I have mentioned before that Crystal (Tim's sister) was in the hospital. I have been sending out updates as to her condition. I figure the easiest way to share the story is to copy my emails and you can read the story as we saw it unfold. And as it continues to unfold. Here are the first 6 updates!
Mon 12/08/08 8:13 PM
Hi all~
We just got a call from a family friend that Tim's sister is in the hospital in Lewiston, ID. We are on our way to go and see her. She is having emergency surgery on a cyst in her spinal cord as I type. I am bringing my laptop with me in hopes the hospital has wifi. I will update as I can. Send a prayer up.
Tue 12/09/08 12:35 AM
Hi all~
I wanted to give everyone an update as I got information about Crystal. So here is the first update:
Crystal had been having migraines and neck pain for a few days prior to today. She went to the ER and they treated her symptoms. Last night at 3am she lost feeling and use of her arms and legs. Her boyfriend Scott called for an ambulance. When she arrived at the hospital she could not move her arms or legs at all nor did she have feeling in them. The local hospital did a CAT scan and found fluid in and around her neck and upper spine. She was sent to Lewiston to the hospital (I think they specialize in spinal and brain injuries). Once in Lewsiton the Dr. diagnosed her with an abcess/infection in her spinal cord and decided they would do surgery to clean the area. They made an incision 4-6 inches long in her neck and down her spine. They drained the abcess of pus and fluid and cleaned the area. They removed some bone and tissue as well as fuse a few vertebrae together.
They will be culturing the infection to determine what the infection as or came from. She is also being treated with a high doses of a very wide spectrum antibiotic. The Dr thinks they will be some permanent nerve damage. The nerve damage was caused by the abcess cutting off blood and oxygen supply to the nerve endings in the spinal cord. She may or may not recover from that damage.
Currently Crystal is resting. She does not want to be alone so Tim and Scott (her boyfriend) and I will be taking turns sitting with her. She is on pain meds, but still is awake and comes in and out quite easily. She really is frightened and is fighting sleep. She can at this point feel her hands and she even squeezed my fingers. The nurse said she also can move her feet a bit.
In the coming days she is at risk of:
* The infection coming back ~but they are treating this with antibiotics already
* Bleeding at the surgery sight. Blood loss at the spinal cord are is dangerous (that is hat the nurse said. I am not sure why it is dangerous. I will find out)
* As the tissues around the surgery site swell she may loss feeling again and it may or may not come back.
* The next 48 hrs will be telling on how she will recover. The nurse said "she is not out of the woods yet"
Long term
* The drs and nurses are hopeful that she will recover, but none of them has said she will be 100%. All have stated she has a LLLOOOONNNGGGG recovery ahead of her.
Tim and I plan to stay long enough to speak to the Dr before going home tomorrow. The Dr will be rounding at some point tomorrow between his surgery schedule and such. I have started a list of questions for the Dr. If you want me to ask him anything or you can think of something I should ask, please text it to me or call and leave it on my voicemail. I carry my cell with me everywhere, but not sure if I will have time to log back on tomorrow very often. The hospital has set us up with a hotel room across the street at no charge. So we will be staying there, that is if we actually get any sleep tonight.
Thank you to my Mom, Dave and Mandie for taking on my kids on such short notice. Thanks to Clare and Dale for offering us a place to stay in Moscow. Thanks to Roselyn for taking care of my cats and mail while we are gone.
Thank you to Vanesaa and Sara for calling to check on us and giving us words of encouragement. It is awesome to have such wonderful family and friends to lean on in time of crisis. Send a prayer up for Crystal to not have any bleeding and minimal swelling at her incision site. Also pray that the antibiotics work to kill the infection. And send a huge prayer up that Crystal will heal from all her nerve damage and will be whole again. Crystal has 3 girls at home. Ashley Melody and Hanna. Pray for the girls as they go through this huge period of adjustment. Thank you all so much and I will update as I can.
