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Showing posts with label ICU. Show all posts
Showing posts with label ICU. Show all posts

Saturday, August 06, 2011

Life is not fair


Something terrible happened last month. Something I wouldn't even wish on my worst enemy. It was a tragedy. There are no other words to describe it, nothing that would do it justice. Justice, that's a funny word, because it seems there is no justice in this world. A world that allows the passing of a little girl to the heavens for no fault of her own. Fault can't even come to play a role because what happened was beyond anyone's control, no matter what one says. And what can you say, when a 3 year old girl falls off the window on the 3rd floor. I think this will be written over twice. One would be the Doctor in me remembering what happened. The next one to follow would be me, a father, a friend, a relative, a human recounting the horror!

It happened in Pune. We were informed and left the next day. We reached the hospital (fortune had it that it belonged to someone I know closely). She was lying in the ICU bed. No external injuries. Eyes closed with gauze and sticking plaster to prevent damage to the cornea. All injuries were internal we were told by the attending consultant (also a good friend of mine)

She had multiple fractures of the skull, ping pong fractures and depressed fractures, bleeding in the brain, blockage of the ventricles (which plays a role in absorption of CSF) and was unconscious. The situation was grim and there was nothing much we could do but wait it out and watch for how she would progress.

Over the days, some levels of consciousness were regained. She would respond to her parents calling out to her, hands and legs would move. To a lay person, this meant improvement. To the consultant, he was more practical. He warned me about some levels of spasmodic contraction remaining on the right side. She was moving but how much was voluntary. Her eyes were opening slowly, but were they able to see. There was serious doubts about sight since the haemorrhage in the brain was compressing the optic nerve.Days passed into weeks, CT scans and MRI's were performed. Physiotherapy started. All that could be done was being done. She was on the ventilator, but a tracheostomy was imminent.



The last scan showed increasing pressure onto the brain and a decision for burr hole surgery was made. Tracheostomy was very much in the piping but was postponed to respect the wishes of the parents. It was decided to give the burr hole a chance to see if drastic improvement occured and the need for tracheostomy could be averted.


The neurosurgeon was kind enough to do it in the night itself so no time would be wasted. He infomed me when it was over. However, he was not too happy with the surface of the brain. In his own words, "It's not pulsating as much as it should after evacuation of the CSF". He was not too happy, but was optimistic as was the need of the hour.

Over the next day and a half, she developed respiratory infections. It was time for a tracheostomy, whether the relatives agreed or not. It simply could not be postponed any longer. It was done the next day. Suctioning was carried out regularly. The child seemed to be losing the battle, though.

Then, at 3.30 a.m. the call came. Middle of the night calls are almost always bad news. This was too.
She was no more!


Tuesday, November 24, 2009

Continuing the Nightmare

In continuation with my previous post, I am glad to inform you all that the patient is doing well. She is still in the ICU but 4 of 8 tubes are out, she's not spiking fevers any more, she is tolerating jejunal feeds (feeds directly into the intestine through a tube) and she has got off the bed and started walking with help.

The ryle's tube (through the nose) is out. The abdominal drain was zero so it came out. The neck drain was harldy anything so that came out as well. Neck staples from the skin are also out. Since she is now able to walk a bit we also took out the urinary catheter just to be nice.

By no means is she back to normal. She's not even close. She still has an ICD in place and a subcutaneous drain. She has a subcutaneous infection at her chest site where we had to open up the thorax. However, compared to her situation I think she's doing really well and should pull through.

Now I can go back to writing my blog with a smile on my face!

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