Thursday, November 30, 2023

Coleman's Journey 11/30

Coleman moved out of the neuro ICU this afternoon and into the neuro ward. The ventilator is gone and he's been talking up a storm. Still has the tracheotomy and feeding tube (called a pug). 

Wednesday, November 29, 2023

Coleman's Journey 11/29

Today, the doctor from rehab thought that Coleman is improving so fast, she thinks he can go probably go there next Monday.  Coleman has a lot of work to do by then.  It's a most excellent goal.

Coleman had the adapter in for a number of hours today that allows him to talk.  His neck muscles are getting stronger.  They were pretty sore at the end of yesterday.  He's supposed to be off of the ventilator during the night as well as during the day.

Tuesday, November 28, 2023

Coleman's Journey 11/28

Coleman was to receive a unit of blood today, because his hemoglobin is low. They think he may be tired because he is low.  He did great on a test voice valve on his tracheotomy. They will test again later today.  With some of his first words, he asked what happened to him.  I actually had a conversation with my son for the first time in 4 weeks! 

Today marks the passing of 4 weeks.  

Monday, November 27, 2023

Coleman's Journey 11/27

Coleman was in the chair again today for some physical exertion.  He benefited from Deb stretching his right leg muscles.  The physical therapist worked his left side.  X-rays of his chest didn't show anything new.  This was a good thing.

Coleman's off the real powerful antibiotics that were introduced early on to make sure he didn't get pneumonia.  He's still off of the sedatives.  This makes it a lot easier to have him communicate with us. 

Coleman's body temperature remained where it's supposed to be all day without any assistance.  Another item to cross off the list.

Sunday, November 26, 2023

Coleman's Journey 11/26

Not a whole lot of change for Coleman.  Still on the ventilator.  Can't wait to get off of that.  He seems to be using a few more right-handed signals.  In addition to "thumbs-up", he lays his right hand out flat and moves it from side to side, as if to indicate "things are so-so".  There's slightly more movement in his head nods as well, but this continues to be difficult since he still has the tracheotomy.    

Both physical and occupational therapy showed up in the late morning today.  Today was the first time that I heard any words from Coleman.  Speech therapy should start right away.  Today, we were also able to use a clipboard with paper and pen for one Coleman's first attempts.     

I guess there were more positive baby steps to report than I thought.  

Saturday, November 25, 2023

Coleman's Journey 11/25

Coleman is able to breath on his own for longer periods of time.  We call these time trials.  He needs less and less oxygen as well.  His temperature is being managed primarily now with Tylenol and ice packs.  Coleman still can't speak.  We communicate with him by having him give us a thumbs up.  Even that doesn't always work.  He can't write messages yet.  We tried this last night, but he had difficulties holding marker.  

Coleman was able to watch some football on Thursday.  He's into the NFL.

Coleman is often responding well to the neuro checks; things like squeeze my fingers, give me a high five, push my hand, pull my hand, wiggle you toes, lift your leg, turning his head to the site.  

Friday, November 24, 2023

Coleman's Journey 11/24

They got Coleman in to the wheel chair today, but didn't go anywhere because he's still connected to the ventilator.  No more sedatives.  Only pain killers, which are being decreased as well.  The stitches in his scalp were removed today.

Thursday, November 23, 2023

Coleman's Journey - Thanksgiving 11/23

At about 9 am, the stopped drip for the last of Coleman's sedatives.  At least for now, we'll find out how long he can go without.  He did about 20 minutes this morning of breathing on his own, without the ventilator.

While he might get another session of physical therapy in this weekend, next week, he should be getting it every day.  This will be great for him.  

Traffic on the way to ANW this morning was awesome.  There was a beautiful sunrise as well.  

Wednesday, November 22, 2023

Coleman's Journey 11/22

Today was a good day! More specifically, a good afternoon. 

Coleman's sedative was reduced through out the day and he seemed to tolerate it. He had some initial PT (who brought a wheel chair suited for him) and OT (who brought him a fitted helmet since that part of his skull is still out for at least 3 weeks). His eyes were open wider and longer. He seemed to be tracking me better as I moved around the room. He was able to slightly turn his head to the right.

