Saturday, March 31, 2012

Quiet Day

There is not too much news to report on Scott today.  It was a quiet day at the hospital and he is resting and recovering.  He is running a low fever as of today.  They do not believe it is pneumonia, but I suppose it is an indicator that he may have a slight infection.  As of now they have no plans to conduct any further tests or scans.  It seems we are just waiting now for signs that he is emerging from the coma - for his eyes to open and for more responsiveness to verbal commands.

Friday, March 30, 2012

Thumbs Up

The CT scan results show that the swelling is going down.  It wasn't a drastic decrease but it is definitely a sign of improvement.

In other news we were present in the room tonight when the nurse took Scott off his meds temporarily to test his responsiveness and reflexes.  We saw him move both arms and reach for his breathing tube, which is apparently the reflex they are looking for.  Then, in response to requests for him to move his fingers, he raised his hand.  A few minutes later, when we were putting in a new CD for him, Jen asked him to give a thumbs up if he wanted to listen to Velvet Underground.  He did!  We saw it clearly, he moved his thumb.  Unfortunately the nurse didn't see this but we know what we saw.  So, we said goodnight to him  and left him resting peacefully listening to Velvet Underground.  I feel like we are on the verge of some new progress coming soon.

Waiting for Results

Scott had another CT scan this morning.  Jen is at the hospital now waiting for results and to talk to the doctor.  The nurses indicated there was a little progress last night, though they could not give her specifics.  I will post more when I hear results.

I wanted to tell people a little bit about his care and his room.  He is in an open ICU room (meaning there is no door on the room, I guess to allow easy access in and out in case of an emergency) right near the nurses station.  There is a nurse at his side 24 hours a day, reading monitors, checking vitals and generally caring for him.  The nurses have music playing for him since they know he's a rocker.  They were originally off base with the classic rock station.  Jen was a little concerned that he'd never want to wake up with that playing all the time.  But yesterday when she went in to see him the nurse was playing some Black Sabbath and some Stooges.  The nurse said she believed it seemed like he wanted to harder stuff so, we are going with that right now.


Thursday, March 29, 2012

Progress

Scott is doing a little better each day.  Today he moved his left hand for the first time in response to reflex tests.  He is still breathing on his own, is coughing now and there has been some eye movement, though he has not yet opened his eyes.  These are all positive signs and we are sure he will continue to progress a little more each day. Tomorrow he is scheduled for another CT scan in the morning which will measure whether or not the swelling in his brain is going down yet and also will show if fluid is still building up.  Fingers crossed for good results.

Morning Update

It was a quiet night for Scott and he is resting and recovering.  He is still responding to stimuli and it appears there has been no change in his responses nor in the swelling/draining.  They have not had to drain any more fluid, which is good news, and indicates that the swelling and fluid are still not increasing.  No progress yet on reduced swelling -- I think he's operating on his own time frame for this and we will just have to wait. 

Jen is spending the morning at his side and Kay is taking a well deserved break from the hospital and going with Floyd on an adventure with his cousins to the Bay Area Discovery Museum.

Wednesday, March 28, 2012

Results

Scott's first scan this morning was inconclusively so, after a long day, they finally conducted another scan this evening.  The doctors seem pretty sure that he is past the phase of increased swelling and bleeding.  Hooray!  And a huge sigh of relief.  I think this means we are past the very critical stage of the trauma.  He is stable.  The doctors hoped, however, that they would start to see some reduction in the swelling, and increased fluid drainage but that is not happening just yet.

I am sure it will be a restful, quiet night for Scott.  They plan to continue to monitor his clinical signs and are hoping to start to see some signs that indicate the swelling is going down overnight.  Doctors plan to run another scan to check on his progress either late tomorrow or Friday morning.

I want to clarify something from a previous post, the doctor explained this evening that they are not actually removing and reinserting the breathing tube as I was imagnining.  They have a switch on the tube and it has remained off since yesterday (Yay!) but they have not yet removed the tube.  Apparently the intubation and extubation procedure is very stressful and not something they can do repeatedly.  So, before they finally remove the breathing tube, they want to be sure that his breathing is strong enough to ensure he is getting the right amount of oxygen per minute.  So, they plan to give him another day or so to build up strength before they remove it.  They report that he is breathing strong and has so far not contracted the dreaded pneumonia.  (Pneumonia keeps getting mentioned - by everyone. They expect it to happen and apparently, when it does it can really slow progress.  So, it is very good that it has not happened yet.)

A huge thanks to EVERYONE for all the support, love, positive thoughts and prayers being sent this way - to Jen's neighbors who've made meals, to folks at Sephora for the goody bags for hospital staff, to everyone who put the donated music together that they are playing for Scott.   Thanks!  So many people are standing by for some direction in how they can help and don't worry, it will come.  This will be a long process and we are reminded by nurses that this is a marathon and not a sprint.

Waiting and Waiting

Sorry, no news yet on the scan. 

Another CT Scan

Scott is on his way down for another CT scan.  He remains stable and there have been no problems overnight however, doctors had hoped that he would begin to open his eyes by now.  They just want to conduct a scan to take a look at the swelling and see the results of the surgery.  It will take a few hours to do the scan and get results.  I will post when I know more.

Tuesday, March 27, 2012

Still Breathing on His Own

The doctors decided to see how long they could leave the breathing tube out and Scott went all day long breathing on his own.  Amazing!  This is great, not only because of what it means in terms of his brain functioning, but it also reduces the risk that he will catch pneumonia or other hospital related illnesses that could set back the recovery process.

