We just got another visit from the surgeon - he's been in every day monitoring Zac's progress and deciding about closing up the incision. Today's news was mostly good: On from clear liquids to not-so-clear liquids (including chocolate milk)! And the IV will only be hooked up for antibiotics.
The sobering news is that his white blood cell count is still a tad high, which is why the antibiotics continue. I casually remarked to the surgeon that I was surprised at how persistent the infection was, and he (in his very measured and balanced way) said that the amount of periotonitis that Zac had was serious and that he wasn't surprised that it was taking this long to clear up. I think it's only sinking in now as to just how narrowly we dodged this bullet - and though we're 98% of the way there, we not all there yet. It will be good to get out of the hospital, but that goal always seems to be two days away.
We had tickets for Cirque Elioze at the Flynn for Wednesday. When we thought this was going to be simpler, we had fantasies of going together. In the event, Jordan went with Lindi and managed to eat at A Single Pebble, which I've been wanting to do for a long time. Margy did double duty at the hospital Tuesday and Wednesday nights.
I think a high-point for Zac was when his friends Neil and Stuart (and their mom) came by for a long session of the card game "Munchkins," which passed most of the afternoon and early evening rather pleasantly. Jordan got roped in to the early part, and Margy took over for him after he left.
Zac's fencing coach came by, but not finding any "Zac" or "Isaac" Young's registered at the hospital, went home. Now I have guilt for having named him "Christopher Isaac (Zac) Young". I'm afraid this is going to be a hassle for the rest of his life. He can change it if he wants, I suppose.
Margy and I got a fair amount of work done early in the week when Zac was sicker, but now that he's more active, it's harder - we spend more time playing games and hanging out. Overall an improvement, but not so good for productivity. As I mentioned, there is wi-fi in the room and Zac has spent some time on a lovely MacBook that's been on loan to our house from our generous friend John. It also plays movies far more effectively than my old laptop.
So Zac's finding ways to pass the time. The nurse pointed out that, had it not been break week, Zac would have had a tutor starting Monday. That would have been a laugh since he was barely conscious. Depending on when he can get back to school, we may end up doing that next week. Margy has e-mailed his teachers and we good a lovely note from his World History teacher.
This isn't exactly the kind of routine one wants to settle in to, but it has given me a little more insight into what it must be like to have a chronically ill child - an experience I would gladly pass by, thank you very much. But we do have a scheme for how things go, in place now just as (I hope) we no longer need it.
Thursday, February 19, 2009
Wednesday, February 18, 2009
The Boring Part
Zac is on clear liquids now, which is a great change of pace. He's also down to one IV (down from a total of five hookups when he came out of the OR). Zac did have a single room, which had no view but good cell coverage. Now he's the only person in a double room with a lovely southern view and a lot of light, but no cell coverage. Go figure. The wi-fi signal here isn't as strong, but it seems good enough.
I had fantasies of his going home tomorrow, but before I got here the surgeon came by and looked at the wound. He decided to wait another day before closing up the last of it. Zac's white blood cell count is also still a little high, so I think they're upping the IV anti-biotic. So now Friday looks more possible, but that assumes progress, so we'll see.
People have been very generous with the dinner offerings. Normally we eat well off of our left-overs, but of course we cleared them all out for the trip that didn't happen. Margy and I have been alternating nights at the hospital, but the other person just seems to go home to sleep and do the minimum necessary (chickens, cats, etc). So we've been eating well off of the largess of others. Nice to have friends who cook so well.
We may try to get some of Zac's buddies over for a Monopoly game this afternoon or tomorrow. Meanwhile Margy and I work (when not posting to the blog), which is kind of odd.
I had fantasies of his going home tomorrow, but before I got here the surgeon came by and looked at the wound. He decided to wait another day before closing up the last of it. Zac's white blood cell count is also still a little high, so I think they're upping the IV anti-biotic. So now Friday looks more possible, but that assumes progress, so we'll see.
