Finally answered some questions...

So the doctor stopped today...this time while I was here. Wait...let me back up the truck a bit....a different doctor that was covering Dr Alexander's patients stopped by. I asked her the same questions I had been asking the nurses....this time, the doctor offered to show me the scans and the doctors notes. Finally! So...Anita actually had blood in two areas. She had a large IPH (intraparenchymal) and a small SDH (subdural) bleed with some ventricular compression. The IPH was the size of small plum, and the SDH was 7mm. There was no midline shift. Dr Alexander said he still doesn't know why she bled, but he didn't see any problem areas after he cleaned out the blood. He's been doing neurosurgery for 18 years....so I guess we assume he knows what he's talking about? She had vision problems on her left side on admit and those have resolved. I saw the most recent scan...she has a little residual blood, and some air, but it looks a lot better than the one that she came in with. She has the usual facial/eye swelling. She will be moving to the general care floor today. They even did a pretty good job hiding the incision! We're joking around that she'd better finally get the puppy that she's been wanting! I even got the nurses in on it. Hope I don't get disowned...

Good News finally...

Anita is off of the ventilator and doing well. She started cracking jokes as soon as her voice came back. She has a little bit of a facial droop and left ptosis, but other than that, I don't see any neuro deficits. She's worn out (obviously). They did start her on seizure meds after surgery last night. The nurses still don't know a whole lot, but now I know its because the doctors here don't communicate well with the nurses and it's not the type of environment where the nurses ask questions. It makes me glad I work in a teaching hospital that encourages autonomy of the nurses....working here would drive me nuts! We'll probably stay one more day and then come back...barring any unforseen circumstances. I only have internet access at the hospital, so I'll try to update again later when I'm here.

Out of Surgery...

Brent's mom, Anita, is out of surgery. They got the blood out with no problem, but claim that they can't find the source of the bleed. It's obviously not bleeding anymore, but if they can't find the source, they can't correct it and she's at higher risk of future bleeds. She still isn't on seizure prophalaxis. They had a very difficult intubation and her trachea is very swollen, so they had to leave her on the ventilator, for sure overnight and likely for a few days. They have her sedated on propofol. The general feeling of the rest of the family is relief. I'm still pretty hesitant because I'm concerned they can't figure out what caused it. You should be able to find the cause of a subdural. The surgeon of course came and talked with the family when I had stepped away for a minute, so I didn't get to ask him any questions. The same nurse that she had last night is taking care of her again, so I'm not confident that asking her questions would get me anywhere. She didn't know much at all when I talked to her last night (I'm honestly not just saying that). We'll see what the next few days bring.

Nurse Kelly is getting ticked...

Anita's surgery is scheduled for 5 or 6pm tonight. The doctor is waiting to finish his clinic appointments. Honestly....I'm getting VERY frustrated. What's more important...an acute bleed or your clinic patient. I'm nervous because the longer they wait, the more likely that Anita could have a seizure from the blood. They aren't starting her on seizure meds at all....we would have started her on those to prevent seizures already. For that matter, she would have had the surgery by now too. This waiting is unnecessary and putting her at more risk from other complications. She's maxed out on her morphine. She's getting some sleep in between doeses, but yeah....anyway. She is stable. the CT scan from 2am was unchanged, which is good. Oh...I should mention it is for sure a subdural bleed....at least thats what the doctor says. Oh...and their neuro checks consist of pupil checks....that's it. I'm just not liking the different level of practice.

This is what I know...

So we're in Rockford, not Madison. Anita had a CT scan and angio, they supposedly can't find the source of the bleed. They're just calling it a right temporal/frontal ICH with some extension into the subdural space. They're not doing surgery right now...waiting to see if she can tolerate the pain and they will reassess in the morning. She's going to have a CT scan at 2 or 3am and then an MRI in the morning. And...this is for all my nursing buddies that read my blog...they've started her on mannitol and decadron, no seizure prophylaxis. Her nurse didn't know what space the bleed was in....and didn't know until I asked her to look it up. All she kept saying was that it was on the right side. Yeah, thanks. I knew that. (And yes, this is all after I said that I'm a neuro nurse, having done ICU.) She looked at me very confused when I asked if it was sub arachnoid or subdural. I then asked if it was subarachnoid, do they have the capabilities to coil aneurysms. Again, she looked at me very confused and said "I don't think so, I don't think we have the radiologist to do that." At this point, I'm giving up on getting any info from the nurse, I think I confused her with my completely appropriate questions. I didn't even broach the subject of nimodipine for SAH since the nurse couldn't tell me what the bleed was. The nurse also didn't know what their usual practice is for starting seizure prophylaxis. Great...we're supposed to be in a neuro ICU. Oh...and did I mention that according to them "transferring is out of the question. We're a level 1 trauma center. We can handle it." She only had one IV for access....the nurse "didn't want to increase her pressure by placing another iv." I guess they missed a few times. It's times like this I wish I could move our whole families close enough to us to be taken care of in our hospital by people that actually know what's going on. I'm really trying to be the "nice" nurse family member, but this is concerning and frustrating, especially knowing that UW would be doing something.

The kids are with my mom and dad...I'm so thankful our families live close to each other. Please pray that goes well....maybe even that Abby will stay sleeping while we're gone.

Prayers please...

I just got off the phone with Brent's dad about an hour ago....Anita, Brent's mom, is being flown by Lifeline to a hospital. She had a sudden onset of the worst headache of her life, followed by some other symptoms. If it's what I think it is (and this is in my field of work), I'm pretty sure they will Medflight her up here. I'll keep you posted, but please pray for all of us right now. I really hope I'm wrong about what is going on.

Abby's 6 month stats...

Abby had her checkup on Wednesday.... she is now 27 1/4 inches, 19 pounds, 9 ounces. I'm also posting some of her 6 month pics...