Saturday, January 31, 2009

Friday, January 30, 2009

Hi All! Tonight's blog is brought to you from the comfort of room 957, Diamond Head tower, Queen's Hospital. Here beside us is Christy Huddy, a beautiful, strong young lady and she's feeling pretty good tonight. Kaeo is spending the entire night here with Christy and I'm keeping him company for the early part of the night. He's actually on a mission. He's McGyvering Christy's side rail pad. Christy has this heavy duty pad on the side rail of her bed to protect her feet from injury. Christy is kicking hard and lots! The pad gets loose and falls on the ground after she kung fu's it for about 10 minutes. Kaeo decided to tie the straps in a knot and tape it secure. I tried to find a picture of the side pads Christy actually has, but there wasn't one available. Therefore, refer to the one on the right, except imagine it along the length of the bed secured to the side rails. Christy has graduated from the skinny side rail pad to the bombucha thick one! These pads were designed to protect people from injury when they were having seizures. It's one of the things we do in "seizure precautions".
Christy's hair is free of knots, and tied neatly in a bun. Her teeth are brushed and her lips moisturized. She's had her lungs cleaned out when the respiratory therapist came by to suction the mucus out. She's had her trach and PEG cleaned and cared fore, and she's had her pain medicine. She's listening to a little John Mayer from her ipod. She's had her 11pm vital signs done. Blood pressure was 116/73, Heart rate is 70-80's and her oxygen saturation is 98% All normal. She's ready for bed. And since I started writing this paragraph, she's just settled down for a rest. Maybe we can get her sleep-wake cycles in order again. I had someone ask about the The Sleep / Wake Cycle (circadian Rhythm). These are the body's clear cycle of being asleep and awake. I found some more detailed info online about it!

"The body clock comprises a tiny cluster of nerve cells sitting in the hypothalamus, which forms the base of the brain. This group of a few thousand nerve cells switch on and off groups of genes in a feedback loop lasting 24 hours. The expression of these genes alters the activity of the nerve cells which therefore effectively 'keep time'. The time registered by the body clock is then used to control the release of other hormones which are concerned with preparing us for activity or rest respectively, and in controlling the parts of the brain involved with alertness and arousal.
Luckily we don't suffer permanent jetlag when we go abroad because the clock can be reset by exposing our eyes to light. A small number of nerve fibres from a specialised group of light-responsive cells in the retina feed in to the body clock and can adjust the rhythm, according to whether it is light or dark, just as one would alter a wristwatch. This system allows the clock to adapt to changes in day length and the demands of modern-day living, but the system is not perfect and does not kick in immediately, which is why we feel jet-lagged after a long haul flight, or after working a night-shift. The neurologist was commenting the other day that Christy's sleep-wake cycles are out of whack. She would be awake for twenty hours-kicking. Then she would sleep for two. The next time she slept for 17 hours, then up and asleep without any pattern at all. There was no talk of blood clots (thrombo-emboli ) in the hypothalmus part of the brain before on Christy. It may be a problem of damage in that specialized area of ells. Not sure, Dr. Maher didn't explain that far.
"Circadian rhythms are important in determining the sleeping and feeding patterns of all animals, including human beings. There are clear patterns of core body temperature, brain wave activity, hormone production, cell regeneration and other biological activities linked to this daily cycle". Hope this added more information about the sleep-wake cycle, without being too wordy.
All this talking about sleeping is making me sleepy. I'm going to take myself to my comfy bed and allow Kaeo to rest too. Right now we're squished together on the reclining chair in the corner of Christy's room.
Just FYI, Christy's got two rashes. One around her peg sight. Looks like hives from the tape because it's no where else and just in that square of tape. She may be allergic now to that foam tape. It' s been cleaned & redressed with a more sensitive tape called paper tape. The second rash is on her back. It has some pustules and we can't figure out what it is. It looks very different than hives. The resident or the surgeon will be notified to look at it again and consult dermatology. The resident (doctor in training) today ordered a steroid cream for it when the nurse showed him the rash.
Ok. that's all for today, see you tomorrow!

Friday, January 30, 2009

Thursday, January 29, 2009

Kaeo and I just got home from the hospital.  Christy was awake and kicking! She gets herself so active it's like she is working out.  She has a fan to put on if she starts to perspire.  She has days where she's very diaphoretic (medical term for sweaty).  One of the Doctors was explaining that when there is damage to the nervous system (All the nerves in the body- also brain & spinal cord), it sometimes affects the area that controls temperature.  I talked about this before, but he was saying this is also why her body thinks she's feverish and sweats to cool her.  The other part of the sweating is that she is so active, she's generating heat when she flexes her muscles so much.  Christy has kicked and kicked so much, that she's broken the boot she wears to keep her foot flexed! (The navy blue boot) There is a thick plastic plate at the bottom, and Christy split the thing in half!  Watch out B.J.!  The boot is just one single soft shoe-ish device that velcros on.  The nurse has to alternate the boot one foot to the other every two hours.  It's purpose is to keep her foot in a dorsi-flexed position. See below picture.The reason they want to keep her feet dorsi-flexed is so she does not get "foot drop".  See next picture...  The problem with this type of foot is that when you are ready to walk on it again, the muscle has shortened & can't be used.  It's contracted.  A muscle contracture is a permanent shortening of a muscle or tendon.  Contractures can't be stretched or exercised away once they occur; they need orthopedic surgery to be corrected.  This is one of the reasons why physical therapy is working with her-- to help keep her muscles flexed and lengthened.

So, since Christy broke the boot, the Occupational Therapist is going to bring her a "cast" instead.  I'm not sure what it looks like, so I can put a picture up when I know!  If you are wondering what an Occupational Therapist is, I'll tell you!  Their primary goal is to enable people to participate in the activities of everyday life.  They help find a way to mold your environment so you can participate in daily activities. Occupational therapist give the "skills for the job of living" necessary for "living life to its fullest."  Right now the occupational Therapist focuses on keeping Christy's limbs supple.  They do range of motion--bend the wrist, arms, shoulders, legs, ankles, knees, etc.  They are getting her ready for doing exercises she can participate in when she regains consciousness.  The O.T. will help her to re-learn activities such as combing her hair, brushing her teeth, taking a bath, and getting dressed.  They are different than Physical Therapist.  PT are the people you think of when you think rehabilitation. PT develops, maintains & restores maximum movement and functional ability throughout life.  Functional movement is a central element in what it means to be healthy.

Although Christy was active today, she was also resting a lot of the day.  She needs to rest up to restore energy needed to heal her brain... A continuous infusion of love, family and friends is happening all the time.  It is so nice to be around people who love Christy and each other, and talk and tell stories.  It's this time together that makes it possible for us to get though another day.  We all share the same goal and wish... to get Christy back to being Christy.  And we can't wait! 

Thursday, January 29, 2009

Wednesday, January 28, 2009

hey gang!  Today was another day of rest for Christy.  Once she had her physical therapy, she was tired!  During physical therapy, they dangled her on the side of the bed in a sitting up position.  The old man on the left is doing it in the picture.  They wanted to put Chris in a chair, but with her big unexpected movements of arms and legs, it's too dangerous.  We don't want her to fall!  