People have been very generous with the dinner offerings. Normally we eat well off of our left-overs, but of course we cleared them all out for the trip that didn't happen. Margy and I have been alternating nights at the hospital, but the other person just seems to go home to sleep and do the minimum necessary (chickens, cats, etc). So we've been eating well off of the largess of others. Nice to have friends who cook so well.
We may try to get some of Zac's buddies over for a Monopoly game this afternoon or tomorrow. Meanwhile Margy and I work (when not posting to the blog), which is kind of odd.
No more nose tube!
The doctor came by at midday yesterday and pulled out the naso-gastric tube, which was way longer than we realized. That's one fewer tube attached to Zac!
The plan for Wednesday is to start clear liquids to see how it goes.
The plan for Wednesday is to start clear liquids to see how it goes.
Tuesday, February 17, 2009
Lots of Progress
Not only is Zac feeling much more like himself, but, earlier than we expected, the surgeon came by and removed his nose-tube. Since that was actually the most uncomfortable part of the whole event so far (aside from the occasional dressing change), this is big news.
Zac is now pretty much himself (aside from the IV in his arm) and the remaining open wound in his abdomen (one inch, down from about five). But much more comfortable.
Zac is now pretty much himself (aside from the IV in his arm) and the remaining open wound in his abdomen (one inch, down from about five). But much more comfortable.
Progress, but not home yet
Saturday Zac was pretty zoned-out from the surgery, but we were all happy that the crisis was over and he was on the mend.
Sunday was slow, and by the end of the day Zac started getting pretty uncomfortable.
Monday was tough, with no visible signs of progress until....
After dinner-time (about 7 or so) things started to look up. His intestines began to show signs of life, and though he was still uncomfortable with the nose-tube, his cough had gone away. He just had better energy.
We (Jordan spent the night) got a good night's sleep thanks to nurse Dawn who grouped as many of her procedures at the beginning of the shift as possible. His intestines had showed signs of life Sunday evening during some of his walks, so the surgeon has left his NG tube disconnected, for possible removal later today (we hope) or tomorrow (more likely). That will be the biggest milestone in his recovery in terms of quality of life.
But his energy today is much much better. He's basically himself, but annoyed that this part isn't over yet.
We've discovered wi-fi in the room (though we probably wouldn't have used it beforehand anyway), so we may be on line a little more.
But for the first time since Friday, it feels like this could end, which would be nice.
Sunday was slow, and by the end of the day Zac started getting pretty uncomfortable.
Monday was tough, with no visible signs of progress until....
After dinner-time (about 7 or so) things started to look up. His intestines began to show signs of life, and though he was still uncomfortable with the nose-tube, his cough had gone away. He just had better energy.
We (Jordan spent the night) got a good night's sleep thanks to nurse Dawn who grouped as many of her procedures at the beginning of the shift as possible. His intestines had showed signs of life Sunday evening during some of his walks, so the surgeon has left his NG tube disconnected, for possible removal later today (we hope) or tomorrow (more likely). That will be the biggest milestone in his recovery in terms of quality of life.
But his energy today is much much better. He's basically himself, but annoyed that this part isn't over yet.
We've discovered wi-fi in the room (though we probably wouldn't have used it beforehand anyway), so we may be on line a little more.
But for the first time since Friday, it feels like this could end, which would be nice.
Monday, February 16, 2009
Still not eating
Zac is progressing, but slowly. The post-appendix-rupture infection in his gut seems to have been defeated, based on his white blood cell count, temperature, and the way that the open incision looked this morning. The surgeon felt good enough about it to close up five of the six inches of the wound, leaving an opening the size of a peach pit. We expect he'll close it completely tomorrow. Fewer inches of open wound should decrease Zac's pain.
He still has very little energy, though, and his intestines don't show much sign of wanting to get back into the digestion business. Until that happens, Zac is stuck with an uncomfortable tube up his nose to drain his stomach. And it doesn't seem to work very well -- even constant fussing by the nurses doesn't keep the tube draining consistently. It's frustrating.