I might go as far to say that this is possibly the best that I have seen him in the past 3 weeks.

Baby steps! 

Tuesday, November 21, 2023

Coleman's Journey 11/21

The neuro NP on duty had one of Coleman's sedative(s) (propofol) stopped so that Coleman could perform the standard neuro checks. It went well. He should have had the lung scope sample of the gunk in his right lung taken today so that they can getter a better feel for what's causing his fever. They started a low-dose blood thinner for clot prevention, which is of interest since they told us that Coleman can not be on blood thinners due to the work and damage in his head. His temperature has been ok, which has also been interesting, since they had him on sedatives due to his shivering, which came about due to the need to cool him down due to his fever.  

Did you get all of that?  

Today marks 3 weeks now that he's been in the neuro ICU at ANW.  Many thanks to family and friends that have been taking care of Deb, Sophia, and me.  We really appreciate your kindness and support.

Monday, November 20, 2023

Coleman's Journey 11/20

Coleman can't seem to catch a break. They can't figure out where his fever is coming from. They are seeing his hemoglobin go down which makes them think he's bleeding in his lung. Whenever they take him off of the chiller, his temp goes up. They are now giving him a full body CT scan. 

Sunday, November 19, 2023

Coleman's Journey 11/19

As a preventive measure, they are putting in the blood clot filter as I'm typing this.  It's estimated to be a 90 minute procedure.  The common, ongoing objective today is to get rid of the fever that Coleman's been running for the last couple of days.  If we get rid of the fever, we can remove the sedatives that he's back on to manage the fever-induced shivering.  He can then build up his lungs.  If we build up his breathing, we can remove the ventilator.  If we remove the ventilator, he can get into rehab.  If he gets into rehab, he can start to rebuild his mind and body.    

Tuesday will mark three weeks that Coleman's been in neuro ICU.  Haven't really communicated with him much during this time.  Once in while, on his right side and on command, he can squeeze your hand, wiggle his toes, and shrug his shoulder.  Haven't really spoken with him directly the entire time that he's been here.  

Saturday, November 18, 2023

Coleman's Journey 11/18

Coleman's neuro surgeon stopped by.  His morning CT scan looked very good. Not as much damage as he thought from the stroke. Stitches will come out soon.

They assumed that the fever Coleman has was treatable with antibiotics. Not so far. Changing gears they now are concerned about blood clots, because he can't take blood thinners right now. They took ultrasounds again today and are considering a filter in the main vein that serves both legs. Waiting to hear more about this one. 

Friday, November 17, 2023

Coleman's Journey 11/17

Coleman has a CT scan last night and everything looked great.  He should be getting the second of two brain drain's removed this afternoon.  We continue to look for positive baby-steps each day.    He's tolerating breathing on his own more frequently and for longer stretches of time.  His tracheotomy and feeding port went in yesterday.  While it's still early to tell, he seems to be tolerating things ok.

Physical therapy should be by this afternoon for their first visit (whatever that entails).  Orders were submitted for occupational and speech therapy this morning.  It took at least 4 people to get him up to sitting.  He's still in the neuro ICU at Abbott Northwestern, which is a short-term acute care facility.  Eventually, he'll need to transfer to a long-term acute care facility I believe.    

His eyes have been open for quite a bit this morning and he's responding well (all things considered) on his right side to commands and neuro checks.  Since he's been in the same spot for three weeks, even his rights side will need some exercising.  His left side is going to need some more work.   

Thursday, November 16, 2023

Coleman's Journey 11/16

Looks like Coleman will be receiving a tracheotomy sometime today to help with his breathing.  Hopefully this will be temporary.  

