I should probably lead this entry off by saying, if you don’t have loads of time, then you may want to postpone reading this entry until you do. I have a lot of catching up to do…
As I stated in my previous post, Scott is back in the rehab unit as of Thursday evening. We had a lot of obstacles to jump to get back into the unit.
First of all, as you are all aware Scott has had issues with his lungs since day one. He has faced an uphill battle because he swallowed water when he was in the lake, aspirated vomit being resuscitated and the muscles that generate a cough are paralyzed. We have gone rounds with pneumonia, collapsed lungs, mucus plugs and the fact that it appears that Scott produces more secretions than most. These are issues we will likely face forever unless he can regain the use of the “coughing” muscles which could happen naturally or with implantable pacing systems. However, on a postitive note, at the moment Scott’s right bottom lobe has re-inflated for the most part and it did so without having to get another bronch. They were able to do this by keeping his trach cuff inflated and pushing high volumes of air into his lungs and by using a bed that is on constant rotation which helps to move the secretions in this lungs so that they are easier to suction. Scott despises both of these techniques but it is truly the better option as it is non-invasive. Also, there are times that the air in the cuff naturally losing a bit of air which allows Scott to project his voice, at least until respiratory catches it!
On another positive note, Scott and I no longer have to decide on getting a pacemaker for his heart. Apparently, cardiology has decided that the procedure isn’t necessary. There has been no real explanation for why this was pulled from the table. My humble, not-a-doctor, personal opinion is that Scott really didn’t need the pacer. His heart rate has been running in the 70’s or 80’s and only dropping a little lower when he rests. The only time his heart really has dropped extremely low was in the first week or so after the injury and more recently during the mucus plug debacle last Thursday. However, last week after the ordeal, I was told that the reason his heart almost stopped twice was because a plug blocked the airway which depleted O2 which in turn caused the heart to crash. I know that placing a pace maker is not extremely invasive but Scott is highly susceptible to any and all infection so I am just relieved that this is one risk for infection that has been avoided. I suppose God cut us a break on this one…No decision necessary!
On another note, because of all of the complications we faced last week in trying to maintain Scott’s lungs and blood pressure, Scott’s bed sore went from a level 2 to a level 3. This was anticipated because Scott was fighting for his life in the SICU, therefore, the bed sore wasn’t any ones number one priority. With that said, yesterday we were told that though it is a level 3 it is looking significantly better and smaller. Furthermore, since Scott is back in rehab PT and OT will have him in his chair more which will relieve him from laying on that same spot which will continue to help it.
In some other news, Scott wanted me to share with everyone that he has a new “party trick”. His feet occasionally tap as if they are dancing to their own tune. I’ve also watched his toes wiggle and knees extend a little. It is important to note that this is not in Scotts control. This is something that happens with spinal cord injuries. It is called spasticity. As I have said before, this is good for muscle tone and reducing the risk of blood clots but really doesn’t have anymore significance, other than the fact, that it still makes my heart jump in hopes that Scott meant to do it.
Scott also wants me to tell everyone about a test he had done last Thursday prior to his move back to rehab. A group of doctors came down to administer a test on Scotts phrenic nerves. These are two nerves that stem from around C3,C4 and they produce contractions of the which is helpful for breathing and respiration. Since Scott has a high cervical injury there was some question of his phrenic nerves being intact. There are two reasons this is important. First of all, if the nerves are intact there is a strong chance that in time Scott will breath on his own. Secondly, if the nerves are intact it makes him a candidate for the diaphragm pacing unit. This is an implanted device that paces the diaphragm by stimulating the phrenic nerve.
The test involved two doctors, one stimulated the nerve through an electrical shock and the other taking an ultrasound to measure the stimulation. It was not a pleasant procedure. The shock was administered through a taser that was pressed firmly into Scotts neck. He had to have four jolts on the left side of his neck and three on his right. Scott said it was painful and I can say it was tough to watch. Although his cuff was fully inflated, he was yelling out in pain over the cuff. He said that the jolt hurt but much of the pain was due to the pressure of the taser that was being pushed into his already sensitive neck area. I think it’s apparent that the test was awful but the outcome was positive. The test showed that his phrenic nerves are intact which gives us hope for a future without the ventilator!
Well, I think I covered everything. I do apologize for the delay in my updates. The connection here at the hospital doesn’t always work and I’m usually too sleepy by the time I get home. I think it’s safe to say that prayers are being answered. Like I mentioned yesterday, rehab is moving Scott a lot more slowly through because he is still very weak and they do not want to have a repeat of last week. Please continue to pray for us. It’s really touch and go and that plays with our emotions a lot. It’s hard too feel really excited about much because we fear that it will be pulled out from under us. We feel God gave a little break from one of the heavy decisions that weighed on us and we are very grateful. Thank you for your continued prayers and support. I do see the small miracles God has brought us and it does bring me comfort.