None of us realized how serious this was for the first day or two -- really life-threatening -- and how long it would take for Zac to bounce back. The drill is that he sleeps, takes a tiny walk, sleeps, does breath exercises, watches a video, walks, and sleeps again. Jordan and I take turns hanging out in the room, partly because he needs help getting in and out of bed, and partly because we can't think of anywhere else to be.
He still has very little energy, though, and his intestines don't show much sign of wanting to get back into the digestion business. Until that happens, Zac is stuck with an uncomfortable tube up his nose to drain his stomach. And it doesn't seem to work very well -- even constant fussing by the nurses doesn't keep the tube draining consistently. It's frustrating.
None of us realized how serious this was for the first day or two -- really life-threatening -- and how long it would take for Zac to bounce back. The drill is that he sleeps, takes a tiny walk, sleeps, does breath exercises, watches a video, walks, and sleeps again. Jordan and I take turns hanging out in the room, partly because he needs help getting in and out of bed, and partly because we can't think of anywhere else to be.
Saturday, February 14, 2009
Zac's appendix adventure
Who knows when Zac's appendix burst -- it could have been as early as Wednesday -- but what appeared to be a garden-variety stomach bug escalated into enough pain that Jordan took him to the ER at 5am Friday morning. A cat scan showed a lot of fluid in his abdomen, so they operated through a 6-inch vertical incision just below his navel. There was goo all over his innards, so they removed what was left of the appendix and all the yuck they could find. They left the incision open so that they can monitor it for infection for a few days before they tape or stitch it shut.
Friday night night, Zac had every known tube and wire attached to him. The spinal block wore off at about midnight and they gave him a morphine machine not unlike the one that my mom had when she was dying of cancer. It doesn't drip though -- he can push a button to get a small dose, and the machine won't give another dose for 6 minutes. He slept most of the night and today, although the nurses have marched him around the halls a few times, and he has to suck on a plastic gadget 10 times once an hour to get air deep into his lungs.
He can't eat or drink anything -- not even water -- until his digestion shows signs of restarting. He's got a tube up his nose and down into his stomach to drain whatever might be in there, because otherwise he'll throw it up. Now we know that stomach bile looks exactly like pond scum. He's got saline with glucose dripping into him, along with two broad spectrum antibiotics that we hope will knock off the appendix detritus.
Zac is pretty limp and uncomfortable, and talking is hard with the nose tube, so we'll see when he can talk on the phone or have visitors. We've been taking turns hanging out with him, and the nurses set up a fold-out chair so one of us can sleep in the room. (Our local hospital is a pretty excellent place to go through an experience like this.) The doctor is talking about a 3-5 day hospital stay. Until his guts heal enough that they can tape or sew the incision closed, and until he starts be able to digest anything, he's not going anywhere.
Friday night night, Zac had every known tube and wire attached to him. The spinal block wore off at about midnight and they gave him a morphine machine not unlike the one that my mom had when she was dying of cancer. It doesn't drip though -- he can push a button to get a small dose, and the machine won't give another dose for 6 minutes. He slept most of the night and today, although the nurses have marched him around the halls a few times, and he has to suck on a plastic gadget 10 times once an hour to get air deep into his lungs.
He can't eat or drink anything -- not even water -- until his digestion shows signs of restarting. He's got a tube up his nose and down into his stomach to drain whatever might be in there, because otherwise he'll throw it up. Now we know that stomach bile looks exactly like pond scum. He's got saline with glucose dripping into him, along with two broad spectrum antibiotics that we hope will knock off the appendix detritus.
Zac is pretty limp and uncomfortable, and talking is hard with the nose tube, so we'll see when he can talk on the phone or have visitors. We've been taking turns hanging out with him, and the nurses set up a fold-out chair so one of us can sleep in the room. (Our local hospital is a pretty excellent place to go through an experience like this.) The doctor is talking about a 3-5 day hospital stay. Until his guts heal enough that they can tape or sew the incision closed, and until he starts be able to digest anything, he's not going anywhere.
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