Wednesday, November 15, 2023

Coleman's Journey 11/15

Yesterday, Coleman's Care Team met to discuss where we were at and where things were going.  Coleman is still in neuro ICU.  In order to transition  from neuro ICU to rehab, he'll need to address a number of issues:

  • Needs to be breathing better on his own.  Presently, he's breathing with a ventilator.  
    • A tracheotomy will help with this.
    • They may remove his surgical feeding tube at the same time. 
    • Yesterday, he breathed on his own for 30 minutes.  Today, he went 45 minutes breathing on his own, 95% to 96% of the time.
  • He's getting most of his meds via transfusion.  He'll need to be able to take his meds in pill form.
    • His second stroke event may have affected his ability to swallow.
    • He's down from four different sedatives to one.
  • His last of his two brain drains will probably be removed soon as well.
There are multiple levels of rehab and care that he could go to after leaving the neuro ICU.  It all depends on what he'll be able to do on his own versus what he'll be dependent on others for.

Monday, November 13, 2023

Coleman's Journey 11/13

Tomorrow marks the date that Coleman entered the neuro ICU two weeks ago.  It's hard to see other patients enter and then leave the neuro ICU, wondering when my son will get to do the same.

Today, the doctors and nurses will continue working further at reducing the sedation that Coleman is on.  They need to back him off of sedation enough to be able to do his neuro checks, but not to the point where his body can't handle all of the issues he's dealing with along with their treatments.  So far, they've been able to reduce his sedation by dropping two of the four sedations that Coleman's been on since his peak -  his skull fragment removal surgery.  They want to get him off of the fentanyl.  The people who have been taking care of Coleman will also be addressing superficial blood clots in both of his arms.  There's nothing to worry about here.  He's been laying in a bed continuously since his first stroke event.  Ultrasounds were ordered for both arms as well has his legs due to this.  Coleman is running a slightly higher temperature.  They'll also be checking the draining brain fluids to rule out infection.

Sunday, November 12, 2023

Coleman's Journey 11/12

Coleman's eyes were open wider today. Weaning off the oxygen and sedation.  Unfortunately, it feels like two steps forward, one step back.  We seem to be at the point where his blood pressure starts to rise whenever the sedation is lessened.  Coleman is still in neuro ICU.  Today, I was able to make direct eye contact with Coleman.  He raised his right leg and squeezed a nurse's hand.  Keep up the prayers for Coleman.  He's going to need them.    

Saturday, November 11, 2023

Coleman's Journey 11/11

Had a good day yesterday. They were able to drop 4 drip lines and pumps and to get a new CT scan which did not show more damage. He's almost got his eyes open, but is still under some sedation.

He's off about half of peak sedation. Will still need to be on the ventilator longer. Still has to struggle with his blood pressure. 

Friday, November 10, 2023

Coleman's Journey 11/10

Coleman 's paralytic was stopped again.  This is the sedative that keeps him immobile.  He moved his head slightly, his right thumb and his right knee this morning. both of which is very good news.  They are going to try to move him onto his side for more oxygen for the right lung, where pneumonia is.

A neuro-ICU doctor was encouraging when she told us that they don't see a reason why a young man like Coleman won't fully recover.  Recovery will be like a marathon though.  

Thursday, November 9, 2023

Coleman's Journey 11/09

It was not a great night last night. Coleman's blood pressure was hard to control, his oxygen levels had to be increased, and his sedation increased too.  They had to turn the paralytic back on.

Keep the prayers coming please.  For the previous two days, it seemed as though he was about to turn the corner to recovery.  

Wednesday, November 8, 2023

Coleman's Journey 11/08

Coleman had a good night last night, as far as we can tell from the machines and blood work and scans that we have.  They warmed him back up to normal overnight and they are in the process of taking him off of the paralytic.  He still has a breathing tube in and a number of strong sedatives flowing in.  

Dr. says he's doing great.  Oxygen levels are very good. May not need it by the end of the day. The order of the day is adjusting sedation meds.

The nurse just checked to see if he would move when she used her little poker, but no reaction yet.  They are still adjusting sedation drugs.

As the layers of devices and drugs get peeled away and he gets pulled closer to the surface, we're anxious to find out how much of our son is still with us.  

The crew at Abbot Northwestern is outstanding.  They really know their stuff.  The facilities are really nice as well, in spite of the massive amount of new construction going on in the area.  The staff takes the time to explain everything they're thinking of doing.  

