Monday, November 30, 2009

First night in ICU

Dr. Ha led us into ICU. There Ashton lay with tubes and monitors and a big white bandage on his head. I expected more blood or more bandage, but he looked neat and comfortable. His left eye was a bit bruised, but not terribly, and the swelling was less than I expected. All in all, I was pleasantly surprised.

Ash’s folks and I came up to him and talked to him. He opened his one eye groggily and answered our questions in a voice that was soft but not terribly weak. His folks did not stay long…they were exhausted from a long flight. However, I think they went back to the motel greatly relieved to see that Ashton pulled through the surgery.

I stayed, though. Ben was the first ICU nurse. He was a tall fellow with warm brown eyes, but a manner that seemed to be both tender and guarded at the same time. I wondered if something had happened, if he was hurt by a girlfriend or something in the past. It did not seem to me like he was just maintaining a professional distance, but rather it seemed like a struggle to him…like part of him wanted to be open, but part of him insisted on maintaining a bravado or a guard. I am probably wrong, but that is how it seemed to me.

He was very patient with my questions. All of them. I was very thankful.
At one point, he had to do a neuro check on Ashton. These checks involved telling ashton to push down with his feet, pull up with his feet, grasp a nurse’s fingers tightly as he could, and follow a light. They also asked him questions. The first night we were talking about what day it was. I mentioned that it was Wednesday. Ben looked straight at me with a raised eyebrow and said “No, it’s not.”. That unnerved me a bit. I mean, I could have sworn it was, but I was so exhausted, that it was entirely possible I was wrong. In fact, the only reason why I thought it was Wednesday was because I thought I remembered us watching After The Catch on discovery channel the night before his surgery, and that comes on on Tuesday.

“No, I think it is Wednesday” I said confused and desperately trying to sort my days and nights in my head “I thought we watched deadliest catch last night.”.
“No, its Thursday” he said, going to his computer.
“Are you serious!? Did I lose a whole day?” I asked. It really was bothering me. He typed a bit on his computer and then said “Oh, no, you are right, it is Wednesday….you have to excuse me, I have been on nights for two weeks straight…” he seemed a bit embarrassed.

“Oh no problem” I said, secretly relieved that I had not lost a whole day.
I engaged Ben in light conversation—my usual questions of where he was from, how long he had been there, etc. I wish I could tell you more about him, but I do not remember anything he said. It was a total blur.

I do remember watching what I came to call “The Ashton Show”. It was a monitor that he was hooked up to. It measured his heart rate, his blood pressure through an arterial line, his temperature, his breathing rate, and his breathing rhythm. The first day, sometimes an alarm would go off when his oxygen level would go down. I was not sure if that was ok, but I knew the alarm was going off in the nurses’ station and no one else seemed to be troubled by it. Eventually his oxygen rate would raise back to normal. Soon I realized that this was par for his course—his apnea had gotten to the point where his oxygen level would go in the 80’s until he sputtered or stirred. “We need to get this taken care of. This is out of control.” I made a mental note to myself. I cannot imagine how exhausted he must be every day if every few minutes of sleep he was not getting enough oxygen. If he pulled through this, I wanted him to be able to rest well.

I even considered that maybe this is why his tumor has grown. I read at one point that people will try to boost their oxygen level in their blood to keep cancer at bay. While I prayed this tumor was not cancer, it would not surprise me if somehow the apnea played a part in it.

I did not know what to do with Ash when I got in the ICU. I asked Ben “Should I let him sleep or keep pestering him?”.

“What would you want to do if you just had brain surgery? Let him sleep.”.

“Ok.” I said. It might seem like a stupid question, but I was wondering if it would be better to keep arousing him. I was afraid he would slip away into a coma and we would not know it. That makes sense, right? Well, maybe it doesn’t, but it did to me at the time.

Right before 7 pm, Ben started making his last chores before he got off duty. I was bummed that he was going off duty. I was not “bonding” to him, but he was becoming familiar in such a strange, scary time.

