Tuesday, November 03, 2009

Post-Surgery...Part II

Okay, so the last time I posted, we were a week post-surgery and doing great, all things considered.

I guess you could say the same now, though the "things considered" are a bit different.

Allow me to elaborate:

On Friday morning of last week, we went to get Wes' staples removed. He was doing well, and felt almost normal. ;) After an exam by the neurosurgery Nurse Practictioner, his mom, the nurse, had the pleasure of removing the staples from his incisions: the one behind his ear from surgery, and the one in his abdomen where fat was removed to plug the hole in his skull (neat, huh?).

When removed, the staples left neat little holes in a neat little row along the cut. As the staples came out, from a few of these holes ran a little stream of clear liquid which dripped down his neck. This was a bit startling, though not completely abnormal. The possibilities were either that the tissue was 'weeping' while healing, or that it was cerebrospinal fluid leaking from inside the skull. It was not a huge amount--a tablespoon, maybe, and then it stopped. The educated theory was that it was not CSF, and the precaution was given to call if a severe headache occurred. We left to walk a little around the mall, then go home.

While at the mall, the dull (normal) headache Wes had had earlier now increased steadily, though not unbearably.

What we did not know at this point was that bacteria had entered his brain from the outside world through the cerebrospinal fluid that had leaked. In twenty minutes, this bacteria doubles. In two hours, it increases sixty-four fold.

This is the kind of bacteria that can kill a person within hours.

After a few minutes at the mall, feeling a bit more tired and in a bit more pain, Wes took two Tylenol and we headed for home.

Within an hour of arriving home, his pain was more noticeable. He took a half pill of a stronger medication given by the doctor. This made no difference. As time progressed, his pain increased to a screaming '9 out of 10' (he reserves 10 for dismemberment and mortal wounds), and he couldn't stand light, couldn't move, couldn't talk.

I called our local neurosurgeon, who prescribed a migraine medicine. This did not work, and by 3:30, I was on the phone with Vanderbilt. They advised that this was definitely not normal, and that if his pain had not decreased in an hour, to go to the ER.

At 4:40, we were headed to the ER. There, they did a spinal tap (lumbar puncture) to start a culture on spinal fluid (to determine whether it was an infection or a CSF leak) and gave him morphine to manage the pain.
The morphine made no difference.

At this point, the doctors had told us it was either a CSF leak causing pressure and pain, or "infectious meningitis." I now know the latter term really means "bacterial meningitis," but doesn't sound as foreboding.

is the irritation of the meninges, which are the membranes that cover the brain. This can be caused by surgery (chemical meningitis), a virus (viral meningitis), or bacteria (bacterial meningitis). The former two are temporary and need no treatment; the third can kill you quickly.

Wes was admitted to the CCU (Critical Care Unit), where they began administering antibiotics to prevent the progress of infection. His temperature wavered around 102 degrees. He was in tremendous pain, unable to bear noise above a whisper, and very lethargic. The skin behind his ear bulged out where the tissue had swollen.

For the next two days, his mom and I alternated our visits to see him during the strict hours of the CCU. We slept in the waiting room and prayed for some clear answers as to what had happened.

By the second day, his pain was somewhat under control and his fever had decreased a bit, so he was moved to his room on the fourth floor. He has remained there since, and has steadily--though slowly--improved.

His blood tests confirmed infection, though the spinal tap showed nothing conclusive as to the type of bacteria involved.

He continues on a strict regimen of two high-powered "broad spectrum" antobiotics, almost constantly administered by IV. Monday, he received a PICC line, a fancy contraption attached to his upper arm through which he gets his medicine (he now calls it his 'bionic arm'). This kind of high-powered central line can last a year. It is through this line that he will continue to receive antibiotics at home for another week or two. Through this same line, blood can be drawn also. Good news for Wes, who at this point feels somewhat like a human pincushion. :)

It is a slow ascent back to normalcy, but every day he gets a bit better. We are so thankful for God's hand of protection on us, for easing his pain, and for giving us great doctors, wonderful family, and a supportive church.

That's all for now...thanks for reading, thanks for caring, and for praying for us. What a story!

1 comment:

Sarah R. Von Haden said...

thanks for the update.....Isn't it good to know Jesus during days like these?....still praying for your family...