Christy got a visit from Dr. Yamamoto who is a physical therapy doctor from the Rehab hospital.  He let us know that once Christy is able to follow commands, she can be admitted into the rehab hospital.  When I say "following commands", he specifically wanted Christy to be able to hold up two fingers in the air when asked.  He also said that he wanted her to be able to lift up her arms off the bed-- horizontal with the bed.  With him was an Occupational Therapist who was the coordinator for the hospital- she said she would be visiting Christy while she was in the hospital.  

Dr. Druger, the Pulmonologist(lung specialist) also came to see Christy this afternoon.  He confirmed that Christy's strong cough is vital to preventing any pneumonia.  He listened to her chest, and was happy.  He said the x-ray was clearing up but that it would take some time for it to be completely clear.  The infection is under control.  He was very nice.

Finally, Dr. Maher, the brain specialist (Neurologist) came by to see her.  I didn't get to meet him-- I was out fetching dinner for our hungry bellies.  I was so bummed.  Donald and Lorene did a fabulous job at relaying all the information.  Dr. Maher seems to take his time assessing Christy. He sat her head of the bed up strait and talked to her. He stands watching her body movements and her eyes.  He asked Donald questions he would normally ask the nurse.  "Has she had any seizures?  Has she been moving the Left leg more?" Donald is the right person to ask, he sees Christy every day for hours and hours.  He really knows every movement and motion she makes.  Dr. Maher looked at Christy's eyes, and explained to Don the difference between Rapid Eye Movement (REM) and a deeper sleep.  REM happens to someone when they are sleeping.  The eyes go back and forth, side to side.  Christy, Dr. Maher explained, "is in a much deeper sleep".  He decided to take her off two medications.  The Benadryl and Dilantin.  Taking her off Dilantin does not leave her unprotected from seizure activity.  They have had Christy on KEPPRA also, which is another anti-convulsant.  Anti-convulsant is anti-seizure medication.   Dr. Maher didn't want her to be in this deep a sleep.  She may have been getting Benadryl for the rash on her skin.   It's healing now, almost completely.  Benadryl can make you very very sleepy as well.   I also found that Christy has been receiving a muscle relaxer called Baclofen.  Baclofen belongs to two groups of medications know as muscle relaxants and anti- spastics.  It's used to treat spasticity (uncontrolled muscle movements) caused by spinal cord injuries.  Christy's spinal cord wasn't severed but the movements were responses of the spinal cord.  Dr. Maher also said that her sleep/wake cycles are all messed up.  That's why we see her up for long periods of time or days, then sleep, and it's not predictable.  Dr. Maher also said that Christy is making slow progress.  He looked at Donald and said compassionately, "slowly but surely"! That's what we like to hear, Doc!

Meanwhile, Christy slept peacefully! See the illustration below of Christy in the bed and Donald gently caressing her hands.  This is a good illustration of our beautiful princess in bed with her brave prince doting on her! Donald knows her turning schedule and recruits us to help pull Christy up in bed and reposition her and the surrounding pillows.  It's very sweet.  
I told them that they are going to ask him to come on board as staff when Christy leaves.  He's picked up all the lingo and helps with her care. The staff commented to Mom that we have a very loving and close family & friends.  She explained that many people suffer through their hospital experience alone.  We are so very grateful to be a part of this loving family.  We are honored to be related to Christy and wouldn't love her any other way than FULL ON!  Thank you guys out there for loving and supporting Christy, too.  

The family and Christy's close friends were visiting tonight.  Donald was telling stories of the night they first met and when they were first dating.  It was so sweet.  Everyone reminiscing of the past and some of us hearing the stories for the first time.  All of us laughing and loving Christy!  We can't wait till she can be laughing and loving with us, too!

Wednesday, January 28, 2009

Tuesday, January 27, 2009

Kaeo and I are back, and we were so anxious to go see our Christy.  She was still active today, arms, kicking that right leg alot!  She's had another stable day... but no real big news. 
Christy had some small progressions today.  Christy's on 28% oxygen now.... closer to room air.  They still have the same size trach in, and she's got a great cough.  A good cough is essential for the mucus to be able to come up and out of the lungs!  That way Christy can fight infection.  Her oxygen is still humidified for easy breathing.  Christy's strong, big arm movements can displace her oxygen mask and has to be watched well and replaced at times.  If the nurse wasn't in the room when Christy accidentally hit the oxygen, she has continuous pulse oximetry machine (see picture below) which will alarm for the nurses to come see what's wrong.  She breathes on her own and requires very little oxygen over the amount  in room air, so it's not an emergency situation.  having mucus stuck in her trach is more dangerous.  Christy's strong cough could clear the mucus & her pulse oximeter would also alarm in this case.  She almost always has family or a friend with her at all times.  Keli'i is sleeping in her room tonight.  The pulse oximeter you see here looks similar, but isn't exact.  The waveform you see is picked up in the finger probe and can also be skewed if the fingers are moving too much or clenching.  You can place the probe on an ear or a toe, etc. It also measure s the heart beat which is the number "87" in this picture.  We talked about Oxygen Saturation before-- 97% is the reading on this person.  97% of 100%.  94-95% oxygen saturation or better is ideal.  This number for Christy is there and stable! 

The P.E.G. was in use 24 hours after it was inserted.  Christy is being fed through it and receives medications through it as well.  It seems to be working fine with no problems!  
This is a general picture of how Christy is fed.  A liquid pre-prepared food is hung and connected to a pump (the pump is missing in this picture) which connects to the PEG. 

Christy was receiving two separate kinds of pain medications today-- Fentanyl and Lor-tab (Vicodin) tonight.  It is still somewhat unclear if she is in pain and if that is what is causing some of the restlessness, or if it is purely reflexive.  When we left tonight she had received her Dilantin (anti-convulsant) and Lor-tab.  The Dilantin can make you sleepy & the pain medication as well.  Christy was finally able to sleep peacefully without the forceful movements.  We turned her lights down low & the room was nice & cool.  It made me happy to see Christy rest & build up her energy for a new day tomorrow.  

Monday, January 26, 2009

Monday, January 26th, 2009

If you haven't already heard by call or text, Christy gave Donald & Lorinne a grin today!!!
Here is the whole story: Lorinne, one of Christy's best friends came in to visit her today. Donald thought her outfit looked as comfy as work out gear. Donald cracks a joke by saying "Look Christy, Lorinne is going to work out without you!" And Lorinne is saying "Not!" Donald continues to tell Chris, "Yes, babe, she's going to work out without you." And Christy cracks a smile!!! What a trip, ya? We know Christy still has her sense of humor!! And Donald continued to crack the joke twice more at different times, just to see if it was a coincidence, and she gave a grin all three times!! You go, Chris!! We can't wait to see that beautiful smile of hers all the time again!

Another eventful happening today was Christy's P.E.G. being placed. Everything went well. The procedure was uneventful, which is good. Christy is up again after the PEG procedure (we talked about this feeding tube placement in detail in a previous blog). Chris is moving around again -arms & legs swinging!!

Kaeo and I leave for the airport early early tomorrow morning. It's almost midnight and we'll be getting up at 03:15 to make our way in the snow, back to the airport. it was about 7 - 10 degrees Fahrenheit today in Denver-- and we still ate yummy homemade ice cream on the way home!! What can we say, we're crazy Hawaiians. I feel like a kid tromping in the snow and catching snowflakes on my tongue. We really can't wait to visit Christy tomorrow and see for ourselves all the wonderful progress she's made!

Unfortunately, the flyer I received for the unbelievable event being held for Christy at Pipeline is unable to load. It is a pdf., not a jpg. Alan's printer is still in the box, so I'll be posting it tomorrow once I can go home, print and scan it!