Tue 12/09/08 8:33 AM
Hi all~
We arrived at the hospital this morning and Crystal did fine overnight. Her muscle tone and sensation in her arms and legs is the same as it was last night. The nurse did express some concern about her breathing. Apparently she is having trouble expelling CO2. They have started some breathing treatments and will also be adding a machine that vibrates her chest (can't remember what it is called) to help keep her lungs clear. Overall Crystal seems a bit worse for wear than yesterday. She is not quite as alert and her speech is more slurred. We expected that to happen just because the day after a surgery is often the hardest day. The nurse was glad to see her feeling and muscle tone stay the same. I am sure over the next few days we will know more. The nurse also said that the Dr. may be up this morning. The nurses last night said he might not be here till this afternoon. I will let you know more as soon as I speak to him.
I also wanted to mention the clinical name for what Crystal has, in case anyone out there wants to Google it. She has an Epidural Abcess Infection. Here is a site that explains it a bit better than I could: http://www.emedicine.com/EMERG/topic168.htm
Thanks for your continued prayers!
Tue 12/09/08 2:53 PM
Hi all~
I was able to speak to the Dr that did Crystal's surgery a few minutes ago. Please forgive me if this is kinda jumbled around. I am very tired. But I did takes notes so hopefully I won't forget anything.
The Dr thinks that the Infection originated from either an infected spider bite, an infected Burn, or an abcess she had on her tooth. She complained of all 3 of these things within the last few weeks. Once the infection got into her blood stream from one or more of those initial infections it settled in the muscle of her neck. Then it worked itself into the epidural space of her spinal cord. They are culturing the bacteria from the infection as well as blood, urine and fluid from her lungs. The cultures will take 1-2 days to come back. Once they determine the specific infections or infections they will be putting her on a specific antibiotic to fight that specific infection. At this point she is one a wide spectrum antibiotic that covers lots of different bugs. They suspect it is staph, but have to confirm that with the cultures.
They are concerned about her breathing. She is retaining fluid in one of her lungs and the concern is that she will develop or already has developed pneumonia (I probably spelled that wrong). They are giving her breathing treatments, as well as breathing exercises to help her move the air better in her lungs. The reason she is having such trouble is that the infection has caused some nerve damage to the nerves that signal the muscles in her chest to help her breathing (I think he said they were called intercostal muscles) At any rate they are not working properly and so she is having difficulty breathing effectively and expanding her lungs fully. In addition to the breathing treatments they are also using a percussion device to help loosen the fluid in her lungs. She is also having her lungs suctioned every 4 hrs. And as I left her room the nurse was trying to find a special bed that vibrates to help loosen the fluid in her lungs as well. If they are unable to get the breathing improved then she will be placed on a ventilator to breath for her.
I misspoke before when I said they removed bone from her spine. They did not. Her neck is stable in that the bone structure is fine at this point. The infection is just in the epidural space and the surround muscle tissue at this point. The major issue with the spine is the loss of blood supply. As the spine swells due to the infection it can constrict the blood vessels supplying blood to the spinal cord and nerves. Without a blood supply the nerve can die or be damaged. The dr wanted to stress to us that even though the infection is getting better the inflammation may cause more nerve damage during the healing process. She is not out of the woods.
Tomorrow they will start physical therapy as well as Occupational therapy and get her more mobile. But the nurse says it will be more just moving her around in bed since she cannot walk or even sit up on her own. She does have increase feeling in her whole body. That is an improvement from last night and even this morning. The Dr was happy about that but said that if the inflammation increases she may lose some of that again. It may or may not return. He is also worried about her left leg. It seems to be the weakest of all her extremities.
Keep praying for her. Also Diane's flight has been delayed by 2 hrs. So that puts us home later than we had planned. For right now I am going back to the housing facility and taking a nap. The ICU nurses have kicked everyone out of Crystal's room for the next few hours so she can sleep. So we are all gonna try to get some sleep as well. The nurses have my phone number if something comes up with Crystal. I am only 5 minutes away. That is all for now. Love ya~ Jen
Tue 12/09/08 8:10 PM
Hi all~
It is me again. Here to update you again on Crystal. Her Mom arrived finally after a delayed flight. But she is here now and is getting settled into the housing facility. She has had visitors coming and going all day.
