Diary of Mary's condition
Last updated Jan 25 2000
September, 1999
Mary was taken to Los Alamos Medical Center, stabilized, and
then transferred to the Trauma/Surgical ICU (TSI) at the University
Medical Center in Albuquerque. Her legs were operated on by the resident
orthopedic surgeons several days after the crash, her arm was
operated on the next Tuesday, the 28th. The second operation was
postponed because of a low platelet count which the doctors were
concerned would cause problems during the surgery. Mary was placed
on the ventilator sometime around the first surgery. Our contacts
at Vencor indicated that all of the information they had about why
Mary was placed on the ventilator was because of "respiratory failure"
during the first surgery.
Mary received an MRI 72 hours after the crash. I have
conflicting reports about whether the MRI was standard procedure or whether
the neurosurgeons suspected a spinal problem (she received a spinal CAT
scan shortly after she came in, apparently the results didn't satisfy
the doctors).
It turns out the MRI showed that she was incredibly lucky. Mary
had a "occipital joint dislocation", which means that her skull was
separated from her spine. The only physical manifestation of this
was the non-tracking of her right eye, which I think the neuro staff assumed
was from a small non-life threatening hematoma seen in the CAT scan.
It turns out instead that her optic nerve had been pinched when her skull
dislocated. We were told that this sort of dislocation results in instant
death when the spinal cord is pulled. If this doesn't happen in the
initial crash, it can also happen during extraction and transport,
unless the EMTs/paramedics are extremely careful in stabilizing the
cervical spine and skull. They apparently were exceedingly careful. The
doctors noted that they have only once before seen such a dislocation
on a living patient. To correct and stabilize the injury, Mary's
first 4 cervical vertebrae were fused to her skull with metal rods and
bone chips from her hip. This surgery was completed on September 29th.
She's presently wearing a cervical collar and a "Minerva" brace to
stabilize her spine, and the doctors have been able to sit her
into a more upright position, which helps in managing her pneumonia.
Now that Mary's surgeries are over and she is slowly starting to
improve, the doctors have been more forthright in admitting how dire her
condition really was.
Oct 5, 1999
Mary is still in TSI. she's continuing
to be mechanically ventilated via a tracheotomy (exo)tube, and fighting a
case of pneumonia from the bed rest and the trachea tube, which was
removed on the 4th. Because of the tubes and the pain killers,
she had not been able to communicate with us since a few days after the
crash. Now that the trachea tube has been removed, she should soon
be able to speak again. The mechanical ventilator will continue to be used
until Mary can tolerate less pain medication (it depresses her
breathing). She's apparently still in quite a bit of pain. Stacey,
and her sister Sonya, are in Albuquerque now, visiting Mary every day.
Oct 18, 1999
I need to recheck the dates, but I THINK that Mary was transferred
to Vencor (on High street) hospital on the 11th. On the weekend before
her transfer, the TSI staff actually had her off of the ventilator
for 7 1/2 hours. Shortly after her arrival at Vencor, a doppler
ultrasound indicated that she had a large clot in her left leg. She
was placed on Heparin to reduce the clot, then over the weekend she
developed a large hematoma in her right arm (the ultrasound was
done Monday - somewhat serendipitously, they were more concerned
with checking her internal organs - which turned out OK. Her liver,
gall bladder, spleen and kidneys are all apparently fine). She
was sent to St. Joseph's across the street where the hematoma was
drained by a Dr. Welch.. She was taken off of the Heparin and a block
was placed in a vein in her left leg to keep the clot contained.
Oct 22, 1999
Ventilator settings on the 21st were 10 assists, %O2 35. Today the
settings are 6 assists, %O2 40. Tidal volume is up. The splint on
her right arm is off, and one eye is patched to keep her from seeing
double. I didn't hear WHICH eye was patched. I assume the right.
Stacey managed an alphabet communication with Mary, her first
question (paraphrased) was "Where are you staying?" (!).
Monday Oct 25, 1999
Not a good day. Vent numbers are up to 12 assists, 60% O2. They
are having to suction her quite frequently, and there is blood in her
sputum. The nurses indicated that the blood is the result of
irritation from the frequent suctionings. Note: I think at this point
she was on the "pressure limited" ventilator that doctor Maple
ordered to manage the beginning stages of respiratory distress (ARDS). They
didn't tell Stacey about this condition until Wednesday.
More information about ARDS
The ARDS Support Center
Oct 26, 1999
She's more sedated today, and pneumonia is coming back. Temperature is
102. She appears to be having some trouble digesting food. The extra
sedation is apparently to keep her from coughing. The vent is set
to 12 assisted breaths, 70% O2. She's only breathing 12 as well (she
was doing 30 last week). No word on her tidal volume. Her right foot
is getting quite stiff.
Oct 27, 1999
Mary is in very dire condition today. She apparently has a condition
called ARDS, which is an acronym for Acute Respiratory
Disress. It's a post traumatic condition. The doctors are having
a very hard time getting her adequate oxygen. Stacey has cancelled
her trip to Tucson, and Sonya is heading back to Albuquerque. I'll
be back in Albuquerque on the 28th. We're
all of course hoping for the best, but we have to be prepared for the worst.
Oct 31, 1999
Mary died today, from respiratory distress precipitated by
the trauma and subsequent complications. On Saturday the doctors gave
Mary less than a 10% chance for survival. A blood sample taken in the
early morning indicated that Mary's blood oxygenation was 49% and
her pupils were fixed and dilated. Her heart stopped a little after
noon. Stacey and Sonya, along
with other family and friends were there at the end. I of course can
not describe the pain and anguish experienced by all of us as she slipped
away. The only consolation is that we all got a chance to tell her how much
we loved her before she died.
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