I had to threaten the resident tonight to order another CAT scan for Mark. Dick and I decided that it would be a good idea if we could see if there was any change, then maybe we would go ahead with their request from Wednesday for Mark to have another ventriculostomy (drain in his head). We had originally requested that they be conservative to see if he would wake on his own, especially considering they found no elevated pressure or bleeding from the spinal tap they did Wednesday night. Unfortunately, out of all the businesses in the good old USA, major hospital ICU's are the shortest staffed business and they don't do anything routine on the weekends. I asked the nurse to call the hospital administrator on call tonight. Within five minutes the resident said he would order a CAT scan and Mark would go down around 4am to have it done.
When his nurse (who he had last weekend before he left for rehab) performed his Glasgow exam, he scored a 5. But remember, people wake from comas all the time.
Saturday, January 06, 2007
Sign Hung in Mark's Room Today
Hi,
My name is Mark Seymour, sometimes people call me Rico. I probably won’t respond to Mr. Seymour.
I have poor circulation in my feet, especially my right foot. Because of this, I move it almost constantly, and the colder they are, the faster I move them.
My gaze has been to the right for the last few weeks. This is nothing recent. Although I have been told that in the later evenings when I was most awake, my eyes looked straight ahead and are focused much better. My nurse last weekend even said my pupils were no longer sluggish.
During my last admission, the last thing I was able to do was open my eyes. I don’t know why, but I’ve been told you will get an earlier, better and quicker response to a thumbs up on my right hand than anything else.
Even though I’m a real ladies man, I respond to a deeper male voice better. Go figure.
I wasn’t always like this. Last weekend while I was still in the hospital I was awake and alert from morning till late at night, nodding appropriate answers, writing my name, mouthing words, waving when my friends came to visit.
Please consider this a short term relapse. Help me get out of here soon.
M
My name is Mark Seymour, sometimes people call me Rico. I probably won’t respond to Mr. Seymour.
I have poor circulation in my feet, especially my right foot. Because of this, I move it almost constantly, and the colder they are, the faster I move them.
My gaze has been to the right for the last few weeks. This is nothing recent. Although I have been told that in the later evenings when I was most awake, my eyes looked straight ahead and are focused much better. My nurse last weekend even said my pupils were no longer sluggish.
During my last admission, the last thing I was able to do was open my eyes. I don’t know why, but I’ve been told you will get an earlier, better and quicker response to a thumbs up on my right hand than anything else.
Even though I’m a real ladies man, I respond to a deeper male voice better. Go figure.
I wasn’t always like this. Last weekend while I was still in the hospital I was awake and alert from morning till late at night, nodding appropriate answers, writing my name, mouthing words, waving when my friends came to visit.
Please consider this a short term relapse. Help me get out of here soon.
M
Friday, January 05, 2007
Evening
Well, you learn something new everyday. Mark’s evening nurse told me about the Glasgow Trauma Scale. Here’s a link. http://www.trauma.org/scores/gcs.html
Seems they’ve been evaluating him every four hours for the last five weeks on his alertness. I had to do some arm twisting to get his numbers for today but it was a 9. Now I know what to ask for.
Mark had some voluntary movement tonight. He brought his hand up to his face and looked like he tried to scratch it. And he responded to pain with withdrawal. Except for when they draw blood and can’t find a vein, this is the worst thing to witness. Other than that, he’s medically stable.
Seems they’ve been evaluating him every four hours for the last five weeks on his alertness. I had to do some arm twisting to get his numbers for today but it was a 9. Now I know what to ask for.
Mark had some voluntary movement tonight. He brought his hand up to his face and looked like he tried to scratch it. And he responded to pain with withdrawal. Except for when they draw blood and can’t find a vein, this is the worst thing to witness. Other than that, he’s medically stable.
Early Evening
Mark has a wonderful new doctor (resident), whose name I don't want to misspell, so it’ll have to wait for another time, but he actually came over to Dick and me this afternoon to give us an update.
Mark is stable medically. They removed him from the EEG machine since there was no evidence of seizure activity. His spinal fluid came back negative for infection or traces of blood, and so did his blood tests. As I said before, his CAT scan was also normal and his intracranial pressures were good.
So, why is he asleep and unresponsive? The area of the brain where Mark had the bleeding is the brain stem, which regulates your basic body functions, like temperature and sleep/wake cycles. When Mark first woke up about one week ago, he seemed to go from almost always asleep to almost always awake. The resident thinks he’s in a “sleep cycle” now.
You probably remember me talking about Mark having fevers on and off, although he had no infection? Well, he hasn’t had a fever in days, so maybe he’s overcome the problems regulating his body temp. Hopefully, he’ll be able to regulate his sleep wake cycles too.
