Day 3: Current plan March 16, 2012

The first thing I am excited to do each morning is to look at Scott's face.  Not only is it comforting to see him and be near him, but it is exciting to see obvious visible change in the amount of swelling in his face each day, especially his right eye.  We take that as a comforting sign that his body is working hard on healing itself.

He did receive a blood transfusion today that they expected he would need.  His blood count was a little low and they want him to have all possible healing resources available to him.

We finally met with the plastic surgeon this am.  He will be doing the jaw surgery.  He explained that he has a mandibular fracture centrally and vertically through his chin. They consider the mandible a "weight-bearing" bone due to the forces involved in chewing. Therefore, they feel it necessary to stabilize the fracture.  They will wire his jaw shut first in order to align the chewing surfaces of his teeth.  Then, they will attach a plate across the fracture line.  Then, they will remove the wiring.  So we expect his jaw to not be wired when he returns from surgery.

They are still coordinating the ventilation piece, so we don't know final timing details on when they will insert the trach and the feeding tube.  But they anticipate that they will do it immediately before the jaw surgery tomorrow morning.  It will be good to get the ventilator removed and it will reduce the risk of obtaining ventilator-induced pneumonia.  The ventilator creates a conduit from the outside world to his inside world. Plus, the mouth is so full of germs, and currently full of blood due to the mandibular fracture, that it is a ripe breeding ground for those germs.  The last thing he needs is pneumonia, so it will definitely be good to have the ventilator removed.  They do clean his teeth and mouth every 2 hours, as a precaution, which he hates!  He may not be conscious, but he does put up a good fight when they brush his teeth.

Occupational therapy was ordered today to reduce swelling and perform gentle passive range of motion (PROM) to his right shoulder, elbow, wrist and hand.  They are allowing me to perform additional sessions of PROM between therapy visits, which helps me to feel like I am doing something concrete to help.   It gives me empathy for all of you, who have expressed a desire and need to do something tangible to help.  I totally understand how you feel, and I am here by his bedside all day long.

He is currently on minimal sedation, so he has been moving a lot more and being more aggressive with his arm and leg movements in response to pain/noxious stimuli.  Still not waking, but becoming more active.  We are still awaiting the "wake assessment" for today.

I do have one more to share, but need to sign off.  I will finish in a little bit....  sorry for the late post today!  Know I am making every effort.

Love you all!
Patti