Monday, February 22, 2010

Not to rub it in but...

The countdown to Mexico begins today! 12 days until Joc and I are in the hot weather. Thank God! This Michigan winter is enough to send someone off the deep end. February has proven to be very blah, cold and more blah, okay so last week we had a few sunshine days but I was mostly indoors without the opportunity to get out and experience them so baaaa! they don't count for me. As excited and ready for a break as I am, it worries me that the semester is progressing so quickly and without regard for my stress level. I keep telling myself that life will ease up after spring break and after the cumulative exam on the 17th but I'm not so sure, but praying it gets lighter. My last three trips to Lansing happen this week (2) and next week (Thursday) and then I'll have a few extra hours to complete homework and readings and get some resumes out to colleges.

I had a particularly emotionally draining day at work yesterday, I am precepting a senior level nursing student (what we call the leadership rotation, it's an opportunity to get the student into the nursing world) who is hungry to learn everything and anything she can. This can be particularly draining simply because it's double the load on my brain and can really slow down my day that is already busy and complex. But, I love to teach and love to offer experiences so I truly don't mind in the least and if it's just not a good time, I say, "we'll need to talk about that later". Anyhoo, we had a 63 year old gentleman who was alone at home for approximately 5 hours and found unresponsive by family, EMS brought him to the ER where he deteriorated quickly needing a breathing tube (for my medical friends he promptly vomited and aspirated with the intubation adding to his problems) then his CT scan (of his brain) showed a brain stem infarct (large) (translation: he had a large stroke). To keep the story short: neurologist comes to assess him and tells the family he is nearly brain dead (but not quite), ICU doctor tells the family he is nearly dead and he will most likely not survive this stroke, family is large and outspoken, upset (understandably), don't understand that his reaction to pain is a reflex as opposed to the brain telling him to respond to pain appropriately. I took over Sunday morning where we met with the neurologist twice (once for a thorough assessment to demonstrate to the family how poor his prognosis is and a second time to look at a new scan of his brain that showed about 80% of his brain tissue severely and permanently damaged), then with the ICU doctor twice to talk about his code status and the options for treatment as well as at the end of the 12 hour day to talk about his rising and uncontrollable temperature (between 38 and 39.5 celcius or 102-104ish F). There were many emotions running high all day and I left with a headache and exhausted. He will die, they were coming to terms with the decision to take him off life support because he will never recover. I hope I helped them feel at ease with that hard and unimaginable decision. They want to be sure he will never wake up, no one can tell them for 100% certainty, we can offer a 99% chance he will never wake up but they cling to that 1% chance of a miracle. Are they wrong? If we wait too long and he doesn't herniate on his own, he will live on a vent with a feeding tube in a nursing home for however long it takes his heart to stop beating of its own accord. How many people want that?
It's been a long time since I've been involved in a case like this one, it felt good to come into their lives at such a hard time and offer a support they needed. They look for hope in every small nook and the word miracle was thrown out a few times, with the neurologist and ICU doctor both saying if he survives this and wakes up, it will be a miracle. It sounds bad to most non-medical people, but I pray he dies on his own. I pray his brain herniates and his heart stops beating and his family is relieved of this burden they truly don't want right now. Can you pray that God will do that for this family?


Jen said...

Wow, Gable... I am so glad you could be there for that family! Everyone needs one of you in their lives! I don't know how you do that job though, seriously... You are amazing! Keep it up!

Jennifer said...

Thanks for the post- full of good reminders.

Life 102 said...

Follow up:
The family decided to withdraw support yesterday, he remains alive but will slowly die because he is unable to breath effectively enough to survive long term. No one can say how long this will last, some people hold on for weeks, again, I pray it is not this way for this family.
p.s. glad i could give you something to bring you back kragt.
p.p.s. Hietikko it isn't always easy but I feel good about being there for people who struggle. thanks for your words.