Mark is stable medically. They removed him from the EEG machine since there was no evidence of seizure activity. His spinal fluid came back negative for infection or traces of blood, and so did his blood tests. As I said before, his CAT scan was also normal and his intracranial pressures were good.
So, why is he asleep and unresponsive? The area of the brain where Mark had the bleeding is the brain stem, which regulates your basic body functions, like temperature and sleep/wake cycles. When Mark first woke up about one week ago, he seemed to go from almost always asleep to almost always awake. The resident thinks he’s in a “sleep cycle” now.
You probably remember me talking about Mark having fevers on and off, although he had no infection? Well, he hasn’t had a fever in days, so maybe he’s overcome the problems regulating his body temp. Hopefully, he’ll be able to regulate his sleep wake cycles too.
Early Morning
There has been no change in Mark's status. His EEG still shows no sign of seizures. He responds to pain stimuli and will open his eyes, but doesn't wake up.
Thursday, January 04, 2007
Later Evening
Mark will probably be hooked up to the EEG monitor for a total of three days (just a guestimate from his nurse). They didn't leave a tube in the spine when they finished the spinal tap because his pressures were fine. His blood was thin so they gave him some plasma. His oxygen is now set to 70% (his highest previous setting was 40%) and his sodium and "stuff" were out of kilter so they're also monitoring that. I wonder if he was just sent to rehab too quickly.
Hopefully Dick will talk to the resident again tomorrow morning to see if they have any idea why he’s so unresponsive. His nurse assured me that the Ativan they gave him last night for his seizures would have made him very sleepy, but that it would have worn off in 2-3 hours. She was pretty adamant that even though there has been no evidence of seizures, she thinks he had had them. I've heard that it is rare for him to have seizures from his original bleed because of the location, but who knows what they did while they were in there breaking up the scar tissue.
Even though he's not waking up at all right now, he’s been here before and has made great strides very quickly so I’m staying positive.
Hopefully Dick will talk to the resident again tomorrow morning to see if they have any idea why he’s so unresponsive. His nurse assured me that the Ativan they gave him last night for his seizures would have made him very sleepy, but that it would have worn off in 2-3 hours. She was pretty adamant that even though there has been no evidence of seizures, she thinks he had had them. I've heard that it is rare for him to have seizures from his original bleed because of the location, but who knows what they did while they were in there breaking up the scar tissue.
Even though he's not waking up at all right now, he’s been here before and has made great strides very quickly so I’m staying positive.
Early Evening
A big thank you to my lovely boss Lisa, who's working extra hard to cover for me so I can get away to visit Mark as often as I can.
They had Mark hooked up to an EEG for over 12 hours. There was no seizure activity. At all. None. (I told you so)
They did a spinal tap to check for new bleeding and increased intracranial pressure. They were also planning to put another drain into his head. Dick asked them to be conservative. Good idea. They're waiting for the labs to come back on the fluid, but that also looks good because they didn't see any blood. His intracranial pressure was fine, they were going to put a drain in his spine to drain the excess fluid, but Dick said he didn't think they had to do it. (I told you so)
He's still out of it. They said the Ativan they gave him last night would knock him out. (They were right)
When I saw him this morning his feet were still - and they were warm. (I told you so)
I'll update again after my evening visit.
They had Mark hooked up to an EEG for over 12 hours. There was no seizure activity. At all. None. (I told you so)
They did a spinal tap to check for new bleeding and increased intracranial pressure. They were also planning to put another drain into his head. Dick asked them to be conservative. Good idea. They're waiting for the labs to come back on the fluid, but that also looks good because they didn't see any blood. His intracranial pressure was fine, they were going to put a drain in his spine to drain the excess fluid, but Dick said he didn't think they had to do it. (I told you so)
He's still out of it. They said the Ativan they gave him last night would knock him out. (They were right)
When I saw him this morning his feet were still - and they were warm. (I told you so)
I'll update again after my evening visit.
Later Evening
I was determined to stay at the hospital tonight until Mark had a CAT scan and I talked to the resident. When I was still there by 1am they decided to talk to me so I'd go away. Do you believe that all the residents had a rotation yesterday and there is a whole new team of doctors there who have never seen Mark before? A great way to evaluate him against his prior status! We know their chart documentation processes leave a lot to be desired.
We need to go back to last night. After his bath, Mark was chilly. His feet were very cold and he was tapping them even more than usual. He does this to help his circulation, something he's done since I've known him. I rubbed his feet to warm them up (they stopped their movements for a short time) and I even put some fuzzy socks on him. They only had a very light weight cotton blanket and it was freezing in his room. And if I'm cold with my hot flashes, you know it's cold! Even the nurse said the room was cold. He was tapping more vigerously than usual.
