in ICU, and she is not going to recover. As the days have progressed, we have watched her go from responding to a few basic commands when asked to wiggle her toes or squeeze a hand to not responding at all. She's sedated now because her body is fighting her intubation when they take the sedation off, so her breathing becomes erratic which then increases her heart rate which causes her blood pressure to rise. She has been intubated since she was in Rockwall, so she has pneumonia. Her body's natural response to some bleeding in her brain started causing her blood to clot, so she has clots in both arms and legs now. Five days ago she had to have a hole drilled into her skull to suction out some blood that she wasn't reabsorbing. Yesterday they have to insert an IVC filter to hopefully keep any clots from reaching her heart. She has tubes coming from everywhere you could possibly put one. It is no way to exist.
I have spent 5 of the first 10 days of this year sitting in an ICU room.
Tomorrow some difficult decisions will begin to be discussed and made. Tomorrow is the day that none of us wanted to come.

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