He has not responded to any voice commands from the nurses or Jen since that one time a few nights ago, but that will come and it probably just means his body is busy doing other things right now.

Scott is Breathing on His Own!

As part of the ongoing clinical tests they are running doctors just removed Scott's breathing tube to see what his reaction would be and...his body took over and he started breathing on his own.  He did so for at least 25 minutes.  Doctors will be putting his breathing tube back in for now but it is a GREAT sign that he is able to breath on his own.  He looks great, Jen and Kay just visited with him, and doctors believe he is very strong and fighting hard.

Good Sign



A full rainbow over Scott's mom's house, taken by Scott's sister Ashley.

Just Waiting

No update yet from medical staff this morning.  The fact that there were no phone calls last night probably means no emergency procedures were required and that it was a quiet night of recovery for Scott.  Let's hope.

One thing to mention is that when the surgeon debriefed Jen last night, he did say that they were able to start to see some of the extent of the damage from injury to Scott's brain.  He said, because his skull was fractured in many places, there are multiple areas of his brain that were impacted.  The area that seems to have been impacted the most is the area that controls movement and balance.

We don't really have any context for what this means right now, I'm just telling it as it comes.  The good news is that the doctors are starting talk longer term, to do things like assess the damage and talk about what procedures they will do a week from now.  This is a significant change from the way they were talking this weekend, when they wouldn't even entertain questions beyond what was happening minute by minute.  I am very hopeful this means that the end of the "critical stage" is near.

Monday, March 26, 2012

Scott is Out of Surgery!

The surgery was a success!  The surgeon reports that the swelling is being alleviated near the cerebellum and that his brain is now absorbing fluid that it needs.  I'm short on any further details right now, he is being brought back to the ICU and it will be a little while before Jen is able to see him.

More Surgery Needed


Scott is headed for surgery now.  Doctors need to relieve swelling that is occurring at the base of his brain which is currently preventing his brain from being able to absorb necessary fluid.  He will be in surgery this morning and it should take a few hours.  Doctors are reporting that he still remains in a very critical stage where the swelling in his brain is increasing.  Again, it is impossible for anyone to say when he will be out of the woods but the doctors are saying that as long as his brain is still reacting to the injury – swelling and possible hemorrhaging – we are not yet in the recovery phase.  They are saying that this phase usually lasts 72 hours or so.  I will post an update following his surgery.   

Sunday, March 25, 2012

What Is Going on?

As many have already heard, Scott was injured in a terrible accident on Friday night. He has suffered traumatic brain injury and is currently being treated in the ICU at SF General Hospital. The purpose of this website is to help keep family and friends informed of what is going on and how they might be able to help.  (Feel free to submit comments for Scott to read when he is better.)

What Happened: 

It is difficult to know exactly what happened. What we do know is that Jen woke to a loud crash around 1 am on Friday night. She found Scott laying at the bottom of the stairs. It appears he fell backwards while climbing the steps and landed striking the back of his head on the concrete landing at the bottom of the steps. Jennifer called an ambulance immediately when she realized he was unresponsive and seriously injured. Scott was taken to SF General hospital, which is very close to their home. SF General specializes in head trauma and he began recieiving emergency care very quickly. As it turns out, SF General is the premier traumatic brain injury center in the U.S. and Scott is recieving top notch treatment. 

His Injuries: 

Scott's official diagnosis is Traumatic Brain Injury (TBI). He remains in the critical stage of his injury where doctors are monitoring his vital signs and the pressure and level of swelling on his brain by the minute. It is a little unclear how long he will remain in the "critical stage" but it sounds like at least for 48-72 hours. It is impossible for doctors to speculate on how long he will remain critical or what the severity of the injuries will mean in terms of recovery. What is known at this stage is that his brain has undergone swelling and hemorraging in three places. He underwent surgurey yesterday morning to remove the left side of his skull to relieve pressure from swelling. Doctors are most concerned now about an area of swelling and bleeding they discovered during surgery that is at the cerebellum which is very near the brain stem-a critical area that controls life functions like heartbeat and breathing. Doctors are constantly monitoring this area and are on standby to perform emergency surgery if there is any indication that swelling is increasing in this area. For the past 12 hours there has been no change in the swelling and no change in his vital signs, he is stable. This is excellent news and the best we can hope for at this stage is that he remains stable and does not require any further, risky surguries. 

More Good News: 

Scott has shown signs of reacting to stimuli. He is currently in a medically induced coma but doctors and nurses bring him slightly out of that state every hour. During that time Scott starts to move his arms and legs and reach for his breathing tube. Doctors are taking this as a very good sign that his nerve centers remain intact and that his brain is responding to stimulation from those centers. Also, last night around 7 pm, he apparently moved his thumb on verbal command from a nurse. This is A GREAT sign! Doctors plan to continue round the clock monitoring. At some point in the recovery process Scott's own system will take over management of the brain swelling (that is currently being done through medication). I think this will indicate that he is out of the woods, but that is not entirely clear. Any way, it is what we are hoping for at this point and whatbwenare holding on to. 

What Can You Do To Help: 

Jen and Kay, Scott's mom, are at his side letting him know about the tremendous support of family and friends out there thinking about him. It is not safe, nor in Scott's best interests at this time to recieve visits. In lieu of flowers and such Jen hopes that well wishers can instead focus their energy on sending support and thanks to the extensive medical team of ICU doctors, nurses, surgeons and others who are working 24 hours a day for Scott right now. Jen and Floyd have immediate support from friends and family in the area and I'm sure in the future there will be lots of opportunities to help make meals, walk pugs, provide child care and hold Scott's hand during the recovery process.

-Penny