For most of the last five weeks, Mark's head is turned to the right and he gazes to the right. I'm sure you can tell this from the hospital pictures that are posted in the link on the front page. There are times, usually at night when his eyes look straight ahead and his head is also straight and he seems to be able to focus better. This doesn't happen that often, but it is improving slowly.
The doctors at the Rehab center thought he was having seizure activity due to the foot tapping and his right looking gaze. Even the resident tonight suspected those two things could be caused by seizures. I asked the resident if it were seizure activity, would the foot tapping stop if I rubbed his feet? He said definately not! For those of you who have seem him in the hospital, I'm sure you remember the foot tapping - at times even his lower leg was swinging off the bed.
His CAT scan showed no changes. What we were most afraid of was another bleed, but there was no evidence of this. And I guess the shunt looked okay too.
Mark was still hooked up the the EEG machine when I left, hopefully this will be read sometime tonight.
But Mark also didn't want to wake up today which was a great concern to the Rehab staff. But do they know he's only been awake for extended periods of time since last Friday? And after all his activity yesterday with the ride to rehab and the shower, maybe he was just tired? He did wake and respond on the ambulance ride tonight from the rehab to the hospital, and again for the resident when he arrived at Jefferson.
I hope I can say " I TOLD YOU SO!!!" tomorrow.
I will keep you posted.
P.S. I received my lovely Angioma Alliance pin today from Mark's angel Connie with a lovely note. I hope you gets yours soon. http://www.angiomaalliance.org/donate.html
We need to go back to last night. After his bath, Mark was chilly. His feet were very cold and he was tapping them even more than usual. He does this to help his circulation, something he's done since I've known him. I rubbed his feet to warm them up (they stopped their movements for a short time) and I even put some fuzzy socks on him. They only had a very light weight cotton blanket and it was freezing in his room. And if I'm cold with my hot flashes, you know it's cold! Even the nurse said the room was cold. He was tapping more vigerously than usual.
For most of the last five weeks, Mark's head is turned to the right and he gazes to the right. I'm sure you can tell this from the hospital pictures that are posted in the link on the front page. There are times, usually at night when his eyes look straight ahead and his head is also straight and he seems to be able to focus better. This doesn't happen that often, but it is improving slowly.
The doctors at the Rehab center thought he was having seizure activity due to the foot tapping and his right looking gaze. Even the resident tonight suspected those two things could be caused by seizures. I asked the resident if it were seizure activity, would the foot tapping stop if I rubbed his feet? He said definately not! For those of you who have seem him in the hospital, I'm sure you remember the foot tapping - at times even his lower leg was swinging off the bed.
His CAT scan showed no changes. What we were most afraid of was another bleed, but there was no evidence of this. And I guess the shunt looked okay too.
Mark was still hooked up the the EEG machine when I left, hopefully this will be read sometime tonight.
But Mark also didn't want to wake up today which was a great concern to the Rehab staff. But do they know he's only been awake for extended periods of time since last Friday? And after all his activity yesterday with the ride to rehab and the shower, maybe he was just tired? He did wake and respond on the ambulance ride tonight from the rehab to the hospital, and again for the resident when he arrived at Jefferson.
I hope I can say " I TOLD YOU SO!!!" tomorrow.
I will keep you posted.
P.S. I received my lovely Angioma Alliance pin today from Mark's angel Connie with a lovely note. I hope you gets yours soon. http://www.angiomaalliance.org/donate.html
Wednesday, January 03, 2007
Wednesday Night
Well, another bump on the road to recovery. After the almost euphoric reception at the Rehab hospital last night, Mark did one of his withdrawal things and refused to respond to the Doctor's tests all day, remaining asleep. He looks much better in a tee shirt and pants than he did in the classic gown, clean shaven except for the goatee and his usual moustache -- very Vincent Van Gogh with his nearly bald head. Yesterday I told him we might have to clip one of his ears to heighten the illusion -- he definitely understood and winced. Because of the setbacks, Dr. Long, the neurologist at the Rehab, decided to send Mark back to Jefferson for an evaluation. He will be transferred back there tonight some time and will return when they think he's ready. Chris and I are quite disappointed, of course -- but the whole recovery process has been like this. I will post more in the morning when we hear something from the Jefferson doctors. (Dick)
Tuesday, January 02, 2007
Evening
Mark is all settled in his room at rehab. He even had a shower tonight! They have a waterproof gurney that they roll right into the shower. After five week, I'm sure he loved every drop. His stitches have been removed along with his IV and the oxygen monitor on his finger, and all the leads to the heart and breathing monitors. I was finally able to get a big hug tonight. They even brushed his teeth.
