Home Finally 4-22-09

Yeah! we are home finally ( hope it's for good) . There is no better place like home. We finally have a good night sleep since our stayed in the hospital. We just have to get his blood check every other day to make sure INR is on the right therapeutic level . Today , INR is only 1.6 it means the blood is a little thicker. We are hoping it should go back to 2 thru 3.




Best Regards!

It was a tease! Another set back- blood clot

I was glad that we are home last April 15 but at the same time a little nervous . I left him in care of his uncle David and I went to town to get his prescription filled . My phone rings within 2 miles from home and he sound so distressed. Man! scared the heck out of me....
He thinks he had asthma attack. I then gave him Pro Air to help him breath easier. I look at him and he just look so sick. Cold hand, sweating and trying to catch the next breath. Few minutes pass by and he said he's feeling a little bit better. He doesn't sound convincing at all. So, I just observed him.

The following day, his sister Becky called the doctors in UNC to obtain a oxygen prescription. Nurse called back and we are told to go back to ER. That conversation ended so quickly. He does not want to sit in ER . So, I tried to call back again . Doctors Marshall quickly return my phone call and we got the same answer " go to the ER " His reason was " it might not be an asthma, it could be something else and that he needs to be seen by a doctor". I called his primary physician office and I was only given 1o minutes to take him in. Wewwww... I knew I couldn't make it but I took him anyway. At least we are there and they couldn't deny treatment.

It was probably a good wait until we are called in. The nurse was so helpful and took him immediately to the room. I answered the rest of the assessment. Dr. Tyler recognize me immediately. ( wow! that was almost 10 years ago ) I told him about hubby. In a few minutes he was in the room with us. Trying to diffuse the intensity of seriousness , he tried to be funny.
Took x-ray and vital signs. Oxygen saturation is only 87 at room air. That was way too low . He immediately told us to head to UNC ER .

After 8 hours of test and assessment. We are told he had a blood clot in his lung. The good news is it's away from the main artery. They immediately started him on large dose of heparin , anti-biotics and IV fluid. I was tired and sleepless . I couldn't believed I survived 19 days and it's not over yet. I have another 4 months to hurdle. Hopefully, it's getting easier day by day.

He is currently resting in bed at this time watching MASH while I am typing away this blog.


Respectfully yours,

Finally going home.....

He woke me up before seven . He look like he had really a good night sleep last night inspite of the pain from the 3rd JP drain site. It was place in a location where there is a lot of nerve endings and really hurt when he move around. He was on morphine last night every 2 hours and oral pain medicine every 4 hours. Victoria was our nurse last night and she is really awesome and caring . She make sure he is comfortable and brings the medicine on time. I applaud people who is in this kind of proffession.

The team of Trauma doctors ( Interns of course!) came in this morning right after I got out of bed. I was really speechless when Dr Kuri said we are going home today April 15, 2009 . Although, the white blood count is at 17 but there is really no reason why we can't go home. Hubby did not even show a slight protest that he is not comfortable yet of going home. Ok, but what about the pain? Hello? I couldn't process my question fast enough to ask the Dr's . I just stood there half awake and said " ok, thank you! " Damn! we can't get access to morphine ... Well he might just have to get used to oral meds.

It's 9:15 am and we are waiting for the 1st JP drain removal. Ouch! that sound aweee! but Dr. Kuri assured him it's a whole lot easier removing the tube than putting it in . At least it's a little comforting ....

We received a few cards from friends and family. Mr. Mann, Shawn and his Family and DA's office. Thank you guys for remembering him in time like this.

Jackson Pratt Drain Care 101

I have been referring so much of this term " JP or Jackson Pratt " in my blog. The following information should help me and my family care for him. He have 3 JP's. One in the middle ( for the incession) 2nd is in the left upper thigh and 3rd is on the upper right buttocks.


So , what is JP? or Jackson Pratt drain?

A Jackson Pratt drain, or JP drain, is used to remove fluids that build up in areas of your body. Unwanted fluid can collect in areas of infection, areas where surgery has been done, or in other body areas. The JP drain is made up of a thin rubber tube and a soft round squeeze bulb. One end of the rubber tube is placed in the area where body fluids may build up. The other end sticks out of your body through a small incision (cut), and is connected to the squeeze bulb.