We love you Christy!!!

Sunday, January 25, 2009

Sunday, January 25, 2009

Today is a day of rest for Christy. She has not had any changes in medication or therapy today. Everything is as it has been. She is resting comfortably-- she's had an active last couple of days and last night.

When talking to Donald today, I didn't realize that Christy is able to lift her head off the bed. Don estimates about four inches high. That's her newest movement! It started yesterday. Small feats every day -- We're behind you Chris!

Family and friends are always with her.

"The greatest healing therapy is friendship and love."

-- Hubert H. Humphrey

Christy is healing little by little as she is being infused with a constant source of love and friendship.

until tomorrow, gabby

p.s. I don't have the detailed information about the fund-raiser yet, but will update you as I get it. Thank you for standing-by

Saturday, January 24, 2009

Saturday, January 24th, 2009

Hello everyone! Today I don't have the same huge amount of news for you as yesterday. Christy is still moving around almost constantly. She is receiving pain medications intermittently as she needs them. She's getting Lor-tab for pain medication , and it is administered down her feeding tube. It's the same thing as Vicodin. She's been on this for a couple days. No seizures- is what Christy's night nurse told me.

She said that Christy's secretions (mucus) from the trach (when suctioning the lungs) are minimal. That's good because the nurse 2 days ago the nurse told me that she was battling infection in her lungs and bladder. Christy has been on Antibiotics (currently- Bactrim) since she was in the ICU. The tubes and lines in her body, (she-she catheter, feeding tube, PICC line--IV access, trach) make her more susceptible to infection. These things are necessary for her care, but are still foreign bodies inside her. Every time they suction her lungs it has the potential to introduce some sort of bacteria from the outside environment. The nurses taking care of Christy have a lot of knowledge and practice in suctioning trachs, so that means they should have good technique while suctioning-- that's vital for preventing infection. They use sterile gloves, sterile suction catheter and they use a new kit every time to decrease the risk of infection. Christy has also allowed them to decrease her oxygen to 35% today. She was breathing 40% oxygen previously. Remember, we breathe about 21% in the air around us [20.95% to be exact!- i looked it up again! :)] So Christy is tolerating less and less help with her breathing. 35% is about the lowest amount of oxygen they would deliver till they switched her to room air, I think. So all is going well.

Kaeo and I are enjoying our quality time with Alan so much. Colorado is lovely... and it even snowed for us which makes it so much fun!

I'll be getting details soon about the "iheartchirsty" fundraiser and will relay them to you as I find out. So far, I heard the line up includes Natural Vibes, B.E.T., Mana'o Sons, & more..... wow! So stay tuned. I should be posting the official info tomorrow. Also, I'll let you know when tickets become available for purchase.

I also want to wish Mr. Kelsen Laboy (Christy's oldest) a happy happy 15th birthday today! He is a charming young man! Donald was able to hang out with the kids today.... they all deserve some QT with each other. Mom Gail spent the day with Christy & Donald and the kids came to visit this evening after the beach. Kelson chose to go to the beach for his birthday outing. Also, when I talked to Donald today, Dylan, soccer Champ, had already scored 4 goals.... and the game was not over yet!
Donald's been camped out at the hospital day and night, his sincere devotion & strength is impressive. Since I've been out of town, he's been doing a fabulous job at collecting all the information precisely and is getting all the medical terminology down. He's Christy's best advocate. Mom Gail has also spent a tremendous amount of time with Chris, insuring her safety, organizing behind the scenes, thinking, advocating, relaying information-- you name it. It's amazing how a mother remains the backbone of the family- no matter what. The strength of mind that allows her to endure pain & adversity with so much love & courage is admirable. I only hope to be as good of a mother as she is one day.

Last but not least, THANK YOU everyone who has emailed me, approached me in person, or commented on here to thank me for the daily updates on the blog. I know I haven't emailed each of you back, but please know that your kind words mean a lot to me. I'm so pleased to know that this blog is helping people who love Christy stay in touch and keep informed. I am more than happy to do this simple thing for Christy and the family. Please know that I truly appreciate the support that I've received in this position I've assumed as the communicator.

Until tomorrow's 8am prayer... much love xo, gabby

Friday, January 23, 2009

Friday, January 23, 2009

Hey all! Today is a good day! Christy worked with physical therapy and sat up in the chair position today. It was her very first time, so she only sat up for a short time. She is dependent on the physical therapist to do the moving, but she's getting exercise. They were going to sit her up again but they didn't want to overwork her. She's been extremely active on her own- much more than yesterday. She is swinging he arms around and over her head with fists. She is kicking her legs up and the right side much more than the left. She arches her back and arms go over her head! The left sided leg being weaker isn't really a surprise when we remember that she had left sided weakness from the blood clots in the brain.... But no seizures TODAY! She's moving so much, the nurses had to pad the side rails so she doesn't hurt herself. She's even getting her hands around the feeding tube... not grabbing it purposefully, but moving so much around it, sometimes she accidentally gets tangled with it. She is receiving pain medication as she needs it intermittently. Her shoulder and ribs are probably hurting her with all of the crazy movement. Since she isn't having seizures, she doesn't need Ativan just to calm her. Pain medication is the better treatment for comfort. Her brain Doctor, Dr. Mayer is calling her violent movements spinal reflexes. Anything called reflexes is not sounding good these days, but there is a difference with these. The exciting thing about her having spinal reflexes is that the brain is trying to send messages and it's getting to the spinal cord, but not quite coordinated in the limbs yet. AND... the doctor sees this as Christy COMING OUT OF HER UNCONSCIOUSNESS, MEANING SHE IS COMING OUT OF HER COMA STATE!!!!!! I'm so excited to be hearing that she's waking up a little!! It's just the beginning, but we're so excited. The medical way to say she is coming out of her unconsciousness is that she is "getting lighter". So if you're going to audition for a neurologist or neuro-nurse on "House", you can say.... "hmmmm, the patient is getting lighter". hee hee! The other thing that the doctor mentioned is that these crazy movements are going to get bigger and worse before they get better... so beware!! Don't get punched in the face while visiting! The doctor actually warned about getting punched! Christy is so strong! The doctor is still monitoring the tiny twitch in Christy's lip and cheek. Without seeing her, it sounds different..... keep you posted.
Christy can also hold her head in the middle and sleeps with it in that position. All the way up to this point, she has been favoring looking towards the right side heavily. People often neglect one side when they have a stroke. One of the ICU nurses mentioned that people tend to favor looking in the direction of the injured side of the brain. And she did have more little stroke-like areas on the right side. (Remember we talked about the emboli and ischemic areas in the brain from blood clots at the very beginning? there were more on the right than left.) So it's so good hear these things!
They also took her cervical collar off! If you have seen Christy, she had to have a grey collar around her neck that was kept in place because they weren't sure if she had any cervical injury. Remember the picture of the spine. The cervical part is near the neck. It has much less vertebrae in the cervical set, then the thoracic set. I'll re-post the pic for you! For some reason, the picture will not come down here, so you unfortunately have to scroll up to see it.
They also did a breathing trial on her today. They capped the trach off, so she could try and breathe through her nose and mouth! They just close the hole in the throat so she breathes normally! Because Christy did well, they decreased the size of her trach to a size 6 (smaller than previous size). They are letting her breathe with this new size trach for now in hope of closing the trach completely! I'll keep you posted the progress with the trach. I'm not sure how long it will take. It will probably depend on how fast she regains consciousness.