Tuesday, November 7, 2023

Coleman's Journey 11/07

Today marks one week since Coleman had his first stroke event.  He's been in the Neurological ICU the entire time.  During this time, he's had mechanical help breathing.  He's been made paralyzed by both the doctors and his two stroke events.  He's had a large part of his skull removed to allow his enlarged brain to expand.  His Intercranial Pressure (ICP) is at 15 and was as low as 10 last night.  Oxygen levels were good last night, but he needed more this morning.  The puffiness around his right eye has gone down some.  I've never looked so forward to getting out of the intensive care unit and into a regular care hospital set up. 

The doctors are going to try for a 16 hr. warm up. They will be removing the paralytic and adjusting some drugs.  Since this process started, his face is looking a lot better than yesterday.  

Monday, November 6, 2023

Coleman's Journey 11/06

Chest x-ray similar to the last one.  No pneumonia.  CT scan this morning showed no change (e.g., no additional hemorrhage).  Blood pressure was a little high today and was addressed with medication.  Coleman's ICP was up a bit this morning and then was able to be lowered, thus no warm-up today.  Increased the oxygen that he was receiving.  Still using a breathing tube and a feed tube.  Not a whole lot of changes to report today.

Sunday, November 5, 2023

Coleman's Journey 11/05

They still have Coleman cooled down to 33 Celsius. His ICP dropped down to 14 last night and stayed there. They have him sedated to the point where he doesn't need the restraints, because he's not going anywhere. Waiting for the doctors to show up to discuss next steps.

The unit Dr was in. Still waiting for the neuro surgeon. D and I had to leave the room. Order of the day seems to be stay the course.

During the second half of the Vikings / Falcons game, the neuro ICU has decided to wait until tomorrow morning to warm up Coleman very slowly, but still monitoring its effect on his ICP. 

Coleman's Journey 10/31

On Halloween, Coleman proposed marriage to his girlfriend at about noon down in front of Minnehaha Falls.

An hour later as he was driving the two of them to eat, his left arm started to go limp. He pulled the car to the side of the road. His fiancée Sophia immediately called 911. Coleman was brought immediately to Abbott Northwestern.

She accepted.

Saturday, November 4, 2023

Coleman's Journey 11/04

Coleman is still sedated. His InterCranial Pressure (ICP) and temperature are both elevated. If his ICP goes up another notch or 2, they may have to put him in a medically induced coma. 

The neuro surgeon said this morning that the surgery done yesterday looks like it had done exactly what it was supposed to do (e.g., give his brain more time to clot around the bleed (of which there has been little to none) so that their wouldn't be more when removing part of the skull. 

His ICP this hour went up and then down one. If that happens again in the next hour... See the previous comment. Well, this afternoon, the ICP hasn't been coming down. They will be increasing his level of paralysis induced to reduce the metabolism of his brain. 

After review of recent CT scans, it looks as though the left side of his body won't be coming back. But someone so young has a greater degree of plasticity, nerves rebuilding themselves. 

They have a pair of soft restraints on his wrists in case he pops up from sedation and goes after the right side of his his scalp where there is no bone. 

Since his brain is irritated, he's running hot and feverish for which they might use a cooling blanket. They are cooling him down to 91.4

They just imposed red light environment restrictions, meaning no stimulus or visitors. 

Coleman's Journey 11/03

Last night, Coleman had a second stroke event which wiped out all attempts to reduce inflammation from the first . At this point, after reviewing the progression of CT scans, it was determined that the pressure was high enough to open a part of his skull.
It's about 12:30pm and Coleman just came out of surgery, back to the neuro ICU at Abbott Northwestern hospital. Immediately after removing a sizable piece of his skull, his brain escaped the pressured confines of his head, to fill the space. The piece of skull will be put back in about 6 to 12 weeks. 

He's sporting a fresh partial hair cut. He's ventilated and sedated for at least the next day or two. The breathing tube will be added along with the feeding tube.  While he has these tubes in, he won't be talking.