For the night shift, a new nurse came on duty. I will be honest, I was hoping that it was not a female. It sounds bad, but sometimes I do not get along well with females. I tend to get along better with males. I like females, but I tend to put women off. However, this little Chamorro girl named Jolene was our new nurse for the night. I soon was praising God for her, as she was kind and open and friendly. She and I talked about Alaska, as she had been there. She was also from Guam, so she and I had that in common as well, as my dad had been stationed there when I was in high school.

I watched her through the night, happy when she stayed to chat with me. Her fingers were short and slim, and they moved with a quick, odd movement, almost like they danced.

Another female nurse came in, and I expected the old “two against one” thing. You know how a group of three girls can get. When there are three, generally one girl ends up being the goat, or at least that is my experience. I figured that they would chat and laugh and I honestly expected thinly veiled hostility. The new nurse had the beautiful skin of a half black, half asian, though I do not know if she was. She had black hair with big curly waves and a t-shirt that I think said “I <3 miami”. Her name was Michelle.

However, again the Lord worked kindness in my life. She was very attentive to me. They brought me a chair, and she brought me a stool to prop my legs on. I had declined a comfortable chair at first, but they insisted later. They also brought me a heated blanket. I cannot tell you how much I was not expecting this. They both talked to me about Alaska, and I got excited to share interesting tidbits about my state.

At one point, I was in the midst of talking about how the sunlight changes through the year. Suddenly Ashton started to cough and then vomited blood. I must say, I am very squeamish about throwing up—when I get sick, I get faint and shocky feeling. In fact, if I know someone is sick, I will stay away from them for a week or two until I know they are FULLY recovered. I flat out tell my friends “If you or your kids have a cold or a fever, feel free to come over. But if you have a tummy bug, I will see you next spring.”.

However, the Lord gave me peace in my mind, even seeing my husband spitting out his own blood (a picture that is burned into my mind). We all came quickly to his side. I gently wiped the blood from his mouth and shirt as Michelle and Jolene suctioned and cleaned up behind him. I was afraid for him, as vomiting blood never seems like a good thing.

However, Michelle, probably seeing my face, quickly and casually mentioned that it looked like old blood, and Jolene (also quickly) agreed that it was probably drainage from the surgery. That made perfect sense, as he must have swallowed quite a bit during the repair of his sinuses.

His tummy stayed tender for the next two days. They tried to get him to eat with very little success. He was miserable. He would try to eat a bite then have to breathe through the nausea through pursed lips. Dr. Ha talked about how he needed to eat protein as each day laying down, the body would digest its own muscle, not fat. He told us that even morbidly obese patients will be nutritionally deficient as they are bedridden (NOT that Ash is morbidly obese!). I felt so bad for him, but there was nothing I could do but encourage him to eat as much protein as he can and hope it stays down. They tried zofran and reglan, but nothing seems to do much for long. They also tried to get him to take percoset instead of morphine, but they thought that was what was making him sick the first time, so he stayed on morphine.

I was surprised at the low level of his pain. They had severed a muscle in his cheek, had unroofed his eye socket, rebuilt a sinus, and removed part of his skull, but he kept saying that the pain was just a 3 or 4. His bad headaches were an 8 or 9. I was sort of hoping that he would back off the morphine and go to Tylenol. I know that was silly of me, but I was eager for him to be better. Come to find out later that that would have been a good idea—it was the morphine that was making him so ill.

Back to Jolene….I noticed that she wore no makeup, but was beautiful. I felt very comfortable with her. Even more so on the second night. The official rules of the ICU (and the med surg ward) were to maintain visiting hours. However, in the med surg ward before his surgery, no one told me I needed to go home. I think it was because they realized that this might be our last night together. It makes me sad to think of that, but thankful they let me stay.

I did not want to leave Ash alone in the ICU either. To me, he was still touch and go. Dr Ha said that the first 24-48 hours were where most of the bad stuff would happen, if it was going to happen. My husband was still in the path of danger, and I did not want him to be there alone.

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