The PEG is tentatively being scheduled for Monday. There was no room on the schedule today, so they plan to do it after the weekend. I will also keep you posted on that.
My mom did healing touch on Christy today for about 40 min. Usually Christy is able to relax and even sleep during the treatments. Today, with her big activity, she would only calm & relax for about 10 minutes. She's still taking the energy in, and has been using it to heal herself... Today we are seeing only what we all already knew. Christy is one tough Portagee and she's fighting her way back to health full force!
Please keep the prayers and love coming, pretty please.... this is the start of a long recovery. A recovery that could not be done without the outpouring of love and support for Christy and for the entire Ohana! We are so grateful for all the constant love and prayer felt in all our hearts. Chris' rehab is starting and we're only expecting more of Christy as the days go on. There will be days that are hard, but there will be days that she will progress. We are so very very thankful for such an incredible day!

Thursday, January 22, 2009

Thursday, January 22, 2009

Spoke to Donald, Mom Gail, my mom, and the Nurse at the hospital today. As it turns out Christy was having a seizure when the Neurologist (brain doctor) assessed her and that was the reason for ordering the Ativan we talked about yesterday. The neurologist sat down with Donald today and explained what that sort of seizure looks like so he can also look out for them to notify the nurse on duty. He also did not feel at this time that it was appropriate to move Chris to another unit. He said that Christy did not receive Ativan during the night and that meant that no seizure activity was going on. We will continue to monitor Christy closely and try to control any seizure activity going on & to keep her comfortable. Donald, Mom Gail, and the rest of the family and Christy's close friends have been at Christy's side daily and are wonderful Advocates for her. Christy is still receiving many prayers & healing touch often.

There has been discussion about moving the feeding tube from Christy's mouth and placing it directly into the stomach. The tube she currently has goes from Christy's mouth, down the esophagus to her stomach. You may refer to the diagram to the upper left to get an idea about the Gastro-intestinal anatomy. Originally this tube was placed in the ICU and went down her mouth, past the esophagus, past the stomach and ended in the very top of her small intestine (Duodenum). Remember, they also had a tube draining any gastric contents (bile) out of her stomach as they were feeding her in the small intestine (2 separate tubes). The second tube hooked to suction was in place to check for any excess bile or back up of food into the stomach. It was potentially dangerous for her to have food in her stomach backed up because of risk of aspiration (choking). You know when your food or drink "went down the wrong pipe"? That's aspiration. Only we aspirate just a little & we can cough it out really good and are fine. If we didn't know Christy had to barf, and she did, it could easily come up from her stomach & slip down in to her lungs and cause an aspiration pneumonia. Even if the nurses were giving her a bath or pulling her up in bed and she was laying flat it could come up & get inhaled. Because we eat, barf, and breathe from our mouth, the windpipe (leads to the lungs) and the esophagus (leads to the stomach) are so close together. Luckily Christy had no problems with backed up food and no episodes of aspiration. So a couple days ago, they pulled the feeding tube back from the top of the small intestine to the stomach. They removed the second tube that was to suction. They are finding out right now if Christy is tolerating food delivered to her stomach instead of the small intestine. So far so good. Why that is important is that they want to place a P.E.G. P.E.G. stands for Percutaneous Endoscopic Gastrostomy. A gastrostomy (a surgical opening into the stomach) is made percutaneously (through the skin) using an endoscope (a flexible, lighted instrument) to determine where to place the feeding tube in the stomach and secure it in place. This will make Christy's mouth more comfortable - no more tubes in there. Also, eventually leaving a tube in her mouth down to her stomach may start to irritate the tissues it touches and damage them. A PEG is the choice for a more long term recovery, meaning we know she won't be eating a plate lunch tomorrow or the next day, because she still is unable to swallow or eat food on her own. Here is a picture of what a P.E.G. looks like. Christy's will be similar, but with much less hair around it! ha!

That's all for today.... like always, please keep the prayer going. We love you Christy!

Wednesday, January 21, 2009

Wednesday, January 21, 2009

Today Donald called me with the update.... Christy was having a lot more movement. She has even been kicking up her legs once in a while. She seems agitated, and maybe even in pain. Unfortunately, she has no way of communicating her needs to us, yet. The new Neurologist (brain specialist) came to see her to do his assessment. Now that she is on the 9th floor, she no longer has the same doctors (Dr. Chang) as when she was in the ICU. He did his assessment and was worried that Christy may be experiencing seizures. If she were having seizures, that wouldn't be good because it could cause more brain damage. The Neurologist decided to treat her with a drug called Ativan (Lorazepam). Ativan is used in a couple different situations including withdrawals from alcohol & before surgery to calm the patient. Ativan is in the class of medications known as benzodiazepams (Valium is in the same class) . At lower doses they do in fact decrease "anxiety" feelings. However at slightly higher doses it can "stop the seizure". The doctor never told us specifically what type of seizure he thought she might be having (there are many types). Ativan is a good drug to be used in conjunction with an anti-convulsant. Phenytoin sodium (Dilantin), is a widely known anti-convulsant medication that is commonly used to control seizure activity. Christy has been on this anti-seizure medication (Dilantin) since the initial finding of seizure activity (which they told us was no longer present on the last EEG). We don't really know if she is having seizures, but the Neurologist felt that if she were having them, maybe she should be moved back to the ICU. We don't really know what will happen from here. There was no mention of any more tests to be done or a transfer back downstairs tot the ICU. The unit she is on now specializes in "respiratory" (with the lung) patients and not neurological patients. So we'll see what happens tomorrow.

During this time, the family would like to ask anyone going to visit Christy a few favors to aid Chris' healing. We ask that no unnecessary stimulation happen right now. This means whispering in the room while talking, not talking directly to her right now, not touching Christy, and keeping the number of visitors down. Christy does respond to talking and touching by moving and waking- and this may be using up too much of her healing energy right now. We don't know exactly why the doctor felt she was having seizures, he wasn't specific. It may be the additional big muscle movements she's been doing or maybe the continuous twitching in her face. The less agitation the better, right now.

Please DO continue to send Christy love and positivity... she needs all the strength and energy to heal right now.
I'll be broadcasting from beautiful Denver again tomorrow! until then.....

Tuesday, January 20, 2009

January 20, 2009

Tonight's blog comes from Denver, Colorado... we've safely arrived at Alan's posh pad. This man should be an interior designer on the side! Anyway, I've talked to Mom Gail and Donald at the hospital. They were telling me that Christy was dealing with some pain today. She looked more agitated and was more physically active and posturing more. Posturing is the involuntary movements to stimuli that are reflexive. They made sure, of course, that Christy received pain medication at those times & she responded by calming immediately. Christy's fractures are healing on their own, but will still be painful for at least another week. Her rib fractures, scapula fracture (shoulder blade), and spinal processes fractures can not be casted like a limb and will heal on their own.
I placed a picture to the right of one of the vertebrae so you could pick out the spinous process. No part of her spinal cord is injured, just fractures of the spinous process in the thoracic region.
The thoracic region of the back refers to the 12 vertebrae in the middle of the back. Here's another picture to check that out.

