Tuesday, May 3, 2016

a simulation

Warning: these photos contain blood. 
The blood is fake, but still. The warning stands.

On Saturday I took my son to his EMT class's MCI (Mass Casualty Incident) simulation. Of course, my son couldn't participate, much to his disappointment, but at least he got to observe. (He was just two weeks shy of completing his training when he wrecked his bike, which totally bums him out. However, his instructors are bending over backwards to make sure he'll complete his training...just a couple months later than the rest of the class, thank you, instructors.)

I had no idea what to expect from the simulation, but once we arrived on the scene, I began to get a clearer picture.

This is the woman (unwittingly) responsible for getting my son interested in the EMT program.

A bunch of already-trained EMTs were gathered around tables, getting fancied up with fake wounds. There were head wounds, bloody noses, gashed legs, a screw sticking out of a chest, road burns, etc. When the "victims" got word that the students were on their way, they got into position and one guy went around with the bottle of blood, adding more where needed.


The students entered the building in groups of two or three, just as though they were arriving on the scene in different ambulances. As soon as the students arrived, the “injured" folk went into action, shouting for help, screaming, and crying. The walking wounded and the bystanders rushed the students, pleading for help. The noise was deafening and the chaos overwhelming. Which was the point entirely. (Another year, they actually had a Medevac helicopter on the scene.)


At the beginning, it was quite stressful to watch—not enough workers and so many injured people. The first wave of students (poor things!) assessed the situation, tying colored bands on the injured folks to signify their level of need, radioing out to the other class members, unpacking equipment. When the next wave of EMTs, and then the next and the next, finally arrived on the scene, I felt actual relief. Now they could finally start doing something.


See the young man in the blue shirt? He was with the ambulance that came 
when my son got injured, and my son greeted him by name.

For the next twenty minutes, we walked around the scene, observing the students as they worked their way through the situations. One guy (who spoke only Spanish to jazz things up) was pinned between two vehicles. Another woman had her foot trapped under a car's tires. A man was completely under one truck. There was a motorcycle victim, a freaking-out woman with a baby, and a dead guy. There was a bystander who heckled the volunteers nonstop and needed to be retrained. One guy started seizing (or something); another woman passed out.

And then the show was over.




And that, my friends, is part of the EMT training process.

This same time, years previous: creamy avocado macaroni and cheese, the definition of insanity, burning the burn pile, how to get your bedding/house/kids clean all in one day, and cream cheese pastry and classy rhubarb pie.

Monday, May 2, 2016

the quotidian (5.2.16)

Quotidian: daily, usual or customary; 
everyday; ordinary; commonplace


In the downtime between play weekends: stocking up.


Thrift is mincing the one remaining corn tortilla and adding it to the chili.


Nanner muffins.


They're coming!


Paying off: fall plantings.


Wallowing.


Horsey pedi.


Rocky Mount Fire: that afternoon we had to shut the windows to keep out the smoke.


Burning down the tent caterpillars.


Flying free.


Just swinging.


Don't choke, because doing the Heimlich maneuver in that brace would be rather tricky.


Pixie: she wants to go still shorter.


Backseat writing nook.


Taking shape: concrete counters (not for us).


Splitting her sides over my ineptitude. 
(Now that the play is over, I'm willing to risk a broken bone.)


They spend hours (upon hours) together.

This same time, years previous: carrot cake with cream cheese frosting, depression chocolate mayonnaise cake, baked-in-a-pot artisan bread, take two, green smoothies, and strawberry cheesecake ice cream.

Friday, April 29, 2016

back to normal

Wednesday night, we were discharged from the hospital, directly from the ICU unit, which, we learned, is unusual. One nurse who had been there for 30-some years said she's only ever discharged one patient. I credit our nurse for getting us out. He advocated pretty hard on our behalf, pushing the doctors to communicate and get on the same page. He was pretty excited that we were leaving at the same time he was going off his shift (our son was the second patient he's seen discharged directly from ICU), so he walked us out to the car himself.



