Sunday, June 21, 2009

Happy stories!

It's not all sadness in the PICU, thankfully!  There are some happy stories.  I'd like to share a few.

JS was a teenage boy who had just gotten a new motorcycle and went out for a joy ride.  He was wearing a helmet, but unfortunately the front piece was not attached... and JS ran into a pole.  Yikes!!  He lost consciousness, and basically his face took the majority of the trauma.  He had multiple facial fractures, including his eye socket, jaw, and skull.  He had massive bleeding in his head, mostly in the frontal lobe (the area of your brain responsible for executive function, making decisions, social inhibition, and long-term memory).  He was aggressive at the scene, requiring sedation and intubation.  He had a number of invasive surgeries and was on the vent for a week.  We weren't sure if he would wake up when we took away the sedatives, and if he did wake up we weren't sure if he'd be the same person.  Well, a week after he came in, we turned off the sedative drips.  Within hours, JS woke up and was looking at his family and squeezing his sister's hand.  Now he's making huge leaps in recovery, already up and walking.  Amazing!

DG was another teenage boy who was hanging out with his cousin, who was cleaning his gun... which was loaded, by the way.  Next thing you know, his cousin accidentally fired the gun and shot DG in the head.  He lost consciousness and had severe intracranial bleeding.  The CT of his head looked crazy - almost his entire right side was destroyed by the bullet.  He went to the OR on his first day of hospitalization to get a decompressive craniectomy.  Basically what they did was take out part of his skull to give his brain room to swell.  He was on heavy duty meds and was on the vent for a week before he was ready to extubate.  We lightened the sedation in anticipation of pulling his breathing tube, and guess what - he woke up!  He opened his eyes, gave a thumbs up, held his dad's hand... incredible!!  He is still in the PICU, but making significant progress.  Praise God!

Finally, DE was yet another teenage boy (these crazy teenagers!!) who was out at the river having fun with his friends.  Like any fun-loving high school guy, he decided it would be fun to jump off a tree branch into the river.  The problem was, as he was getting ready to jump, the branch broke... and he fell into the river at an awkward angle, landing on his neck.  He injured his spinal cord, fracturing his C5-C7 vertebrae.  He didn't lose consciousness, but on impact had loss of sensation from the waist down.  He came into the PICU and was started on a protocol for medical management of spinal injuries.  He got IV steroids and a vasoactive medicine to keep his blood pressure high (with the idea of increasing blood flow to his spinal cord).  There was nothing surgical that could be done.  He has now been in the PICU for over a week, and is starting to have a tingling sensation in his legs.  And this morning, I swear he could tell which foot I was touching.  I'm not sure how much function he'll re-gain, but I am extremely hopeful and I've been praying for him.  The happy part in his case is that he's still here!  He could've died from that injury.  He's such a sweet kid, too.  He is taking it all in stride.

So, there are a few happy stories from the PICU after all the sadness.  Yay!

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