Christy's medications are slowly starting to switch over from being administered IV (intravenously) through her P.I.C. line, to being delivered through the feeding tubes. Most times the medications that go down the feeding tube are regular pills, crushed and added to water and administered down the feeding tube. Sometimes they come in an elixir or suspension. You may also be wondering about the "P.I.C." line. It's a Peripherally Inserted Central line that is placed in the arm, usually at the crook of the elbow and travels up to the large vein towards the heart. The vein that the PIC line sits in is much larger than the ones further from the heart. A large vein allows you to infuse antibiotics, potassium replacements and other potentially irritating drugs safely. Some medications are too strong for delivery into the smaller IVs in the hands and arms. You can also draw blood easily and painlessly from this type of line.

This picture shows a PIC line (or also written PICC line) in the right arm. Christy had received this maybe a week ago at her bedside in the ICU. They place one of these lines for long term IV use. This is different than a regular peripheral IV, shown in the picture below. A regular Peripheral IV only lasts about four days or less & then has to be moved. Also, the catheter that stays inside the arm on a regular peripheral IV (below) is only about two inches long and very narrow in diameter. As you can see in the above photo, the PIC catheter that stays in the arm is of substantial in size and length in comparison to the 2 inch regular IV catheter.

It's 1am here and I'm very sleepy... I will continue to update the blog as I receive information. May everyone have a sound sleep... and I'll be praying at 08:00am tomorrow with all of you guys to Christy back to consiousness.

big hug, gabby

Monday, January 19, 2009

Monday, January 19, 2009

Aloha everyone! The big news today is that Chrsity moved out of the ICU to the 9th floor at Queens. She's on a "respiratory" unit where most of the patients have tracheostomies like Christy.  This means that they are experienced in taking care of trachs and with the care of them.  The nurses are comfortable suctioning and cleaning and changing the inner cannula.  The inner cannula of a Trach needs to be changed daily (they used to have ones that need to be cleaned, made of metal. ) The new inner cannulas are made of disposable plastic.  The picture to the right shows the parts of the actual tracheostomy tube.  The tracheostomy tube is placed in the stoma (stoma is the actual name of the hole in the windpipe) & has three parts: outer cannula, inner cannula and obturator.  The outer cannula is the outer tube that holds the tracheostomy open. (It's the big one one the bottom of the picture)  A neck plate extends from the sides of the outer tube and has holes to attach cloth ties or velcro strap around the neck. It also has a "cuff" the air filled balloon-like thing on the inside of the windpipe.  This balloon holds the cannula in place and attempts to prevent secretions from going down into the lungs.  The inner cannula (middle) fits inside the outer cannula.  It has a lock to keep it from being coughed out.  The obturator (top object in picture) is a plastic guide with a smooth rounded tip.  You will use the obturator if the trach  accidentally comes out and needs to be put back in.  The obturator does not stay in the tracheostomy.  Christy still has 40% oxygen delivered to her like in the ICU by the ventilator. You and I breathe about 21% oxygen in the atmosphere, so it's not that much more.  Chris' trach collar/mask (that we talked about last blog) delivers the warmed humidified oxygen.  Her tube delivering this humidified warm oxygen even has a little thermometer that shows at what degree of warmth the oxygen is... cool huh?  Christy is doing just fine breathing on her own and has a good oxygen saturation.  We talked about oxygen saturation in a previous blog. We want her to be 95-100% and she's there.  She has the E.T. lighted sticker on her finger to measure it, just like the ICU.  She has a tiny monitor that displays the just the oxygen saturation & her heart rate.  The heart rate is measured through the little pulse reading in the finger.  The heart rate measurement isn't as reliable as the EKG stickers she wore in the ICU because its read by the finger probe & not by reading the electricity of the heart.  The heart rate number, as well as the oxygen saturation can be skewed by her moving her finger around or loss of blood circulation to the hand for the short time that the blood pressure cuff is measured on the same arm.  Christy never had an irregular rhythm or any other rhythm than normal sinus rhythm.... therefore it's unnecessary to continue monitoring the EKG.  Her blood pressure has been stable for about a week, so she just has it measured intermittently now.  Christy is more medically stable and we're just giving her more time to awake from her slumber.  We play her favorite music, continue to encourage her, and let her rest and heal.  Patience is a virtue!

So, on a different note, people have been contacting me and the family about helping out financially with Christy's medical bills.  Billy (a very close friend of the twins & knew Chrsity well) works at Bank of Hawaii.  He was able to start a fund called the "iheartchristy fund" with the bank.  This means that anyone can go to any Bank of Hawaii throughout the state and ask to donate money to the "iheartchristy fund" and they could help you out!  
Also, I wanted to mention that Pipeline offered to donate $3.00 of each admission collected from the Classic Rock concert this weekend to the iheartchristy fund if the person purchasing mentions Christy's name!  So if you are going to that concert this weekend or you know anyone going, please mention Christy's name and the iheartchristy fund!  We thought about sending people down to Pipeline this weekend to explain Christy's story to the people in line & ask them to mention Christy's name as they went in. hee hee

Lastly, Kaeo and I are leaving town for a week: Tuesday to Tuesday.  We come back on January 27th.  We are going to be with Alan in Colorado.  At this time, Alan could use some family love.  No worries, I will continue to blog.  I will do the best i can- long distance.  Kaeo and I will both be in touch with Don and Mom and family as well as the nurses taking care of Christy.  I got the direct line to the nurses station and let them know I'd be calling daily... xo, gabby 

Sunday, January 18, 2009

So I wanted to share with you a picture  of Christy's pedicure.  When I went to visit her  yesterday, Kanani had added a pretty flower design and some bling!! You can't really see the rhinestones in this picture but they are there. Christy has the sassiest toes in the hospital--hands down!

So the exciting news of the day is that Christy is completely off the ventilator (breathing machine).  She no longer needs the breathing machine to aid her.  She was taken off the breathing machine this morning around 9:00-9:30 am.  They have been weaning her since she got her trach on Friday.  So, remember yesterday we were talking about needing humidified oxygen because the trach bypasses the nose and upper airway? Well, I wanted to show you another picture of what is delivering that humidified oxygen to her-  the picture below shows a trach collar/mask.  This device is hooked to oxygen coming out of the wall from the central oxygen delivery system of the hospital.  From the wall extends tubing hooked to a plastic bottle of saline & then more tubing that leads to the mask.  The oxygen is humidified & warmed by the attachment on the tube with the saline bottle.  It's band is worn loose around the neck for comfort.  The other picture below is a side view of  where the trach is actually placed in her windpipe.

Chirsty breaths completely on her own and is maintaining good oxygenation without distress.  She was breathing about 18 breaths a minute when we were in the room tonight.  She was calm and look like she was just resting.  If she was breathing 30-40 breaths a minute, that would be too fast.  It would be a sign that she is in respiratory distress.  She would be working too hard to get her oxygen.  Christy looked very comfortable.  Christy also has a good cough which will be instrumental in getting any mucus out of her lungs.  She can be suctioned intermittently by a nurse or respiratory therapist as she needs it.

Christy is still on tube feeding (liquid food, looks like "ensure" if you've seen that in a can).  Her feeding tube goes from her mouth down to the very beginning of the small intestine. She is still tolerating her goal feeding (optimal nutrition) without any problems.  

Chrsity's blood pressure and other vital signs have been very stable.  She still wears a cervical collar (neck brace) around her neck in case she suffered trauma to the neck.  They don't think she has a neck injury, but they weren't able to do a MRI the first 48 hours to be positive.  The hospital policy is they have to leave it on for 6 weeks without that MRI, or have Christy say to them that she has no neck pain.  It stabilizes her neck to protect her from moving her neck too far in any direction.