Speaking of nurses, we had excellent care throughout our stay. Like, really excellent care. One nurse had trained at John Hopkins and went out of her way to explain all the procedures and why they mattered. Our first nurse was the one who saw to it that we got moved to a better room so we could sleep. Other nurses went out of their way to offer to get us drinks, blankets, pillows, shaving cream, whatever. They told us stories about the types of illnesses they see in their particular ICU: Stevens-Johnson Syndrome, smash face (that's what they call it!), etc. Our ICU unit was the one that has medical-grade leeches and maggots on hand for burn patients, and the unit is certified (or whatever) to treat the president should the need arise. One of our nurses said that the coolest thing she had ever seen was a bladder made from a sheep's intestine. A good nurse is never to be taken for granted. Never ever ever. They make all the difference in the world.

A personalized pain pump also makes all the difference: punching the button.

The frustrating part was the specialists. They were kind and capable, but they didn't communicate efficiently with each other. We'd get an MRI and then have to wait 18 hours for the results. The results for the spine x-rays took another 18 hours. What irked me most was that they didn't want our son to eat because there was a chance he might need surgery, so there he was, flat on his back, pumped up on painkillers and with no nutrition. No wonder, come Tuesday morning, he got disoriented and agitated. He didn't know where he was and kept trying to pull off the leads. They ordered a sedative, but we didn't end up using it because he settled down after I sponge-bathed his hands, feet and face.


Tuesday afternoon, after strapping him into his made-to-order brace, they got him to his feet. He got light-headed and threw up in the giant condom puke bag. So they let him rest for a couple hours before trying again.




The second time around, he did fine, so they took him for x-rays (he had to be able to stand by himself for a couple minutes for the x-rays) to see if his spine was stable. Apparently, he passed the test, and that evening they cleared him to eat. He said his two saltine crackers tasted superb.


Wednesday's physical and occupational therapy went great, and we got cleared to go home mid-afternoon.


an ICU hair wash

But then the doctors got concerned about his double vision and we had to wait while a whole chain of them took turns coming up to examine him. (He's fine, probably. PT gave him an eye patch to ease the eye strain, arr matey. If he still sees double in six weeks, we'll go back.) It wasn't until bedtime that we finally got off the floor. Home at ten.

And thus concludes all things hospital. YAY.


The first thing we did our first morning at home (after I went running, glory be!), was lay the kid down on the dining room table and shave off his hair. We had done two of the shower cap washes while in the hospital, but they were a complete joke. The kid's hair was beyond disgusting. So off it went.


Day One was spent lounging in his new sleeping quarters, hanging out with his siblings, eating and drinking and peeing (never take for granted the basics!), and reading a whole pack of hilarious get-well cards from his cousins. His sister fashioned a computer station out of his walker and a piece of wood, and that evening his father and I introduced him to Sherlock.


Last night, my son had his first shower, and my husband and I argued nonstop throughout the changing of the braces. (Being a solid team for three days in a row is wearing—who knew how refreshing it is to argue over stupid stuff once again!) My son was like, No! You do it this way! and Let me check that brace before you put it on, and Geez, you guys. All my training gone to waste. I can't believe I have to just lay here while you figure it all out, and Look, I'LL hold c-spine myself, and No! Don't roll me until I say! Don't you know the person holding c-spine in the one to count? Okay, one, two, three! I about peed myself laughing.



To summarize: we are doing well! I slept a full eight hours last night (the first full night of sleep in weeks, since I didn't sleep much while working on the play) and went running again this morning. My younger daughter has a friend over to spend the night; they're making chocolate cupcakes as I type. My husband is back at work, and, for today, my older daughter is working with him. Right now, my older son is actually out on a leisurely drive with a friend from church.