How does a Jackson Pratt drain work?

The JP drain removes fluids by creating suction (pulling) in the tube. To produce suction, the bulb is pressed flat and is connected to the tube sticking out of your body. Suction is created as the bulb sucks in air from the tube going into your body. This pulls fluid out from the area where the drain was placed and into the rubber tubing. The fluid then travels through the tubing and into the bulb of the JP drain. As the JP drain bulb fills with fluid, it goes back to its round shape.

Why do I need a Jackson Pratt drain?

When fluid builds up in a body area, the area may not heal as fast as it should, or an infection may start. Too much fluid in a body area may also cause pain and swelling. Using a JP drain after surgery may help you heal faster and decrease your risk of getting an infection. The JP drain also helps clear away pus and may help infections heal faster. A JP drain may be used after surgery on your spine to check if spinal fluid is leaking, and collect it. JP drains may also be used after skin flap surgery and skin grafting.

When is a Jackson Pratt drain removed?

The amount of fluid that comes out of the surgery or wound area and into the JP drain will decrease as the area heals. In most cases, the drain will need to stay in place until less than 30 milliliters (about two tablespoons) of fluid are draining from it in a day. Your caregiver will keep track of how much fluid is draining into the JP drain, and he will tell you when the drain will be taken out. If you are caring for your JP drain at home, you will need to keep track of the amount of fluid that you are emptying from the drain.

What are the risks of having a Jackson Pratt drain?

If a JP drain is not taken care of correctly, it may allow germs to enter your body and cause an infection. If the drain is placed after certain types of surgery, you may get an infection if it stays in your body longer than it is needed. If you get an infection, you may have more pain and swelling, and your wound will heal more slowly, or it may not heal at all. The end of the tubing inside your body may get blocked with blood or other materials. If this happens, the bulb cannot correctly suction fluids. You may develop a fistula (unwanted tunnel), or the drain may make a hole in your intestine. If you have a drain after skin flap or skin graft surgery, the tissue may not heal.

How do I take care of the skin around my Jackson Pratt drain entry site?

Change bandages at the JP drain entry site every day to keep it clean and dry. Your caregiver will tell you if you need to do this more often. Collect the following items and place them where they can be reached easily:

• Two pairs of clean medical gloves.
  
• A clean container.
  
• 5 to 6 new cotton swabs.
  
• New gauze pads.
  
• Saline solution or soap and water.
  
• Plastic trash bag.
  
• Surgical tape.
  
• Waterproof pad or bath towel

Follow these steps to care for your skin around the JP drain entry site:

1. Wash your hands with soap and water. Dry your hands and put on clean gloves.
   
2. Loosen the tape and gently remove the old bandage. Throw the old bandage into a plastic trash bag.
   
3. Look for any new redness, swelling, or pus at the place where the drain enters your skin. Check for a foul (bad) smell coming from the area. Tell caregivers if you see any of these changes. Make sure the stitches that attach the JP drain to your skin are tight. Tell caregivers if they are loose or missing.
   
4. Place a waterproof pad or towel under the JP drain to soak up any spills.
   Pour a small amount of saline solution or clean water into a container. Dip a cotton swab in the solution once. Gently clean the skin around the drain, moving in circles. Start from the place where the drain enters your skin and clean outward in circles, moving away from the insertion site. Clean your skin 3 to 4 times, using a new swab each time.
   
5. Let the skin dry. Take your gloves off and put on a clean pair. When the area is dry, put a new bandage around the JP tube entry site. Use surgical tape to hold it down against your skin. Tape the tubing down to the bandages. Attach the bulb to your clothing using a safety pin.
   
6. Throw all used supplies in the trash bag along with your gloves. Wash your hands after you are finished.

When do I empty the Jackson Pratt drain?

For the first 24 hours (one day) after most types of surgery, there will often be drainage coming out of the wound. Check the drain at least every four hours. Empty it if it is half full of fluid. Do not let the drain fill up any more than half full. After one day, empty your JP drain when it fills up half way, or every 8 to 12 hours even if it is not half full. After the drain is emptied, the empty bulb needs to be squeezed. This is done to keep the suction of the JP drain strong enough to pull out more fluid.

How do I empty the Jackson Pratt drain?