Chrsity is at a point where she is breathing on her own, tolerating her food delivery well, and not requiring frequent correction of lab tests.  All of her other injuries to the internal organs and her ribs, shoulder blade and spine are stable.  She is so stable that they will probably move her to another floor tomorrow.  When I get more details about that I will update.  
Now all Christy needs to do is regain consciousness! Please keep praying for her speedy recovery.  Until tomorrow!

Sunday, January 18, 2009

Saturday, January 17, 2009

Christy is doing about the same today- still opening her eyes and blinking. We love talking with her when she's got both her eyes open!  She is starting to move her eyes more, almost looking at us it seems.  She is still not tracking voices yet ( turn eyes to look at someone when they talk to her), but we hope it will be soon!  She definitely appears to have clear sleep and awake cycles.  She recently (maybe yesterday) has started to calm down into a deep relaxed state that looks just like a deep sleep.  She even has times where her face isn't twitching at all anymore.  The twitching in her face is calming down overall.  Christy is still receiving medication to prevent seizures.  She only had seizures initially and received medication for them immediately.  (Remember the EEGs confirmed the twitching was not seizure activity after the anti-seizure medication was started, Plus she had therapeutic levels (the right amount) of the anti-seizure drug in her blood). Tonight, Hanae & I were with Christy and she was awake.  Hanae treated her to a foot massage while I did some range of motion (exercising arms and legs to prevent stiffness).  It's nice to have a masseuse in the family, huh Christy? :)

Christy got her Arterial Line taken out today.  An arterial line is a small plastic catheter that was in her artery that measures blood pressure second to second.  It's like an IV, but it is in an artery instead of a vein and it has to be continually flushed (about 4ml per hour) to keep it from clotting off.  A bag of saline under pressure automatically flushes the line.  The arterial line measures blood pressure by being attached to a transducer (plastic contraption which serves as a translator).  The movement of the catheter inside the artery goes to the transducer and translates into a waveform and correlating numbers (blood pressure) on the bedside monitor. Look at the picture at the top right. Christy's blood pressure has been stable and they don't really need the second by second reading of blood pressure now.  She has a automatic blood pressure cuff (similar to the one they use at the doctor's office) to measure her blood pressure less frequently.  The arterial line also served as an easy, painless way to draw blood when needed.  At one point Christy was requiring labs to be drawn every four hours.  On top of that- frequent blood gases.  Blood gases are a lab test on blood drawn from the artery.  They measure the PH of the blood (how acidotic or how alkalotic), oxygen and levels of Carbon Dioxide in the blood.  These are directly related to the lungs and how they are functioning.  Arterial blood is measured for this test instead of venous blood because it just came from the lungs.  Arterial blood is blood that has been oxygenated by the lungs and is going to deliver the oxygen to the tissues of the body.  Venous blood is de-oxygenated blood already used up by the body that is going back to the heart to be pumped to the lungs to exchange their carbon dioxide for oxygen.  The ventilator settings can be changed to give more breaths or bigger breaths to Christy if her carbon dioxide is too high.  Luckily Christy's breathing has been stable and she's regulating her acid-base balance all on her own.  She's got good numbers on her blood gases, so she won't need this lab test as frequently.  This leads me to another small victory today... Christy is on the mode of the ventilator where she's practically breathing on her own.  They switched her today around 09:00am.  They are monitoring Christy closely for signs of exhaustion.  If she is breathing too fast or too heavy (using too many muscles to breathe), they can give her more support from the machine.  Christy seemed to be doing fine on these minimal settings and that's great! I bet she'll be breathing on her own without the machine soon!  Christy will still need humidified oxygen when she is off the ventilator.  It's called a trach collar.  It needs to be humidified because she is breathing from an opening in her trachea which bypasses the nose and throat.  The passage through our nose and upper airway acts as our natural humidifier & air warmer when we take breaths.  The body is pretty cool, huh? I think so too! 

Ok, so tomorrow when you see 08:00am on your clock- in your car, at work, at home, whatever- let's send positive awaking energy to Christy's bed at Queens through a prayer.  And by the way, I have been receiving your comments and emails, and have been relaying to the rest of the family your messages of love and prayer... they thank you from the deep parts of their hearts! Until tomorrow, gabby

Friday, January 16, 2009

Friday, January 16, 2009

Hello everyone.... I really want to thank everyone who checks up on Christy daily and for the continual outpouring of love and prayers. The picture above is a big poster board brought in by her friends from Hawaiian Airlines at the Honolulu station! So sweet! She has drawings from the kids and a big beautiful handmade card from Kaeo's employees at Ko'olina Landscape & Maintenance! Angles, sculptures, framed pictures surround her and in her hand she holds a red handmade cross. Thank you for all bringing your love and treasured creations!
When I came in to the hospital today we (Donald, Tina, Kanani) were talking story with Christy & holding her hands. Christy's eyes were open (both of them, not just the left) and blinking. When Christy just opened her left eye, Tina would ask her to open up her right eye and she seemed to be trying. We're seeing more coordinated eye movements. Her eyes moved as if they were looking around. She is not tracking quite yet, but it I feel it's just a matter of time. We're still looking out for any progression in movement.... She was randomly pointing her left pointer finger during heavy stimulus today. And she started to pull her arm back towards her body to painful stimuli once today, too. Christy enjoyed the musical styling of John Mayer and Jason Mraz. We sang along on all the good parts, but we're not sure she enjoyed that! hee hee! We did some range of motion today, too. Range of motion is exercising the arms and legs so they don't get stiff staying in one position. Christy remained calm, coughing less today and maintained her blood pressure & heart rate in a good calm range. Christy seemed to know it was just us.... enjoying her. During this visit Christy enjoyed some pampering by the girls! Kanani brought her nail kit and painted her nails a pretty mauve color after Tina removed the old polish. They took turns holding the flashlight on each toe, to get it just perfect. Christy's room is usually dim to avoid constant stimulation and to aid healing. It was nice for all of us to be with her today, singing and loving her. I felt like it was healing for me.

There are little signs coming through to us everyday. When you go into her room and talk to her, watch her open her eyes, you can just feel her there with you. My mom does healing touch for Christy and has given her multiple treatments since day one. And when Mom came out of the room today after the treatment, she shared something with us that uplifted our spirits. She explained that the universe is the big energy field. She made an analogy and named the universe the "battery". She called herself the "cable". Being a healing touch practitioner does not mean you are a "healer" she explained. It just allows the practitioner to deliver the energy to the patient so they can heal their own body. The exciting part was that she felt Christy drawing the energy through her. Christy wanted more energy and was really pulling it down into herself. Christy can take all that energy and use it to heal herself. The body is an amazing thing.

