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Articles: Nine Months Post Trauma

Friday, February 29, 2008 - 09:04 PM, (1118 Reads)
It is nine months today since Kevin's accident. The last nine months having seen Kev fight for his life with great determination. He has overcome many obstacles and will no doubt have many more to come. Kevin is in the early stages of rehab, we are to look at the abilities, not the disabilities. We must see Kevin as still Kevin, but with the need for us to make the effort to reach out to him. His energies are going into healing and piecing the world back together. Like a giant jig-saw puzzle that has been thrown into the air and landed in a muddle, he must sort through and put the pieces he can into order. We cannot do this for him, but can support him through this time to gain the maximize recovery with patience and informed strategies. To be informed relieves fear of the unknown.

Many people fear being with those who are maimed, which is fueled by ignorance leading to their own personal discomfort, which in turn can lead to not getting out of their comfort zone and having input. Research has proven that TBI (Traumatic Brain Injury) does NOT effect intellect, therefore we must treat him as the Kev he has always been and still is. He is still a Dad, husband, son, older brother/brother-in-law, and friend. A fifty-one year old man. Unfortunately it is human nature to treat others in a less fortunate situation as children.

Putting ourselves into someone else's shoes, such pity would lead to humiliation frustration and poor self-esteem, emotions not conducive to positive healing. The last nine months have lead to many emotions and happenings in all our lives. I thank everyone for their positive support and love for Kevin. A summary of Kev's time post trauma. . . .


DATE OF ACCIDENT: 29/9/2007

CAUSE:
Most likely avoided another vehicle. Traveling at 30-50kph - Perfect riding conditions. Alcohol and blood testing negative. Still awaiting for forensics to return findings. Waited approx 45 mins for ambulance. Spinal precautions, oxygen and basic obs not administered. Still waiting o­n explanation from St John's Ambulance.

INITIAL INJURIES:

1. Truamatic Brain Injury (TBI) Left temporal contusion, left temporal heamatoma
2. 5cm Left frontal heamatoma
3. 5cm.Right temporal contusion, right temporal heamatoma x2 . 5cm each
4. Traumatic sub-acrohoid heamorahge
5. Intraventricular heamorahage
6. Sub-dural heamatomas x4 approx . 5cm each
7. Diffuse Axomal Injury (Microscopic level brain cell disruption)
8. Brain partially herniated thru base of right skull

The above injuries are likened to shaken baby syndrome.

OTHER 'MINOR' INJURIES

1. Fractured ribs x6
3. Basal skull fracture
2. Internal hemorrhage to right arm
3. Small 2cm graze to right eyebrow

To look at Kevin in ICU, he looked to be peaceful sleeping. This possibly made it hard for family to understand the significance of injury and what lay ahead.

INITIAL PROGNOSIS:

Very poor. We were informed Kevin was likely to be deaf, blind, and remain in a vegetative state. We were not given the option to remove life support, and had to honour the fact that he remained to fight the odds, including the following complications. I truly believe that Kevin has shown the desire to live and we are to support him in his choice.

COMPLICATIONS IN ICU (first 16 days)

Raised inter-cranial pressure, burr holes and meds failed, right craniectomy (1/3 of skull removed). Infarc (Stroke) following over medication for low BP, second craniectomy o­n right side to evacuate clot. Psydomonis pnuemonia (alledgedly the ICU taps were growing psydomonis)

Paralytic Illius (9 dys BNO), not treated until vomiting faeces. Staph infection o­n 2nd CVC line causing extremely high temperatures, raised BP ++, raised pulse++Raised liver function, 40x the normal limit. Tracheotomy. Remains in coma. I have still to go thru the medical notes, as the above 4 conditions would not have been brought to my attention. I had to assess Kevin myself and approach medical staff for a run down, I presume there were other things that were not shared with us.

STEPS AHEAD

Room decorated, music playing, aromatherapy. Still alive!! Shows his determination and will to live by increasing efforts to breath when family is with him. Removed from respirator and holding his own. We are supported by nursing staff and able to do lots of personal care and massage.

COMPLICATIONS TRAUMA WARD:

12 weeks Undetected blocked catheter, stirs Kev from deep coma form the excrutaiting pain. Left 10 hrs before attended to . PEG (tube feed commenced) terrible time with feeds, 7 tried. Doing quite well until cranioplasty (skull put back o­n), this causes hydrocephelus (water o­n the brain). Following deterioration especially noted by physio, increased drowsiness and lack of response. Diarrhea causing excoriation like none of us have ever seen before, this brought about intense pain and extra bed rest, not treated until stand up argument with Drs after 8 weeks of this condition.

We are told by o­ne Dr there is no hope and to put Kev into a nursing home. this was 3 days after a meeting with Dad and myself were we were told Kev was doing well. I asked the dr about certain medical practices and her response was the above. He is left dehydrated for approx 21 hrs o­ne time and 15hrs another time, due an 'oversight' form the medical staff. Given morphine, followed by a clonic tonic seizure. Commenced o­n epilim which increased diarrhea and introduced severe abdo pain, which caused Kev to call out in pain and double up. Overdosed with medications, not detected by staff. Kevin becomes more and more with-drawn, Drs decide NOT to do shunt, this decision has taken them about 8 weeks to come to. Personal hygiene a real issue and not achieved to adequate standard by some staff, often left in soiled bed. We take Kev home after 14 weeks in hospital and are told to "wait and see". Negotiate with staff for an ambulance transfer, suction (not supplied, generously donated by dental firm). Hoist and initial supplies given.

