April 27 update. This is me reporting to a doctor who asks me questions which show that she knows a lot more about medicine than I do 18:40 Hai inviato Intensive care attending (primaria) says intensive care no longer really needed. DR who knows more than me: What is her heart rate Me:Fever down to 37.5 central (so according to (other doctor we both know) not a real fever). Sometime they switched antibiotics. DR: Sister says patient follows commands per neurosurgeon what does melia say Me: When reasting 120 maybe 130. Steady except sometimes she moves around (as if seeking comfortable position) and it goes up. Old unexplained tachycardia (days ago) no longer happening (see update below) DR: Why is it high now Hai inviato Melia said she does not follow instructions. My effort was blink and tell her to blink and she blinked. Seems way more alert and eye tracking me. Likes to hold hand Hai inviato You asked why pulse so high (120). I guess often lower. I just saw “not tachycardia” DR: Does patient sqeze hand when you ask her to Hai inviato Always squeezes. I didn’t ask to release. dr: Eye tracking for sure? Hai inviato Yes odd sister and brain surgeon both quite definite that patient has followed instructions. IC attending has other view DR: Ask her to release If your still there (with patient) Hai inviato Eye tracking for sure. Assessment by IC attending not just my impression. Hai inviato I am out now (not with patient) Hai inviato Will try that tomorrow CR: Or next time DR: Who visited today you and boyfriend? Hai inviato Impression totally totally different from on April 25 (already different yesterday, but I didn’t see patient) Hai inviato Visits sister and mostly me Dr: In what way? Hai inviato Eye now tracking, seems awake, I think I got a smile. Then semi conscious. Now seems conscious, weak, and very very taciturn (as in no effort to speak) Hai inviato Left eye still always closed to mostly closed. Eyes not pointing same direction, left eye moves less (fits ocular motor nerve trouble). Does move same direction. DR: What does she do when you let go of her hand? Hai inviato Reaches around for my hand. For days, if I try to sneak it away m, patient grabs. Definitely responds in reasonable way as if patient wants my hand which is trying to get away Her hand Seems very alert (this also back before eye tracked well) DR: Thanks Carol For update Boyfriend notes that on April 26, heart beat when sleeping 75-80. The 120 today is awake moving and a bit agitated One thing we learn is that dialogue on messenger is not normal back and forth. Often I write, then dr asks question, then I write another thing, then I get to answering the question. It might be hard to follow, but I hope it is somewhat useful

Comments

Post a Comment

Popular posts from this blog

Image
Here is the referto of the MRI. See the key point is that there is contusion but not detectable ischemia (suspected some small areas of ischemia somewhere). The effects should be temporary. Also Dr Veneziani says the bruised area has no known function -- when it is removed to remove a tumor, there are no known effects. So very good my effort to translate Exam rquested and executed in basal conditions with sequence t1,t2,presente, flair, GRE T2 amd with sequences weighed in diffusion according to axial, sagitale and coronal axes and with an axial sequence aiming in correspondende to the “tratto di rachide” C-4-C6 Extensive craniotomy temporal and fronto- parietal on the left. A collection of extracerebrale fluid collected near the surgical breach of maximum thickness of 18mm. Frontal and temporal bilaterally (walways more evident on the left, there is an extensive area of hyperintensity in the FLAIR and T2 sequences with some characteristics also of a hypointense component i
Read more
Very late update (sorry). Patient had successful surgerty to stabilize the neck. There had been hope that the broken C5 vertebra would just heal, but now it is fixed also using a bit of bone from the right hip. recovery from surgery fine (limp over). Brain issues seem almost resolved. Verbal problem of confidently using the wrong word (eg "ice" for "water") almost over, especially when rested. Behavioral problem of renewed immaturity definitely over. Patient has become a patient and prudent adult again (this time growing up took weeks not decades -- it was surreal). The titanium plate has still not been inserted (last delay because of a fever due to a urinary tract infection cured with 3 days of IV antibiotic). Patient Verrry bored with hospital. ALso afraid of the operation (as is normal). Decision on whether to insert it next week is imminent (there will be a third MRI and if it looks like the second or better, the plate goes in).
Read more
the Titanium plate has been inserted. Patient awake and said high. Head normally shaped (under bandages). They are doing a CT scan (TAC).
Read more