There are many people emailing, calling and asking if there is anything we need, please let them know. There is one small thing that the family is asking of everyone. Every morning between 8:00- 8:05, if we can all collectively say a prayer for Christy- sending all of our love and blessing all at once. Christy normally wakes up at 08:00am each morning, so it would be a normal time for her to awake from her slumber! Our love and prayer is powerful in numbers and Christy needs all the love and good energy she can get to heal herself at this critical time. xo, Gabby

Thursday, January 15, 2009

Today Christy had a procedure done called a Tracheostomy (see picture to left).  People often refer to it as a "Trach".   It's a surgical procedure on the neck to open a direct airway through an incision in the windpipe or trachea.  This was presented to the family by the doctors as an option because it is the method of choice for long term mechanical ventilation (being on the breathing machine).  The family decided that this would be a more comfortable way for Christy to breathe.  The tube in her mouth seemed very uncomfortable for her, and could possibly damage her vocal cords if it stayed there for too long.  Since the doctors feel this may be a lengthy recovery, we didn't want to have a tube in the mouth making oral care difficult and cause unnecessary discomfort for her mouth & face.  With a trach in, Christy doesn't have to have the pressure and stickiness of the tape holding the breathing tube (ETT) in place.  The suction can still be hooked to a trach to help remove mucus.  The trach can also still be hooked to her ventilator.  Christy received a short acting type of sedation and some pain medication for this procedure.  It was done at the bedside by surgeons who use a scope to look down the airway.  The procedure itself is quick- maybe 15 or 20 minutes.  The recovery will be mostly watching the new "wound" heal by monitoring for bleeding and keeping it clean.  Christy is receiving intermittent pain medication for any discomfort she may be having. A trach is reversible, so when she is conscious again and can maintain her own airway, it can be closed.  Christy is on minimal settings on the ventilator.  She is on the mode where she is initiating all of the breaths on her own.  The machine supports each breath and delivers oxygen. 

Today while Kaeo and I were in visiting, we saw some exciting eye movement.  Christy was coughing and needed some suctioning, which can be uncomfortable... with this stimulation, she opened both her eyes.  Christy has opened her eyes before but we actually saw some movement of the eye balls as if she was trying to look around.  When we call Christy's name and ask her to open her eyes, she does not, but it was wonderful to see her pretty eyes open up as if she was awake.  We don't know when Christy will come out of her coma, but it's the little things like these that make us so hopeful that it will be sooner than later.  We stand by daily hoping and praying for our miracle!

I also wanted to take the time tonight to mention that there will be a fundraiser held to dampen the burden of medical bills accumulated during Christy's recovery.  It will be on February 28th, at Pipeline Cafe, from 6:00 pm to 2:00 am.  There will be food and live entertainment.  The tickets will be sold for $30.00 per person.   It will be a lively celebration in honor of a woman we all know to be beautiful inside and out.  I will pass on more of the details as I receive them.  And, if you feel that you may be able to help out with donations for door prizes or with recruiting bands or advertisement or anything else please let me know. 
good night xoxo, gabby

Thursday, January 15, 2009

Wednesday, January 14, 2009

Today Donald witnessed Christy lift up both her arms in front of her as if she was carrying some logs.  I don't know how to describe the flexion better than that, but it's the most movement we've seen from her upper body ever!  She is still extending/straitening her arms as well, which isn't good, but we're so happy to see her move more.  Christy is continually trying to open her eyes and she's blinking all the time.  She still has the twitching on the face, still more prevalent on the right side than the left.  Christy is coughing somewhat frequently due to a couple things. Christy is no longer on her continuous pain medication IV drip-- allowing her to wake up more.  It makes her more sensitive to that Endotracheal tube in her mouth going to her lungs to help her breathe (The endotracheal tube or ETT is the purple thing in the picture above). Waking up more means your gag reflex is also more sensitive, and that's probably making her want to cough.  She also has some white secretions that need to be coughed up.  It's good that they're white and thin looking.  Sputum (gulla gullas) that's green or thick or grey or smelly is always bad and means bacterial infection-- you need antibiotics.  Christy has been on antibiotics and they are doing blood and sputum and urine cultures as she needs it.  To culture something means that they take a sample of mucus, or she-she, or blood and send it to the lab to be examined under the microscope.  They usually call this the "gram stain" part of the test.  It's a first look at identifying any bacteria that may be there, but it just tells the shape of the bacteria.  They also inoculate agar plates (for anyone who took biology, remember the round plastic dishes that had a hard gel medium in it that served as a friendly environment for bacteria to grow?).  The she-she or mucus or blood is allowed to grow out bacteria in the plate over a few days.  When they look at what is growing they look at the shape of the bacteria and how it hangs out-- in pairs or chains or clusters-- they can identify what specific bacteria it is.  If Christy has any bodily fluid that looks suspicious for infection, they will culture it.  They also watch for a spike in temperature. A spike in temperature means having a fever. Having a fever is the body's way of heating up the bacteria to kill it.  Like boiling water to kill the bacteria & making it safe to drink.... except blood doesn't reach boiling temperature (obviously!).  It's also possible that with Christy's brain injury, she will not be able to regulate her temperature perfectly, so they just have to culture the blood to assure there is no infection in the body with fevers. They also look at white blood cell counts.  These go up when fighting an infection because they are the body's defense army against infection.  Christy is more susceptible to infection with all the tubes and IVs she has in her body. When the cultures don't grow any bacteria, we know she's on the right antibiotic to kill the bacteria growing.  She's had a sinus infection and a bladder infection, but they have been treated.  They are all under control.

So back to the ETT and suctioning the mucus out of her lungs.  When Christy is coughing and she has some mucus to get out, the endotracheal tube (pictured above) has a suction attached to it.  The suction catheter lies right outside on the tip of the ETT in a plastic wrapper (to keep it clean).  When suctioning is performed, the clear plastic catheter (looks like a super super long, skinny clear straw) goes into the ETT, down into the lungs and automatically makes her cough to bring up the mucus to be suctioned out.  Your body just feels the suction catheter down in the lungs and the body tries to cough it out.  The cough brings the mucus up from the deeper areas of the lung so the suction catheter can reach it. Christy needs this suctioning of the lungs to clear out the mucus, since she can't cough and spit it out herself.  The suction for the catheter comes from the wall suction unit.  The hospital rooms are built with suction in the wall.  The mucus collects in a canister hanging  against the wall and the canister can be changed when full or when up for a day or two.  She also has a second suction that is built into the ETT.  It is along the part of the ETT that sits at the very back of the throat.  It catches any mucus that may fall back there while she's lying down in bed and prevents it from going into the lungs.  This is good for helping the prevention of pneumonia.  It's called a Hi/Lo Evac.  
Chrsity still has a tube in her bladder to help her go she-she and she is still eating via the tube in her small intestine.  All of her internal injuries are very stable and her blood pressure and heart rate remain stable as well.  
 I feel so selfish..... I can not wait for Christy to wake up and be with us again.  I can still hear her talking and calling us "nails", I can hear her laughing, and remember her listening and caring.  We all long to hear her voice again and can't wait to give her the very first taste of an ice cold diet coke.  It's a lesson in patience, i guess.... Every day without Christy is a heartache for the whole family.  When I say family, I mean her friends too.  The friends who love Christy so much, they are there every day, all day long. They have not left her side. That's true love. Our constant Love is what will bring her back to us.  So many of the people who know the family are sharing their own amazing stories with us.  People who have pulled through what was called an impossible journey.  I also have seen it myself, working in the ICU for the last 8 years.  The family is encouraged by the "miracle" stories of others in Christy's situation.  All we can do is continue to love and pray for her.  We Love you so much Christy...with all of our hearts.