• The following are general directions for emptying the JP drain bulb, and squeezing the bulb. Gather the following supplies, and place them where they can be easily reached:
  
• One pair of clean medical gloves.
  
• Clean measuring container.
  
• Cotton balls.
  
• Medical alcohol or alcohol swab.

Follow these steps to empty the JP drain:

• Wash your hands with soap and water. Dry your hands and put on clean gloves.
  
• Place a waterproof pad or towel under the JP drain to soak up any spills. Place the bulb lower than the wound to prevent fluid from going back into your body. Check the bulb for any holes or cracks.
  
• Remove the plug at one side of the bulb and pour the fluid into a measuring container. Do not touch the tip of the spout with the mouth of the collection cup or anything else. This keeps germs from getting inside the bulb and tubing. Clean the plug with a cotton ball dipped in alcohol, or an alcohol swab.
  
• Squeeze the bulb tightly while the plug is still off. Do not squeeze the bulb if the plug is in place. While the bulb is being squeezed, put the plug back to seal the bulb. If you cannot squeeze it and plug it at the same time, ask someone for help. You may also place the bulb on a hard surface, such as a table. Use your elbow or hand to press down hard on the bulb, and then stick the plug in it.
  
• Measure the amount of fluid that came out of the JP drain bulb. Write down the amount, color, and odor of the fluid, and the date and time that you collected it. Use a piece of paper, a notebook, or JP drainage chart to keep track of this information.
  
• Flush the fluid down the toilet. Throw all used supplies in the trash bag along with your gloves. Wash your hands after you are finished.
  

What can I do to prevent problems with my JP drain?

• Always keep the bulb lower than the wound. This will stop the fluid from going back into your body.
  
• Do not pull on the tubing. This can loosen the stitches holding the drain to your skin, causing the drain to fall out.
  

When should I call my caregiver? Call your caregiver if:

• The fluid removed by the JP drain is cloudy, yellow, or foul-smelling.
  
• You have more swelling or redness where the drain enters your skin.
  
• You feel more pain in the area of your drain.
  
• You see holes or cracks in the tubing or bulb of the drain, or the drain is leaking.
  
• When should I seek immediate help? Go to the nearest emergency room if:
  
• Liquid has suddenly stopped coming into the bulb of your JP drain.
  
• The JP drain starts filling up very quickly with bright red blood.
  
• The JP drain stitches come loose or break off.
  
• You have a fever (increased body temperature).

• Your bandages are soaked with blood.
  
• Your JP drain comes out.

source: http://www.drugs.com/cg/jackson-pratt-drain-care.html

Flower Girl

I love weddings. I even watch it a lot on TV from famous stars to Bridezella . This will be my 4th wedding that I will going to attend here in the US. It's so much different in US culture compared to Filipino tradition. A Filipino groom is mostly responsible for all financial aspect . At least that's how I had observed . Here in America , the brides parent is responsible for paying the reception . The most expensive part in a wedding.


Josh and his fiancee Elene are getting married in May. Josh is Isabel's first cousin . He is the son Becky and Don Trull. Becky is my husband's older sister.


Isabella is going to be one of the flower girl along with Kirsten. She is Isabel's 3 yeard old 2nd cousin. Yehahhh... I already bought a dress from http://www.cutieclothes.com/

So, I guess we are going shoe shopping when her Daddy felt better. For now, I will just look in the web.

( pictures: from cutieclothes.com)

Adding another JP - hubby's update

We woke up today with high hopes that we are heading home. But I guess not. He is been restless for staying in the hospital since last Thursday . It is better to stay here and they can take care of everything but on the other hand it is impossible to rest. So, we are both sleep drive specially him .

Doctors came in early with good and bad news . Their suspicion was correct. Based on the CT scan result, the first abscess shrunk but the second is not draining. So, he will have to undergo another 1 hours procedure where they can add another JP to drain the infection and it will be CT guided so they will not accidentally poked on anything important. ( cross my finger ! ) The good news, White blood cell count fall below and it means we will be out in here in a few days. There is also an infection in the incision but that can be taken care by oral anti-biotics ( I hope! ) We have been told since Saturday that we can go home but some things pop up that prevent doctors from sending us home. It's good in a way. I rather for them to take care of the infection rather than me panicking at home .