Oh, right. The treatment plan! He'll wear the neck brace for six weeks, and ninja warrior/turtle shell/clamshell brace for six to eight weeks. The neck brace is to stay on at all times (we can change the foam pads when he's laying down), and the clamshell can come off if he's laying flat, to give his skin a break. He's not to lift more than ten pounds. Physical therapy will start when the braces come off. (We also noticed a chipped tooth, so I want to have a dentist check his teeth. Plus, there's the vision problem and the concussion after-effects to monitor.) My guess is—because they wouldn't give me any specifics—that he'll be at average functioning (singing, studying, walking, doing household chores, feeling good) in three months and fully back to normal (construction work, running, lifting weights, biking, etc) by the sixth month mark.

And thus concludes this series of medical posts. (The kid has hogged entirely too much air time.) Next posts will be about non-traumatic topics like pixie cuts, salad, and post-play depression. Normal life is beautiful.

This same time, years previous: creamed honey, let's pretend this isn't happening, taking off, the quotidian (4.27.15), coffee crumb cake, the quotidian (4.28.14), Sally Fallon's pancakes, out and aboutmango banana helados, and better brownies.    

Tuesday, April 26, 2016

thank you for holding us

You guys. 

Never before have I experienced such a tidal wave of love, both from people I know and from people I've never even met. Y'all are doing me in, in the wonderful-est of ways. Most of the time since the accident, I've been focused, centered, even jolly, but then I'll open my computer to check email/Facebook/the blog and be totally overwhelmed by the outpouring of kindness. Those moments, I break down. 

(Also, when I wake up in the morning. I cry then, too.)



The accident was nothing unusual really. Just a combination of teen-boy energy, riding fast downhill, clipping another bike (the other rider maintained control and was fine, thank goodness), a swerve that took him over a five-foot incline, and then a collision with a ditch in which the bike stopped and he didn't. He flipped over the handle bars and landed on his head and back.

***

Public Service Announcement

People, listen up. When my son crashed, he landed on his head. His helmet cracked. We are fairly certain that we would be dealing with a horribly different situation had he not been wearing that helmet. Helmets are head-savers, brain-savers, life-savers. WEAR THEM.

End of PSA

***

The accident took place at a local park where our church was having a mentor-mentee ice cream social. A number of people saw the accident, including a nurse who took immediate charge and kept him still. The downside of crashing at a church event: this was distressing for the people who know and love us, particularly the children (including his sisters). The upside of crashing at a church event: being surrounded by loved ones, an immediate emergency safety net.

Neither my husband nor I were there when the accident happened. My husband was running errands, and I was, mostly likely, bowing after our final performance. I had about exactly fifteen minutes to come down from the show (thank you, my son, for waiting to crash and burn until after the show's run was completed) before my husband called to say our son was on a backboard and being loaded into an ambulance.

(Actually, the first thing he said was, “Don't panic,” followed by, “Sorry, that's not what I should have said first.” When he added, “He's conscious” and “he can move his arms and legs,” I realized that if those were the markers he was looking at, then things might be serious. So I semi-freaked, naturally.) 

(You know, I was super worried about the ravages of post-play depression but it hasn't even been an issue. A silver lining, perhaps?)


When I said the puke bags looked like giant condoms, the nurse busted up laughing. 
"That's the first I've heard that one," she said. 
Seriously? How could anyone NOT think that?

At the local hospital, the first CAT scans came back with the mild neck fracture—he would probably need a neck brace for six weeks, they said, but no biggie, really—but they wanted to do more CAT scans because they didn't get a good read on the thoracic.

My son was clearly in a lot of pain, but I downplayed it. From all the times I took my kids to the doctor thinking they were dying from pneumonia or appendicitis only to learn they had a stupid virus and there was nothing the doctors could do, I've learned to downplay all medical situations. Besides, my son has a flair for the dramatic (no idea where he gets it). His back was just sore from the fall, I told myself.

