upcoming changes

Late update tonight, my apologies. Mom & I talked to the neurosurgeon late this evening, who worked with us on a plan for the next few days. [Some of this may be overly detailed for ya'll -- the gist of it is: tracheotomy tomorrow or Friday; remove the brain drain (there must be a more technical name than "brain drain," someone help me out with that one, please!) and see if Dad will need a shunt into his stomach; if no shunt, place a PEG tube (a feeding tube directly into Dad's stomach) early next week.]

1. Tomorrow morning-ish, they are likely to give Dad a tracheotomy. It's a bedside procedure that should take about 30 minutes. I find the idea of a trach pretty freaky, but a lot of people have said very positive things about it, including the doctor, Dawn, and other medical personnel-types. The benefit of a trach is that Dad won't have a ventilator tube down his throat, which is generally painful and annoying -- Dad is still coughing pretty strongly even in his comatose state, especially when they bump the ventilator stuff at all, so it does make sense that the tube is bothering him. Maybe he'll show some amazing progress after the trach! Wouldn't that be fantastic!!
   
2. Dad's ICP numbers (indicating brain pressure) are stabilizing -- they are able to leave the drain closed for 2+ hours at a time now. So the doctor may be taking the drain out in the next few days. Then (I think?) they'll do a CT scan to see if Dad has developed hydrocephalus which will require a (permanent) shunt from his brain into his stomach.
3. If Dad doesn't need a shunt, they'll place a PEG tube either this weekend or early next week. The reasoning for this operation is that the feeding tube is another source of irritation to the throat...and also another possible source of infection, which has got us all running scared right now.
4. They might perform an ultrasound on his legs to see if he's developed any blood clots, which might explain his current fever. [Which, actually, would then make him & Mom a matched pair, haha.] If they find a clot they'll do some other complicated stuff to make sure the clot doesn't get into the heart or the lungs.
5. The fever might also be being caused by the anti-convulsant drug that he's on right now (Delantin?). So if they can't find any other source of the fever then they'll switch him to a different anti-convulsant drug.
   

Whew! It was actually quite a long conversation with the doctor, and we feel so blessed that he was the neurosurgeon on Dad's case -- he's always happy to stay & talk with us, and to make sure that we understand everything that's going on (to the best of our abilities!).

Okay, other updates...

Dad's hiccups seems to have disappeared! Yay! That's so awesome, you guys, you have no idea. Thank you thank you. He spent the entire day breathing on his own, without any ventilator assistance (which is what makes them think it would be okay to do a trach soon). He breathes at a fairly low rate of 8 breaths/minute now, but at the same time takes very deep breaths, which Mom says is actually normal for him. He is displaying a bit of apnea, which he was doing even before the aneurysm, and he doesn't do it too often, so that seems to be okay.

Dad's fever is up around 102 again. :( They've sent off culture samples but don't seem to have received anything definitive back from that. Since the brain swelling is behaving fairly nicely now, that shouldn't be the cause of the fever, so it's a little bit of a mystery. Please send prayers that they figure it out, and that whatever is the source of the fever doesn't cause my dad to lose any ground in his road to recovery.

Dad is responding less strongly to the pain stimuli. :( We really have no idea why that might be the case (though it does seem to differ depending on which doctor/nurse is giving the stimulus), but it's not really a good sign. We thought that maaaaaaaaybe the fever + hiccups were wearing him down?, but we're not too sure whether that's a plausible explanation or not. However, our hope is a little fragile right now so please don't pop our bubble until later. ;)

Other than that, he's holding pretty steady in his comatose state. We'll continue to hold onto our hope that Dad will begin to show stronger signs of recovering soon. The doctor has counseled us to be somewhat patient over the next 2 weeks...and the good Lord knows that patience is not our strong suit, so please please pray for strength for our family during the next few days and then weeks.

God bless you all.

--Kristy