So, that's were we stand at this point. This coming Monday April 20th, I'm supposed to go back to work. I'm hoping I can really take a good rest . My kind of work is so demanding and entails attention to details. One wrong step is like a panic button ringing in every department.

I am currently waiting right now while blogging in Surgery waiting room. Someone will inform me if they are done. He went past 11:00 am and it is now 12:51 . Hopefully, everything is all right.

Definition of JP drain ( source: http://www.medterms.com/ )

JP drain: The original suction drain. The drain itself is inside the body. It is made of Teflon and has multiple drainage holes. The drain is connected to clear plastic tubing which is usually sutured to the skin at the point it leaves the skin. The tubing connects to a bulb reservoir. The bulb, when squeezed empty, applies constant suction to the drain and pulls the fluid out of the body. The drain is removed when the excess fluid has stopped draining from the body. A JP drain may be used, for example, for abdominal or thoracic drainage. JP stands for Jackson-Pratt.

Another snag....( hubby's update )

We were supposed to go home Saturday April 11, 2009. Doctor said that his white blood cell count is a little elevated . There might be an infection . Tomorrow , if it's still high they will have to do another CT scan to see what's going on in the Lumbar area. They had added another drain tube to collect the pus that was setting in the Lumbar region. Doctor said this was from the injury. They thought they had collected all of the toxic material. I guess, this is some microscopic toxic material left that was creating this problem.

I went home yesterday for about 3 hours. It helps my sanity to switch environment. Of course, I can walk to other places within the hospital but I choose to stay closer to him. He still have that stubborn streak trying to be man even in this situation like this. I think he still have a hard time trying to communicate what he truly felt in terms of pain ,breathing, and other issue. So, I have to talk to his nurse and tell them what I have observed.

When I came back yesterday, he said he went walking around the nurse station with the help of his uncle Dave and portable oxygen. He is still having a hard time breathing. We talk for a little bit and he told me with a sad face that he thinks we will not be able to come home tomorrow.

I said " how come? he replied , " I just have a feeling" I sensed a little sadness in him but I quickly try to changed topic. I don't want to borrow tomorrow's problem. I'll wait until we talk to the Doctors in the morning and find out.

All of the Nurse here are very caring and encouraging. We have Nurse Gail last night who was so encouraging about his situation that he got up yesterday around 9:00 pm and we walk again in the hallway and back. I knew it hurt but at the same time it will help him to keep the blood circulation going and build up his lung function. They slowly wane him off oxygen but at night when his oxygen saturation tends to fall below . It is really safe just to used it . The whole body needs oxygen to repair itself.

Today, April 12 2009 anxiously waiting for the Trauma doctors to come in and gave us good news I hope. But I guess, we hit another snag. I am still trying to be positive about it and he also understand that it is for his own benefit. They ruled out asthma and fluid in the lung area. Doc said that it sounds clear and no wheezing. They order another CT scan for him again to check for any possible blood clots in the lungs. If they find it , it's treatable. So, that's what we are now. Waiting around 3:00 pm for his CT scan. I am hoping doctors will find whatever is causing his shortness of breath.

I guess we know more by tomorrow and hoping it's positive. I thank everybody to the utmost bottom of my heart for their continued prayers and support.

p.s.. picture above is for fun only . what are you smoking honey?????

Life Changing moment: March 29

One fateful day March 29, my daughter Isabel wants to call her daddy. So, we call her dad and got a voicemail. He called back and said he can't really talk he is in a tree. OK, but try explaining that to a 5 year old. She was crying.... I really felt odd at that time and I don't know why. I guess little children have some kind of premonition. I am not even sure if this is the right word. So, I was trying to calmed her down and successfully diverted her attention in helping me making a bread. Mixed all the ingredients and proof it in the oven. Just as I about to do other chores, Lisa my sister in-law came in and said we have to hurry . Kirk have an accident and was taken by an ambulance to the hospital. What ???&%$$##$# the heck could happen? Panicked sets in. I don't do well in any emergency situation . All I can say is oh...my God! over and over again. I got dressed in one minute and brushed my teeth and off we go. I don't even care how I look . No make up or lipstick not even a lip gloss. Just lucky there was a comb in my purse.Off we go, drop Isabel in Ashley's care who was still in her pajamas and oh that wild bed hair. I was supposed to gave her a bath that morning but unfortunately things happen. Guess what happen to that bread proofing in the oven? Still proofing for the whole day until I remembered and called her sister to turn the oven off.