Tuesday, January 13, 2009

Tuesday, January 13, 2009

So, I attempted to go back to work today after being at the hospital every day with Christy, and it was hard.  I was constantly thinking of Christy the whole day, distracted and anxious to see her. My co-workers made it possible for me to leave early... thank you to them.  
When Kaeo and I got to the hospital, Christy cooled my anxiousness.  We waited outside her room while the nurse and Respiratory Therapist re-taped her Endotracheal tube.  The Respiratory therapist is the person responsible for managing her Ventilator (breathing machine).  They come and monitor how many breaths she's taking, how big of breaths she's taking, and make any necessary changes to the settings.  They watch, with the nurse, to see if she's getting enough oxygen carried on her red blood cells to deliver oxygen to every part of the body.  Christy wears a sicker on her fingernail that has a red light-- makes her look a little like E.T.  It measures "oxygen saturation".  That means it measures how full of oxygen each red blood cell is.  It's like a ride. The red blood cell has 10 seats.  If all are filled, the oxygen saturation is 100%. Christy has always had a good oxygen saturation 95% or better.  Luckily, even with a damaged lung Christy hasn't needed a lot of oxygen to maintain a good oxygen saturation.  (Remember Christy needed a chest tube to reinflate the collapsed left lung and drain blood & air from around the lung) Look at the picture at the top of the page to see a chest tube. But Christy's already overcome that challenge- remember, she has her chest tube out already!  So back to the "re-taping" of the Endotracheal tube.  The endotracheal tube or ETT is inserted in the mouth and passes through the vocal cords to the spot right above the where the lungs split.  It is how the machine breaths for Christy and delivers oxygen.  It needs to be moved from the right side of the mouth to the left, so it doesn't cause any injury to her pretty little lips! Watch out Angelina Jolie!  

While we waited for them to finish, Dr. MiHae Yu came to talk with us.  Dr. Yu is one of Christy's main doctors.  The petite woman is small but MIGHTY. Dr Yu's specialty is Critical Care Surgery & General Surgery, she's also a professor at UH medical school.  She is the reason for much of Queen's ICU advanced research and cutting edge treatments. Christy had a blood volume analyzer treament in earlier days to determine what kind of fluids she needed.  Would it be blood, so she gets enough oxygen to her organs? Should it just be fluid (like water for the body)?  It's hard for doctors to tell sometimes when patients need blood verses needing fluids or needing no fluid/blood at all.  In Christy's case, they found out that even though they thought she may need some volume, she really needed to pee out more fluid.  So she recieved a drug called lasix to make her kidneys release more fluid from the body.  Having too much fluid in the body can fill the lungs with fluids and make it hard to breathe and oxygenate.  Hope that wasn't too boring, but the point was that she's getting cutting edge treatments to avoid more complications. It's exciting for me to hear about these different NEW treatments being in the field.  It's mostly comforting to know that the doctor in charge of Christy's care has a big big brain and that she is doing everything she can to get Christy healthy! WE ARE SO SO HAPPY THAT DR. YU IS TAKING CARE OF CHRISTY!  To top it all,  Dr. Yu has a great bedside manner and it's easy to like her personable, friendly personality.  

So back to the story I've been trying to tell all blog...... Once Kaeo and I were in visiting Chris, we were able to talk story with her and each hold a hand.  So much of her swelling has gone away, and she looks so good. The nurses do a killer job a french braiding her hair.  Today it was a single french braid instead of a double.  After all of the stimulation of re-taping her ETT, we were able to talk to her while she had her eyes open.  She was blinking her pretty eyes, and it was like she was listening.  The doctors say that Christy's eye opening is only associated with big stimulus (like turning positions in bed, painful stimuli, and her coughing and while suctioning her).  This kind of eye opening, they think is a reflex.  We are still waiting for Christy to turn to us and look right at us, & give the doctors the finger, but for now, it felt so good to be with her, hold her hand and talk to her with her eyes open.  The recorded voices of Kainalu and Dylan reading her a book was playing in the background, and we know she can hear them. Christy was calm... no coughing, no flexing her extremities, and no big elevation in heart rate or blood pressure.  We told her how many people were rooting for her and praying hard for her to get well soon.  We explained how much she's really touched people's lives and we wish she could see the amount of visitors she's had- superstar status, man!  We finally told her about this blog, and how many people read and wait to see how she's doing. We told her how blessed we have felt to have her in our lives, and we can't wait to laugh and rip on each other again!

Thank you for the pictures that everyone's sending. I'll try to get those in the slideshow tonight.  I have to be at work again tomorrow, so we'll see.  I'm so tired I could barf....  I won't miss a day of blogging for you guys, though. No worries.

Monday, January 12, 2009

Monday, January 12, 2009

Today Christy is doing about the same as yesterday.  We still want to see some improvement in her movement- to become purposeful.... Purposeful meaning- scratch her face, try to pull out some tubes in her mouth that may be uncomfortable, pick her nose, show "thumbs up" on command or open her eyes and track the voice speaking to her.  The Doctors and Nurses are going to be weaning off her sedation medication to give her a clear chance to wake up more.  She has been on a continuous intravenous drip(going in her IV into her bloodstream) of pain medicine since her admission to the hospital.  Initially, while on the cooling- hypothermia treatment, this medication was at very high doses- 250 mcg/hour.  Christy's broken ribs and scapular and spinal fractures are painful injuries.   Every time she breathes, she uses her rib cage and moves the entire area surrounding her injuries.  We can not cast her ribs like we could cast a leg because the cast would have to be around her chest, making it impossible to breathe. The continuous IV pain medication has been weaned down to 25-50 mcg/hour now.  We are leaving her on the pain medication, which may be somewhat sedating , because we want to keep her comfortable.  We will take off one medication at a time.  She will be taken off of the small amount of sedating medication called Versed.  This medication is used in other medical procedures to make you sleep.  Because it's so important to get a clearer picture of her Neurological (brain) status we are starting to completely remove these medications.  She has been on these medications to provide her with comfort and to decrease her blood pressure and heart rate during "agitation".  Christy has always been sensitive to voices and touching- even while on sedation and pain medication. By sensitive I mean her blood pressure and heart rate go up when she is touched and talked to.  She also continues to have the facial and body twitching, that worsens with verbal and tactile stimulation.  Sometimes its hard for Christy to get comfortable after coughing  or repositioning and the pain medication and sedation have been helping her settle down.  We want Christy to be comfortable but don't want to keep her from waking up.  The good thing is that the nurses can always put the medication back on.  

Chrsity is tolerating her tube feeding at a goal rate.  This means she is being fed through a tube from her mouth to her small intestine and she is digesting it fine.  Being at "goal rate" of 55cc per hour means she's tolerating the proper amount of calories designated for her healing.  A dietitian calculates her nutritional needs for healing and how much protein and fiber, calories, etc. would be ideal for her.  They find a formula of liquid food that matches her needs and pump it through the tube for her to ingest.  

Chrsity has been receiving healing touch and Reiki.  These are both energy therapies to help aid healing.  My mom, Joyce is a Healing touch practitioner (and a pediatric nurse).  She's been coming in to give treatments to Christy almost daily.  Queen's hospital offers this complimentary therapy to patients who request it.  Volunteers also come to do treatments on patients, so Christy has been receiving this calming therapy daily.  It helps pain, sleeping more sound, and opens her to healing.

I wanted to offer everyone to send their favorite picture or two to me.  I would love to add to the slide show pictures that are dear to you.  You can email me pictures at (my email still has my maiden name :) )   I will be back to work tomorrow after being away for a week.  I may not get to blog until later in the evening.  Please send your love and prayers to Chrsity and the entire family at this time.