Saturday, November 29, 2008
"A Basic Day"
When I asked Heather what I should write today, she said that she "just had a basic day." I like those. In fact I vote for nothing but those from now on. She worked hard in physical therapy, standing several times and continuing to do exercises in bed. Other than that I have nothing new to report.
Friday, November 28, 2008
Nearly Independent Standing and an Allergic Reaction
Today when physical therapy came in to help Heather try to stand, Heather stood up very quickly and almost without any help. It was really great to see. She took a few steps, sat back down, and then stood again. It was harder the second time, but she did significantly better than she has in past. It was great to see. Her dressing changes have been much, much better the past couple of days, and her wounds look better every day. I saw her abdominal wound for the first time in about a week, and it is looking much better. It is really pulling together, and the nurses rave about how healthy the tissue looks.
We had a bit of a scare this evening. You know, we can't have things go smoothly for too long. Her hematocrit was a little low, so they decided to give her some IV iron called Venofer. Approximately an hour after they started the drip Heather had a major reaction to it. She first felt what she calls "extreme chills" that came on within seconds. She began shaking from head to food and her teeth began chattering. Her jaw began tightening up, and then all the muscles in her body began tightening up. It became difficult for her breathe, as it felt like her throat and lungs were tightening up. The nurses were quite concerned (as was Heather). Her nurse initially gave her Benadryl. This didn't seem to have much effect, so she then gave her hydrocortisone. Within about five minutes, Heather felt markedly better, and within ten minutes even better. She now seems back to normal. Of course the nurse said this is a very rare reaction. I could have told you that because Heather had it. Apparently if there is a low probability, negative occurrence out there, Heather will have it.
We had a bit of a scare this evening. You know, we can't have things go smoothly for too long. Her hematocrit was a little low, so they decided to give her some IV iron called Venofer. Approximately an hour after they started the drip Heather had a major reaction to it. She first felt what she calls "extreme chills" that came on within seconds. She began shaking from head to food and her teeth began chattering. Her jaw began tightening up, and then all the muscles in her body began tightening up. It became difficult for her breathe, as it felt like her throat and lungs were tightening up. The nurses were quite concerned (as was Heather). Her nurse initially gave her Benadryl. This didn't seem to have much effect, so she then gave her hydrocortisone. Within about five minutes, Heather felt markedly better, and within ten minutes even better. She now seems back to normal. Of course the nurse said this is a very rare reaction. I could have told you that because Heather had it. Apparently if there is a low probability, negative occurrence out there, Heather will have it.
Thursday, November 27, 2008
Wednesday, November 26, 2008
Stronger Than Ever
Heather is doing really well. I can't believe how much strength she has gained even in the last few days. She really seems like her old self. I got to the hospital an hour or so, and it is just so good to see her doing so well. Shortly after I got here the physical therapists came in. They helped Heather stand three times and take a few small steps with a walker. I love seeing her feel better and able to do more. She acts like a woman with a mission...to get out of here.
Her wound dressing changes have gone quite well. Yesterday, she was feeling more pain in her abdomen without the wound vac on, so they put it back on. Heather says it feels much better. Having the wound vac on will also make physical therapy better because Heather won't be worried about the wound popping open. Hooray for progress!!!!
Her wound dressing changes have gone quite well. Yesterday, she was feeling more pain in her abdomen without the wound vac on, so they put it back on. Heather says it feels much better. Having the wound vac on will also make physical therapy better because Heather won't be worried about the wound popping open. Hooray for progress!!!!
Tuesday, November 25, 2008
A Day Without Major Incident
Heather had a reasonably good day. She said that her daily dressing changes on her back and legs went well and that she felt the least amount of pain yet. She has been working with the physical therapists to build up her leg strength and maintain and build her upper body strength. I think the next big goal is to get her walking. Doing so would help many of her difficulties.