Unlike the TV in the hospital which is mounted high on the wall and not at all mobile, he now has a TV like the overhead light at the dentist. It can be lowered, raised, swiveled, moved forward and back. I guess you all know where this is going.
Our visit ended earlier than I thought, but it was good to get home and to bed early.
I may not get a chance to visit tomorrow, but I’ll have Dick Seymour take over the blog for me for a few days.
Unlike the TV in the hospital which is mounted high on the wall and not at all mobile, he now has a TV like the overhead light at the dentist. It can be lowered, raised, swiveled, moved forward and back. I guess you all know where this is going.
Our visit ended earlier than I thought, but it was good to get home and to bed early.
I may not get a chance to visit tomorrow, but I’ll have Dick Seymour take over the blog for me for a few days.
Afternoon
Mark is going to rehab today. Here is their website and their directions page. http://www.mainlinehealth.org/br/article_1951.asp
I will update their visiting policy etc. tonight.
P.S. Bryn Mawr rehab is not in BRYN MAWR! It's in Malvern. Please Mapquest or Google Map it for directions.
I will update their visiting policy etc. tonight.
P.S. Bryn Mawr rehab is not in BRYN MAWR! It's in Malvern. Please Mapquest or Google Map it for directions.
Monday, January 01, 2007
Evening
Even though Mark was awake all day today, he wasn't as lively and responsive as we was yesterday. I think all the excitement of visitors tuckered him out. But I brought in his favorite soap (Pure and Natural) and shampoo (green apple) and gave him a good washing. I think he liked my bath better than the one the nurses give him. Since my kids read this, I won't go into details. And he smelled like Mark again!
He's had no more fevers but the medicine that they give him in his breathing treatments makes him perspire, which they said was normal.
He's been moving his entire legs, arms and head, and even moves his body a little to get comfortable. When his nurse shined the flashlight in his eyes tonight, she said his pupils weren't sluggish at all, which was a first. And he's beginning to look straight ahead, up till now his eyes were looking to the right only.
Derrick and Tina stopped by today and although I wasn't there, Mark agreed that he enjoyed their visit very much. And Mark had other visitors this morning, but I forget the note they left and don't remember their names. But he remembered their visit when I saw the note and asked him about it.
I'm back to work tomorrow and don't know how much I'll get to see Mark. Hopefully we can work something out so I can leave a little early.
I think he may be transferred to rehab soon. Let's keep our fingers crossed. He told me that the hospital was boring. I offered to read to him again today but he declined. I hope my reading's not as bad as my singing!
He's had no more fevers but the medicine that they give him in his breathing treatments makes him perspire, which they said was normal.
He's been moving his entire legs, arms and head, and even moves his body a little to get comfortable. When his nurse shined the flashlight in his eyes tonight, she said his pupils weren't sluggish at all, which was a first. And he's beginning to look straight ahead, up till now his eyes were looking to the right only.
Derrick and Tina stopped by today and although I wasn't there, Mark agreed that he enjoyed their visit very much. And Mark had other visitors this morning, but I forget the note they left and don't remember their names. But he remembered their visit when I saw the note and asked him about it.
I'm back to work tomorrow and don't know how much I'll get to see Mark. Hopefully we can work something out so I can leave a little early.
I think he may be transferred to rehab soon. Let's keep our fingers crossed. He told me that the hospital was boring. I offered to read to him again today but he declined. I hope my reading's not as bad as my singing!
Sunday, December 31, 2006
Evening
Today was the best day ever! Mark was wide awake when I arrived at 11 and was still awake when I left at 9. He was also the most aware that I've seen him since this all happened. We were having a nice little visit when his friend Doug arrived. When I told him that Doug was there, he turned his head with no effort and grinned the biggest smile I've seen yet. He was so exicted to have a visitor, and if that wasn't enough, Tina came to visit after Doug left. He had a really big day today.
And if that's not enough, the ventilator left his room tonight and he had no fever at all today. I gave him a good washing up which he didn't seem to mind at all. He seemed to have better control over the movement of his head and eyes tonight - the best I've seen so far. He even looked toward the TV, but I'm not sure he was interested in it.
Oh, I even bought the newspaper today and read him some. I think that's when he took a short nap. Then I tried People and it put us both to sleep.
Have a good New Year and a safe 2007!
And if that's not enough, the ventilator left his room tonight and he had no fever at all today. I gave him a good washing up which he didn't seem to mind at all. He seemed to have better control over the movement of his head and eyes tonight - the best I've seen so far. He even looked toward the TV, but I'm not sure he was interested in it.
Oh, I even bought the newspaper today and read him some. I think that's when he took a short nap. Then I tried People and it put us both to sleep.
Have a good New Year and a safe 2007!
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