UPDATE FROM VAN:
A Stall in Progress...For a Moment
Written 9 hours ago
Thursday morning, I got to the hospital to spend time with Kim before she headed to surgery only to find that surgery has been delayed again. The neurosurgeon (not to be confused with the orthopedic surgeon, that's for sure) met me in the ICU to tell me we had to put things on hold, as Kim had developed a fever overnight. Her temperature was up to 102, but they had gotten in down to 100.3 by the time I got there just after 8 AM. The doctor said that it would be detrimental to her to introduce metal into the body while she has a fever. I can't repeat here the words I said when I found out that were stated strictly out of frustration and disappointment.
I went to see her, and she had a fan on her, and she was out of it, I assume from the fever being added into the mix. While I was spending some time with her, a doctor came in with a socket wrench to tighten the bars sticking out of her leg, and he spoke with me. I found out he was an orthopedic resident who was checking on everything with her leg and toes, and I politely yet tersely let him know about my dealings (or lack thereof) with the orthopedic doctor. I stated I merely wanted to know the extent of the injuries, what had been done, and what was going to be done, as well as prognosis. He was very helpful, and he pulled me back to look at the scans of the bones on her right leg and left foot. The bones were shattered vertically, as well as horizontally, and the fractures run through the ankle and all the way through the bone on the heel to the bottom of the foot. He showed me where the plates, rods, and screws were, and showed me before and after of the right leg/ankle/foot. The damage is extensive and she has more hardware in her than a True Value store now. He said that as a result of the fractures running through the ankle, and the subsequent metal that was put in, she will have arthritis in that ankle, but when it will set in and to what extent it will be will only be determined in time.
He explained to me that the next surgery is to remove the external bars which have been stretching the bones back to their original length, and plates and screws will be added at the time the bars are removed.
As for the left foot, there are two or three small fractures on the edges of the big toe and one or two others, but they are small, in place, and should heal on their own without any surgery. As for the number two and three toes, they had to amputate them behind the first joint, and then close them up. They had to amputate behind the joint, because if you amputate and leave the joint, it drains a lot, and there is the risk for infection. When asked about the possibility of keeping or losing the toes, the doctor said that he had changed the dressing on them earlier in the morning, and they looked good, and there should be no reason why they would have to be further amputated.
I again expressed my displeasure with the ghost doctor, and I was told that it would be conveyed. I had more things to take care of outside of the hospital, so I left.
I returned just before noon to meet with two of my superiors who drove out from Dallas to check on everything, and discuss Kim's case with the on call. This is not the forum here to talk about it, as this is about Kim, but I will briefly say that the support from my agency has been beyond belief, and greatly appreciated.
I met with the on call surgeon, and got the rundown from him on the fever (which was down to 99.3 by that time). He stated that they are trying to determine where the infection is, and it is possible it could be coming from the degloved area under the skin towards her back. He also said another possibility is that she is getting pneumonia. They wanted to go into her lungs through the breathing tube with a scope and see if there is an infection, and if they see some, they will take a biopsy so they know what strain of pneumonia she has, and that will help them know which antibiotic works best to defeat it. That is IF they determine that she has pneumonia. Jury's still out.
I went home, stopping to get a to go lunch on the way, and that's when I fell asleep on the way home, prompting my earlier post. After I had woken up one time, I received a phone call from the neurosurgeon, telling me that there was something that needed to be considered in regards to her neck, and the alignment of the spine. He said that they had intended to get the screw in the C2 vertebra by now, but since they hadn't, her bone was going to start healing on it's own, and they didn't want it to do that, as her spine would be out of alignment. The best thing to do was to apply cervical tongs, that kind of look like giant tongs you use to carry an ice block. Those would go over the top of her head and down each lateral side. They would be screwed into the skull, and then it would be used to pull the head straight up from the body, allowing the spine to stay in alignment. he also said that it would make it much easier to put the screw into the C2 vertebra when the time came. Kim would be out during this, and local anesthetic would be used, as well.
I hated so much to add something to Kim that would cause her to have that much more pain, but I had to look at this realistically, and I knew that it was best for Kim in the long run. This was done bedside, and they did it immediately after the bronchial scope was done, since she was already under.
That is where we stand at this point. I dread seeing her with the tongs on her head tomorrow, but I know it's all so she can heal as correctly as possible.
I will be back up there again tomorrow, and hopefully I will know the results of the lung check.
On a side note, I mentioned again to the on call about the ghost doctor, and the case manager who was there said she would work on getting in touch with him immediately. The charge nurse paged him, and when I checked back about an hour later, I was told he had been advised, but he was in surgery at the moment. The ghost doctor finally called me after the neurosurgeon had called and gotten approval to do the tongs, and he ran down over the phone with me everything that the resident had done earlier in the morning. He wasn't as in depth, but in his defense it was over the phone and not in front of x-rays to point things out. When I told him about Saturday, and the fact that I waited for a consult after he got out of surgery, he apologized and said he was in surgery all night, as he had a bunch of trauma cases come in. Funny thing is, and I didn't confront him on this, that I was told Saturday night that he had already gone home. My opinion of him is NOT very high. He could learn some things from the resident I met this morning.
Post again tomorrow.....
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This update answers a lot of things we have not known to the extent of the right leg injuries.
Been following this from the start.Sounds like she is a fighter and things will be ok in the end. Hang in there. Any word on what caused the accident or the condition of the other cars occupants?
Mandie (I spelled it with a y instead of ie in the begining) had "a bruised hip, bum knee, sprained wrist, bruise on her waist from the seat belt, and a bump on her head." She is from Tulsa and is back there.
Van (Kim's husband) has "a fractured sternum, bruise on my waist from the seatbelt, bum knee, sore back, sore right foot, and I think I have a rib that pops in and out when I twist it just right." Only additional information that I have is what he has posted since and it is contained in the updates I have posted.
As far as the cause of the accident this is what information I have heard from Sue and the television station website. "Officials say that a white SUV was traveling northbound on Highway 155 when a green Ford Taurus failed to yield the right of way."
Thanks to all that have been following this thread and praying. Please keep the prayers coming.
More updates when I get them otherwise I won't be posting on this thread.