Dressing Change Okay Last Night
I stopped in to see Heather on my way to work this morning. She seems to have a bit of a fever, but was sleeping soundly. She said that the dressing change wasn't as bad as she thought it would be. She said the dressing at the top of her back fell off by itself, which suggests that it is really healing up. She said the bottom of her back was still painful, but bearable.
Monday, November 24, 2008
Blunders Cause Pain
Today the nurses changed the wound vac dressing in Heather's abdominal wound. You may recall that this is a foam that they cut to the size of the wound, cover it with tape, and attach a small vacuum hose to it for the purpose of sucking out discharge and improving healing. The problem was that they were supposed to change it on Saturday or at least yesterday because it is only supposed to be in for two days. However, there was some miscommunication, and it didn't happen until today. The problem with waiting too long, we found out today, is that the tissue begins growing into the foam which makes it very painful to remove.
I was at work today, so I missed all that excitement. Apparently it was incredibly painful, and they had to give her a lot of fast-acting, IV narcotics. On a positive note, the nurses said that the wound looks fantastic and is healing extremely well. They decided that because it looks so good it doesn't need the wound vac any more. They felt that it was wrong for the UofU to use the kind of wound vac foam (silver impregnated) they used on the last wound vac dressing. We didn't understand it either, as they had always used a black (instead of gray/silver) foam in the past. The nurses here said that the gray foam is more likely to cause the tissue to grow into it. They put a different dressing of some sort on it that no longer requires the vac.
Because they had to use so much of the IV narcotics to get the abdominal wound dressing out, they could not give Heather any more for her legs and back dressings. They had to wait 6 hours to give more IV narcotics, so they put the legs and back dressing changes off until tonight. When I just talked to Heather (8:30pm) they had not yet done it. The problem with that is that the most well-trained wound care nurses are there during the day and they had put the abdominal wound dressing change off so long (They had told Heather they would do the dressing change in the morning, but didn't get to it until afternoon.) that they were off shift by the time the 6 hours were over. That leaves the job to a less well-trained nurse for tonight. The long wait also increases the chances that the dressings on Heather's back will stick to her and be more painful coming off. I am not impressed. It is bad enough that Heather has to go through so much pain, but when it is largely avoidable it is maddening!
In other news, Heather used the toilet for the first time in over a month and a half today. She had to be wheeled on a chair to do it, but it is big progress just to feel well enough to sit up. She seems to be doing better each day, but I think she will be doing remarkably better when they stop torturing her.
I was at work today, so I missed all that excitement. Apparently it was incredibly painful, and they had to give her a lot of fast-acting, IV narcotics. On a positive note, the nurses said that the wound looks fantastic and is healing extremely well. They decided that because it looks so good it doesn't need the wound vac any more. They felt that it was wrong for the UofU to use the kind of wound vac foam (silver impregnated) they used on the last wound vac dressing. We didn't understand it either, as they had always used a black (instead of gray/silver) foam in the past. The nurses here said that the gray foam is more likely to cause the tissue to grow into it. They put a different dressing of some sort on it that no longer requires the vac.
Because they had to use so much of the IV narcotics to get the abdominal wound dressing out, they could not give Heather any more for her legs and back dressings. They had to wait 6 hours to give more IV narcotics, so they put the legs and back dressing changes off until tonight. When I just talked to Heather (8:30pm) they had not yet done it. The problem with that is that the most well-trained wound care nurses are there during the day and they had put the abdominal wound dressing change off so long (They had told Heather they would do the dressing change in the morning, but didn't get to it until afternoon.) that they were off shift by the time the 6 hours were over. That leaves the job to a less well-trained nurse for tonight. The long wait also increases the chances that the dressings on Heather's back will stick to her and be more painful coming off. I am not impressed. It is bad enough that Heather has to go through so much pain, but when it is largely avoidable it is maddening!
In other news, Heather used the toilet for the first time in over a month and a half today. She had to be wheeled on a chair to do it, but it is big progress just to feel well enough to sit up. She seems to be doing better each day, but I think she will be doing remarkably better when they stop torturing her.
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