Next month on the 4th of August, it will be 1 year since Chris was helicoptered on a mercy dash, 80 kilometres to our closest major hospital for emergency cardiovascular surgery. I’d been instructed to contact family members to say our goodbyes before he was transferred. Still conscious he couldn’t grasp the enormity of the situation and said so in as many words. I was grateful that our youngest daughter was with me, she was able to leave her workplace having just started a nightshift. We waved the helicopter off, praying that he would make it to the hospital.We knew the surgeon and theatre were ready/ waiting at the other end.
Chris did arrive safely and he went straight into surgery. The surgeon told us that Chris had only just made it in time and after 8hrs in surgery the next fews days of his recovery would be critical.
I can’t fully explain how it feels to see you’re husband in the ICU environment on full life support. The only consolation was that he was not in any pain, looking very restful and peaceful. I was familiar with acute units and understood the need / importance of the ventilator, temporary pacemaker, IV lines and replacement fluids, blood products and drugs. We could see the length of the surgical incision with drainage tubes protruding at the base of it. All very confronting for our 4 children to see.They had their individual ways of coping and I am more than proud of them. My sister and some very close friends were also suportive and present for us in the early days.
It became apparent after several days when Chris was not waking up that something was very wrong. A brain scan and MRI were done and they identified a watershed infarction with brain stem involvement, the immediate problem and also extensive global areas of involvement. My sister was with me when we spoke to the neuro specialist who showed us the scans and explained the relevance and severity of the damage to Chris’s brain. She could not confidently give any guarantee of recovery.
She left us and I heard this mornful/primal soulful sound of distress and disbelief and realised it had come from deep within me followed by copious uncontrolable tears. Such was my reaction to the news.
The dreaded family meeting was arranged to discuss Chris’s ongoing management. We were told that it was necessary for a tracheostomy to be performed so that the ET tubes could be removed. This would support long term ventilation. Chris was showing no sign of waking even though his drugs were being weaned.
After 10 long days Chris opened his eyes, although it was difficult to asssess his mental state as he was unable to communicate. It became apparant that Chris was paralysed down his left side. Fortunately he did regain movement in his leg but the arm remained dense and swollen. This also resolved after a few more days.
The physios at this time were more concerned about keeping his lungs clear. We made sure that Chris had a stress ball to squeeze and grab to work on his fine motor skills. He managed to throw it as far as the foot of the bed and have us retrieve it. The team were doing their afternoon rounds and one of the doctors asked if Chris could throw tbe ball. He did so and suprised them all. This amused the nursing staff as well. He would sometimes, on purpose , drop the ball over the side bed rail and have us retrieve it from under nearby patients beds.
It was difficult for Chris to communicate, he couldn’t talk, couldn’t write and sign cards didnt help. It was not known just how much Chris was capable of or understood at this time. I felt that he recognised us . One thing he was able to do was use his right index finger to point or bring attention to himself.
Our girls made a compulation of his favorite music which we played on an mp3 or phone when we visited. He would close his eyes and tap his finger to the beat.
Fatigue was a huge issue and just repositioning him would exhaust him.
About 3,4 weeks in and Chris was becoming very restless and agitated with a form of delirium that many long term ICU patients are affected with. It was horrible to see him like this and made worse by the fact that he needed to be restrained at all times. We were allowed to remove the restraints while we were there but had to watch him closely.
He was troubled by profuse, copious sweating where rivulets of moisture would run down his forehead and around his glasses. He would attempt to wipe it away and we would have watch that he didn’t grab the NG tube and pull it out.
Weeks 5,6 and 7 were the time to wean off the ventilator. They used a method called sprinting which increased the time off the ventilator during the day and on overnight until he was capable of breathing spontaneously. Chris didn’t do too well initially but when he didn’t require the ventilator overnight he was moved to ICU2.
Weeks 8,9- The decision of when to remove the tracheostomy tube was the issue. The team were not happy to remove it too soon because they wanted to be certain it wouldn’t be needed again as it had been a difficult intubation.
The day finally came and we were waiting to hear Chris speak again. Imagine how we all felt when it became obvious that Chris wasn’t able to speak. We were told that it may take some time for his voice to return. An ultrasound revealed that there was some damage to his vocal cords.
At long last he could have some food starting with puree food and thickened liquids.
His voice was a hoarse whisper and he was having difficulty with his speech.
Chris no longer needed to be in ICU so now the plan was to be transferred to rehabilitation ward. It was decided that Chris could be transferred closer to home. He was transferred to the cardiothoracic ward until a bed was available.
It was becoming obvious that after a week waiting that there was a long waiting list for a bed in the public system. I asked about going to a private facility and we had a bed a day later.
Chris was transferred to our local private rehabillitation hospital and was wheeled in on stretcher. His challange now was to be able to walk out under his own steam when the time came.
Joans jottings 