Then the kid started puking. Turns out, throwing up while in a neck brace is rather horrific to watch (not to mention experience). Wave after wave of vomit. No time to suction. Thrashing around. Projectile vomit. That was the only time I lost it with the medical staff. I think I yelled something profound and super effective, like DO something!




bright spot: his EMT instructors transported him to UVA 
(and excused him from class this week)

At 10:30 that night, my friend popped in with burgers. My husband and I had just about finished scarfing our food, when the doctor came up and informed us that there were, indeed, breaks in the thoracic and that they would be transporting him to University of Virginia for more specialized care.

I lost it. I had so successfully convinced myself the whole event was no biggie, and here things were, spiraling out of control. The whole thing royally pissed me off. While I ranted and cried, my friend stayed steady, making me drink water, feeding me chocolate, and talking me through the necessary steps. (Nine years before, our roles had been reversed. She'd called me from the hospital in a panic—her baby just diagnosed with a tumor and ordered to UVA for treatment—and I had been the one doing the clear-headed thinking: pack your glasses and contacts, camera, insurance card, clothes, money, etc. And now she was returning the favor.)

He'll be a better EMT for this experience, I think.

When we arrived at UVA in the middle of the night, the ER lot was deserted, but once inside the pediatric ER, it was a completely different world. We were met by an entire trauma team.

The examining room was crawling with doctors and nurses—at one point I counted eighteen people, not including myself. I had my own social worker (I'm here for emotional support, she said gently while staring hard into my eyes as though assessing how close I was to becoming unhinged, and, inadvertently, making me wonder if I ought to perhaps succumb to histrionics to keep up with appearances), and soon after a chaplain popped by. The medical professionals seemed divided into groups. One team was suited up in face shields and surgical gear (they were working so quickly that I wondered if they were prepping him for surgery and had neglected to tell me). Over the hubbub, the EMS workers called out the relevant details. A man dressed in street clothes stood at the foot of the bed and called out orders. Other people stood at the head of the bed, announcing his information as it came up on the computer monitors. Within just five minutes, they had stripped off his clothes, slapped on leads, started IVs, done an ultrasound, log rolled and spine checked him, and taken x-rays. It was absolutely dizzying.

By the time my husband arrived, the room was nearly empty, the floor littered with trash. He had missed the whole show.


Things slowed to a crawl after that. We were moved to a room in the Trauma/Surgical/Burn ICU. There were more CAT-scans, many rounds of doctors (floor doctor, spinal doctor, trauma team), visits from social workers, and lots of nurses. There was no place to sleep, so my husband sat in a chair and rested his head on a trash can, while I went to the family lounge and draped myself over three hard chairs. We each slept about an hour.


Yesterday afternoon, our nurse found us a bigger, better room with huge windows and a sofa for us to sleep on. It's not in the ICU section, but we are still under ICU care, so our nurses generously trek back and forth on our behalf. (The medical staff has been wonderful.)






"Look. The sky." (Name that play!)


downright luxurious

The medical staff has been wonderful. And looky here.....

Family!

Friends!

Food!

Flowers!





Diagnosis: A broken neck and back, whoo-hoo! (Okay, okay, so that sounds way worse than it is—but it's true! It's not every day you get to claim an actual, though ever-so-slightly, broken neck! Gotta live it up a little, I say.) Oh, and a concussion; his vision is still all screwy.

The Neck: tiny C5 fracture.
The Back: fractures in T7, T8, and T9. The T7 and T9 fractures are mild, nothing to be worried about, but the T8 one, while not terrible, is the problem spot. It's a compression fracture, and the vertebrae is 50% the size it should be. An MRI showed that there is also a torn ligament, which means that area is weaker.

The treatment plan, as of Tuesday noon: A c-collar (neck brace) for the C5 fracture. A clam shell brace for the thoracic fractures. Right now he's wearing both braces and waiting to be taken to x-ray where they will stand him upright to see if the spine remains stable once gravity gets added to the equation. If so, we go to physical therapy and go home, maybe on Wednesday. If the spine is not stable, then we'll reevaluate, I guess.



upright: for the first time in 40-plus hours

Thank you for holding us.