I checked in with the Dr. and the nurses around 6:30ish. The Dr is still mostly concerned that she is not moving air well and retaining too much co2. Crystal is on a special percussion bed that moves her around from side to side and helps loosen the mucous in her lungs. They are still suctioning her every 4 hrs or more. She is in quite a bit of pain and the percussion bed is quite painful for her. Every 2 hrs they come in and turn the bed on Percussion mode and it shakes her around for about 10minutes. It is VERY Painful. We have requested that they coincide the percussion treatments with a dose of pain meds.
Tim and I are planning to go home in an hour or less (hopefully). I have the direct line to the nurses station and will be calling in a few times a day to get updates from the nurses as well as Diane. I will pass the info on to you as I get it. There is other family that will be checking in on Crystal over the next few days. Tim & I will come back over the weekend as long as Crystal's condition continues to improve. If something comes up we may be back sooner.
I spoke with Ryan today and he has all 3 girls with him. He will keep them at his home until Crystal is better. The girls are doing well. They do know what is going on with Crystal. They want to speak to her and see her. Crystal and Ryan spoke today about a plan for that to happen. I don't know what it entails for sure, but I know that the girls best interests are being taken onto consideration. I applaud Crystal and Ryan for their parenting skills and ability to work together despite their recent divorce and the current set of circumstances.
Alrighty. I am gonna get off here and try to make our way back top Spokane. I will send out another update in the morning. Love you~Jen
Wed 12/10/08 1:10 PM
Hi all~
I called the Hospital a few minuted ago and got an update from Crystal's nurse. The cultures from her abcess came back. The bacteria is MRSA. Google MRSA if you don't know what it is. My short version is MRSA is a penicillin resistant strain of Staph infection. Yeah. YIKES. Crystal is currently on 4 different antibiotics to try to fight the MRSA. Because of the contagious nature of MRSA she is also in isolation now. Anyone going into her room must gown up and wear gloves. Visitors are limited.
Her breathing continues to be a concern. She does have pneumonia in her right lower lobe of her lung. The 2 factors contributing to this infection are nerve damage that tells her innercostals to breathe and her diaphragm to cough. Because of this nerve damage the muscles (innercostals) that help her lungs expand fully are not working effectively. Due to her lung not expanding fluid and mucous is building up in her lung creating a moist wet place for pneumonia to grow. Coupled with her diaphragm not effectively working to help her cough up the mucous and fluid she has developed pneumonia. The Nurse mentioned (again) that they may but her on a ventilator to help her exchanges gases more effectively while they treat the pneumonia. We are still waiting to hear what the Drs order on that.
Her feeling and sensation is still about the same. She is still able to move her hands and her rt leg but her left leg is still not moving at all. This is a concern. The Nurse felt that the left leg and the lung issues may be related to the same nerve path. He mentioned she may or may not get the function back in these 2 areas fully.
Please continue to pray and send up good thoughts for Crystal, her girls and the rest of our loved ones as we watch her journey through this illness.
Wed 12/10/08 7:13 PM
Hi all~
I just called an talked to the nurse again that is caring for Crystal. I got a bit more information. Since Crystal has been in St. Joes she has had a tube going through her nasal passage and into her stomach. I understood that it was to suction the fluids and acids out of her stomach. While that is correct, the reason why they need to remove the stomach fluids is because she has no bowel tones. Her bowel and bladder are effected by the paralysis. It is unknown whether that will improve.
Her movement and sensation has not changed from what I reported earlier. She is still having breathing difficulties. She is now on Bipap. The Bipap helps her exchange gases more easily. Read this link for more info on bipap: http://www.wisegeek.com/what-is-bipap.htm The nurse said they are trying the Bipap to see if they can avoid the ventilator. The nurse also said she seems a bit more sleepy today. And she is still running a fever.
Pray that the antibiotics they are using will fight the MRSA and that she will get some reduction in swelling in her abcess. She needs the swelling to be reduced so that no more nerve damage is done to her spinal cord and hopefully she will begin to get movement and function back to her body.
I will update again in the morning.
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