Monday, November 8, 2010

Kris update – Good News and Bad News

Dear friends and loved ones,

As the saying goes, I have good news and bad news this week, and I’ll give you the good news first.

As mentioned in our latest update, we took Kris back to Brooke Army Medical Center on Thursday for an ear, nose and throat appointment.  The doctor was very nice and scoped her nasal passages and down her throat.  Wonderful news: her voice box is not paralyzed.  It is working.  She groaned rather loudly having the scope down her throat, which showed us on the monitor that both sides of her voice box are working perfectly.  This means her inability to speak is a neurological thing and she will talk one of these days when that part of her brain kicks in again.  Hooray!  The scope also showed her nasal, sinus and throat passages are clear.  No abrasions, scarring or trauma in her throat that would inhibit her from eating properly.  They have authorized a new swallow study back at Health South RIOSA.

Now for the bad news.  When I knew the appointment with the ENT group was made for Thursday morning (thanks again to that great case manager!), I contacted Dr. Teff (the neurosurgeon who operated on Kris the night of her accident) and explained about the area on the right side of her head.  It has been tissue thin since her cranioplasty in September when the neurosurgeon who operated on her back then had to stretch the skin up over the implant.  It has been sore, red, and basically showed signs of infection for some time and infection is the last thing we need in that area.  I asked Dr. Teff if he would be able to just take a look at it after her ENT appointment on Thursday.  He said he would be happy to see Kris and check it out.  We went up to the neuro clinic after the ENT appointment and this is where the day suddenly took an abrupt turn.

When Dr. Teff looked at the old incision area that was now tissue thin, he was not happy.  And, when he swabbed it a bit, he was admittedly concerned.  Deeply concerned.  The implant actually showed through.  He said this will never heal because it is over the implant and is not thick enough to receive nourishment from the blood.  He reminded me that, should any infection get under the implant and into the brain, it would be disastrous.  He said he wanted to take care of this immediately and, in the very next breath, he said, “I want to admit her today and schedule the surgery.  I’ll remove the area, check under the implant for possible infection, then fix the scalp area so there is blood flow and hair will be able to grow there.”  He explained, however, that the implant would have to come out if there was any signs of infection, and that meant another surgery somewhere down the line to put it back in again.  Dr. Teff said he was on duty this weekend (which was a blessing!) and he would like to do the surgery Saturday morning.  I looked at Kris and explained again what he was talking about.  I could see her apprehension but she seemed to understand and agree with what had to be done.  I called Russell and explained it all to him and, of course, he agreed it should be done, too.

Kris was admitted to Brooke Army Medical Center for the third time.  Friday was a day of preparation and more explanations from Dr. Teff about the procedure and what would happen.  She had a CT-scan and there were lots of forms to fill out, and the surgery was set for Saturday morning.  Please understand the military usually works slowly but, this time, there was nothing slow about it.  A list of medications had been sent over so that everything she was now being given could be continued.  In all the planning, however, there was one medication overlooked somewhere along the way: her anti-seizure medication.  I spent the night with her Friday night so that she wouldn’t be anxious or worry and, at about 5 a.m. Saturday morning, Kris’s body erupted in a full blown seizure that must have lasted well over a minute and a half.  I cradled her in my arms and my heart sank as I pushed the call button for dear life (hers!).  The room suddenly filled with nurses and nursing technicians, and everyone was busy doing something.  Someone asked me when she had had a seizure last and I said never.  When I asked if she had received Kepra as one of her meds, they checked and said she hadn’t.  That meant she had received her last anti-seizure medication early Thursday morning, and none had been administered since then.  48 hours!  She had a dose within minutes and things settled down, all except my nerves. 

Kris went into surgery then at 7:30 a.m.  When it was all over, Dr. Teff came out to explain all that he had done.  The surgery had gone very well and he was pleased with how everything looked inside.  And there was no sign of infection!  The implant was put back into place and he had even fixed a very tiny leak that allowed fluid to seep out under the skin at the temple area.  Praise the Lord, Dr. Teff even fixed the leak site!    But... there was good news and there was bad news.  He wanted to know if Kris had ever had trouble waking up from anesthesia, and I said she had not.  Well, Dr. Teff said it seemed she was having some trouble waking up from it this time.  My heart sank again!  He explained it could be a combination of things, not the least of which had been the seizure, or the need to give her the anti-seizure med right before the surgery, or that it had to been given on an empty stomach in such a large dose, or that she was just tired out and here she was in surgery again!  In any case, it would all bear close watching for the next 24 hours. 

Kris was finally moved into what they call a “step-down” monitoring room.  It was not ICU, but nursing staff would be able to follow her vital signs and give her good care in a room right off from the nurse’s station.  She was hooked up to all sorts of  monitoring systems again, and we waited.  I stayed with her Saturday night again and she spiked a high fever.  Watching her in so much pain yet another time was so very hard, and she was given morphine every two hours.  Lots of prayers and cold water cloths around her face and neck finally helped get the fever down, and Kris is still waking up this evening as I write this update.  It’s very slow and the she’s “in and out” a lot, but she is doing much better.  Of course, her face is beginning to swell again and... oh, yes... she has no hair.  But... it still beats the alternative!!!  I don’t know when she will be discharged back to the rehab center; likely Tuesday or Wednesday.  If more seizures occur, however, she will have to have an EEG at some point.  But, of course, not right away.  Her head must heal again first.

So that was the “bad news” for now.  Prayers?  Yes!!  Please keep her in your prayers.  Just when we think things are going along pretty smoothly, something pops up to set us back a notch.  But it’s just a notch and there’s every hope it will turn out to be a minor one.  There is other good news to also share this time, however.  For those who have asked now and then, son John who had the cancer surgery at the beginning of this year is cancer free!  He had a quarter-sized melanoma removed from the side of his head back in the winter of 2009-2010, and then underwent chemo.  Additional surgery to remove lymph nodes and do some more grafting only added to his illness and discomfort, but that is all behind him now.  He is back at work, still coping with some pain issues, but doing fine nonetheless.  Many, many thanks for your prayers for John.  They worked!

More good news: son Gary is coming to San Antonio to visit Kris.  She doesn’t know he’s coming yet.  We want it to be a surprise!  George will pick him up at the airport tomorrow (Monday) and he’ll stay until Thursday.  I know this will pick up Kris’s spirits, and it certainly will do our spirits good as well. 

So, while this week has certainly had its ups and downs, we’re going into the new week with our hopes high and our faith unshaken.  God is in charge and we like it that way!!  Keep Kris in your thoughts and prayers, as always.  That’s what helps us all get through!

Blessings and love,

Carol and George

[If you have an encouraging word for Kris, Carol and George, please leave a comment under ‘anonymous’ and sign your first name.  Or email me with your thoughts  at lavon7_99 at yahoo dot com and I will forward to Carol.]

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