My husband and his brother was working in Lexington , NC which is about 2 hours from where we live. They were cutting trees to put a gravel path to start a construction for a new house for his other brother who currently reside in New Mexico and wants to move back to NC. Ride on the way to Wake Forest Baptist Hospital was rough. Lisa drove and I knew I couldn't drive. I was too nervous and I don't want to end up having an accident . I was quite on the way and I prayed to God to keep him alive. I don't want to raise Isabel without a Daddy . Of course it doesn't help all of this crazy scenarios running through my brain. I braced for the worst to come. It even scared the heck out of me when we got the call and inform us that he wasn't stable. I couldn't even remember what my reaction was but I guess I was shock. I didn't cry but I continued my prayers and ask God that this isn't the time to take him away from me. Our daughter is just 5 years old and we really needs him.

We we're lost several times and went to a wrong hospital. We finally reached Baptist hospital after 2 hours. He was lying in ER with a neck brace covered in white sheet. All of his clothing was cut. He open his eyes and look at me . Said he was sorry for what happen. I just want to cry that time but I stayed composed. I want to be strong for him .

Up to this point , I wasn't sure exactly what happen . All I knew is big boys toys like backhoe is dangerous . Imagined being hit with a blunt force . It got to hurt! God is still watching over him at that time. Some people who got hit with the same equipment is not so lucky enough to tell the story what happen . I just thank God that he was working with Quin at that time . He was able to free him from the machine and called 911 . He probably screamed on top of his lungs . helpppppppppppppppp!!!!!!!!!!!!!! . I was sooo thankful to First Responder who took him to the right Hospital that is capable of treating this kind of injury.

He stayed in ER for 2 days . Doctors are really worried about the inflammation in his stomach. At first, they thought he had broken pelvis. But said, nothing wrong with the pelvis but there are non-supporting bones in lumbar area that was broken. The muscle in his left thigh was really badly damage . Over the course of 12 hours, he cannot take anything by mouth. 5 kinds of doctors monitored him every 4 hours. Then, they let him have cleared liquid and finally he was given solid food towards the end of 48 hours. He was running a fever here and there mostly low grade but it progressed to 100 degree before we left the hospital. The nurse said that it is normal to have a fever due to a lot of inflammation in his abdomen and legs. With a good dose of morphine, we drove home. He really doesn't want to go home but the hospital is private and with doctors diagnoses insurance company will not pay anymore . So, therefore he was discharged.
Less than 48 hours, we brought him to UNC Chapel Hill hospital- ER. In less than 4 hours, we knew he needs surgery. My big question is, Why did the other doctors cannot find anything????!!!!
They assembled a team of surgeons and by 4 pm he was wheeled to operating room. We meet the surgeons and said that they didn't really knew where the leakage is but they are going to explore and find it. They will going to do the best they can.
The surgery took more than 2 hours. The surgeon came out with a good news. Surgery went smoothly and he was stable the whole entire time. He said there are 2 issues they found. A laceration in his stomach. The fat and muscle in the abdomen separated. Second, there is a hole in his colon and toxic waste was already free flowing .The hole in the colon was really difficult to find . A young petite trauma surgeon found it in the back near the vertebrae. For 6 to 8 weeks , he is going to wear a colostomy bag for his waste. When everything healed doctors can put it back to to normal .
He was place in ICU for close monitoring for 3 days after the surgery. They were really worried of infection. He was then moved to a regular room and I was able to stay at night. It was really painful looking at him in severe pain and there is nothing I can do. Severe cramping in the stomach due to gas that was trapped and stomach trying to work again after severe trauma. He was given all kind of pain medicine plus the push button morphine when needed . I wished there is something I can do to make him fell better. I wished there is a magic button somewhere to pushed to take away all the pain. **sighed**

Last night he felt a little better . I was able to sleep for a few hours as well. I am really really tired at this time. Red Bull and coffee became my best friend.
At this time, I am still in the hospital with him. Hopefully, he can go home in a few days and dramatically improve at home .

I am very thankful to God that he is watching over him. Also, very thankful to his Family, all his friends and colleague in Chatham County Sheriff's department who prayed for his fast recovery and continued support .