What started as something relatively simple, and I say relatively because the hospital is never simple, became complicated Sunday night. We checked into the hospital, Sunday, for a fairly routine treatment of IV antibiotics. The bacteria in her bladder, causing a new urinary tract infection was not sensitive to our normal arsenal of medicine, we did this same thing about a 1 1/2 years ago with success.
That night, right as they were starting the IV, right after Marty had her usual night time meds, after I had gone home for the night, Marty had a major seizure. Marty's has had seizures, but the last was in April of 2007 and were directly related to an asthma medicine Marty was taking and quit taking back then. She has had no apparent seizure activity since then and taking her off the seizure meds really helped her overall recovery as these meds tend to have some debilitating cognitive effects on her.
Nikki was here with Marty when she had the seizure and immediately called the nurse and they immediately responded with their rapid response team and made sure Marty was not in danger. The staff, Nikkie, all did a great job. When I got there Marty was just starting to recover from the seizure, these electronic assaults on your brain require recovery time. As Marty began to regain her bearings she knew Nikki, she knew me and was oriented at least to place, she did complain about her arm burning. She kept saying, "My arm, my arm, my arm", and could not really move her arm. We figured the IV was burning, the medicine was burning, and the seizure was limiting her ability to move it. I left the hospital for a little sleep when it was clear Marty was stable and safe.
When I came back in Monday a.m. Marty had not slept well and was complaining about her arm. Keep in mind Marty does not complain, if she says it hurts, it hurts; and she said it hurt. I looked at the arm and the shoulder was starting to swell and I called the nurse, who called Great and Wise (who has been very great and wise throughout all of this), who ordered an x-ray.
This is the only complaint I have of the hospital stay. The x-ray was ordered at 10 a.m... It was finally done at 5:15 p.m... ; Much too long. They came up twice to get Marty in a wheel chair but she was in pain and medicated with both pain meds and Ativan to ward off any more seizures and was not wheel chair capable. We sent them back twice for a gurney and twice they never returned. Our nurse kept calling, I kept harping and began to get very frustrated as Marty's shoulder continued to swell and bruise. It was clear something was wrong.
Great and Wise came in right after the x-ray was finally done, in Marty's room. We talked about the UTI, blood test results and then he went to check on the shoulder x-ray. I knew when he came back the news wasn't good. I had thought the shoulder was separated, it was a compound fracture, the ball on the top part of the humerus, the large arm bone, had broken off Marty's arm. Apparently, during Marty's seizure she had broken her strong arm, the arm she uses to eat, to play the piano, to drink, to take her meds, to support herself in her wheelchair, to help us help her stand. I know the color must have drained from my face when I heard his words. It sure felt like it.
"What does this mean", I kind of stammered. "Surgery", G & W replied. I went pale again.
Marty and I have often talked about what we needed to do for her in the event new problems arose. She has been very clear, no surgery, she did not want the anesthesia, she did not want another tube in her throat, she did not want to face another recovery. All I saw was she could not move her arm without a lot of pain. It was devastating news and I was immediately taken back to five years ago and all of the false choices we had to face then, do you want it to suck big or bigger?
Marty seemed to get sicker Monday and Tuesday. Great and Wise had already requested another culture on the urine and sure enough we found another bug, not sensitive to the Azactam we were using, but another antibiotic we had used before, he called at 10 p.m. Tuesday night to add the new antibiotic. Wednesday, yesterday, Marty started getting better.
We have talked to an orthopedic surgeon several times over the last couple of days. He said Marty's bones are really older than her age because of the medications she has taken and just the general assault on her body; which explains why the bone broke under the tremendous pressure from the seizure. Her bone density, or lack thereof, really complicated any potential repair and in all likelihood the only surgical option would be to completely replace the shoulder. The other option, do nothing.
The short summary, (I know, I already went past short) we have decided, after talking with our kids, after talking with Marty, after visiting with friends, after visiting with doctors, the surgery is just not worth the risk. Marty is a very high risk surgical candidate and the potential gains from surgery are just not worth the risk; it's just too much to ask of her. We are going to let the arm heal. We are going to work really hard, after it has healed to get Marty back to the point she can fully participate in her care the same way she does today. It's an unknown, but we can handle it, until then Dilaudid is her friend.
As of this writing we are still in the hospital but we have made good strides in dealing with the infection that brought us to the hospital. Marty's white count is much improved as is her sodium, both very positive signs. She needs a little more antibiotic and we are awaiting the results from the EEG to discover next steps regarding seizures. I guess we are starting another new normal.
Good thoughts and prayers are always appreciated.