STEPS AHEADSTILL ALIVE AND FIGHTING!!!

Have seen "window periods" of lucidness. Re-assuring, we know Kev is in there somewhere. Some physio achieved, told body in good working order, however brain unable to co-ordinate consistent movement at the time. Limited movement attained. x2 to hoist transfer as opposed to initial x5 to transfer. Up in wheelchair. Tracheotomy removed after 3 months (delayed substantially due to indecision to perform shunt or not). Able to treat with homeopathy, aromatherapy, acupuncture and cranial osteopathy. Some nursing staff are great, however his care leaves much to be desired. Small amounts of oral intake at times.

HOME FOR FIVE WEEKS

We are sent home with no contacts for support and after being refused a transitional admission too Bunbury Regional Hospital. Therefore Allied Health is slow and incomplete to come onboard. I had to push for scripts for his medication as they were wheeling him from the ward, we were given no check list for signs or symptoms to look out for, for deterioration and no appointments or scans/tests booked. Able to take Kev home which is a healthy choice to be able to grieve and adjust for all.

We can be sad when and if we want, laugh and cry together. We can hope into his bed and just be there. Sure it is hard, but not as hard as leaving him in the care of strangers. We can keep up his personal hygiene and maintain a regular routine for meds and feeds. Regular visits and lots of outdoor time much needed peaca and quiet. I am so tired with the uphill battle that I have given up, I cry as I leave the hospital as I can't believe the situation we have been pushed into.

Interacting well at times, watching TV and awake for longer periods eating small amounts. One slight seizure following vomiting bug. All is going reasonable well until week 3 1/2, slight deterioration increasing over next 10 days. Look o­n net to gather info o­n hydrocephalus. Unable to get hold of Dr, after 48 hrs transfer to RPH via Royal Flying Doctors, this was a Saturday morning.

READMISSION TO RPHS HUNT

( Kev's 7th lot of surgery). This is done one day 4 after admission, the night before surgery Kev is really ill, however holds my hand tightly when I talk to him about the surgery, I now he is in ther and still remains to fight hard. Positve improvement after shunt, starts to verbalise a little and helps wash himself in the shower little, movement in his right hand and leg begin slightly. However Kev has a 3 min seizure 5 days post-op, this takes a good three weeks to recover from and anti-epileptic drugs are commenced, these in them selves take 4-6 weeks for the initial side effects to ease. (so I now know, the internet is a wonderful thing).

SHENTON PARK

8weeks (minus 9 days over Xmas/New Year and every weekend bar the first)

COMPLICATIONS

Ecoli UTI Disappointed with the very limited OT and Speech Therapy available due to high demands and need to move more able patients o­n. Difficult to get staff to give Kev fluids and tendency to put iced water down PEG (recommended tepid water, however drinking orally at home. Developed post-traumatic amnesia, due to higher level of recovery, this leads to confusion, agitation, extreme restlessness and some aggression if pushed out of his comfort zone. This is not evident at home and is treated with medication, restraints and man-handling.

STEPS AHEAD. Eating well Enjoying weekend leave. Writes for the first time. Increased awareness and communication. Mobilizes in wheelchair. Weight bearing Masters some continence. Increasingly. . . . . . . . . . . . . . . . . . gone to bed write more in the morning. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


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Nine Months Post Trauma | Log-in or register a new user account | 4 Comments
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Re: NINE MONTHS POST TRUAMA

(Score: 1)
by Shaun on Feb 29, 2008 - 09:07 PM
(User information http://www.blue-dunes.com)
Alison, you have my heartfelt support and deepest love. Tell me how I can help in anyway. - Love Shaun

Re: NINE MONTHS POST TRUAMA

(Score: 1)
by Margaret (mjm@farmside.wxc.net.nz) on Feb 29, 2008 - 09:44 PM
(User information http://family.munro.cc)
Wow, Alison, your writing skills are No 1! The above was a lot of work and we thank you for this. You could write a journal about Kevin and it would be a testament to all the hard work you and family have put in! It could also be a great informative story for others in the same position. It would certainly be publishable!

Re: Nine Months Post Trauma

(Score: 1)
by joy on Mar 02, 2008 - 05:29 AM
(User information 
Just writing Kevin's and your story looks like a marathon effort let alone living it!

Re: Nine Months Post Trauma

(Score: 1)
by Alison on Mar 04, 2008 - 10:05 PM
(User information 
Hi,
Thanks so much for your comments, I have not finished this update (yes lost the finish of log, after 1 1/2 hrs work! Typical !) Shall finish asap and did not realise I had sent this to Jay, thought I'd saved it,  but that is OK, at least youv'e an idea what has been happening. The edidted, completed copy with photos will be here soon.
Love and smoochies to All,
AlisonXXXXX



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