Yesterday Sunday marks the end of my week-long duty on the in-patient service and on night call. I awaken early to administer Teri’s morning IV meropenum infusion, ready her 10 oral medications and heat up her morning food before heading off to in-patient rounds at Children’s Hospital. These rounds are supposed to be ‘patient-centered’, that is to involve the family in the discussion of the day’s plan. We invite the parents, vastly outnumbered, to join in our intimidating, technical discussion full of jargon and numbers. After rounds and completion of the written notes, I perform GI procedures (e.g. endoscopy), teach, and provide curbside consults or opinions to referring physicians. Because this week is not so busy, I choose to help the medical students spiff up their oral presentations on their patients because of needed improvement. It was a good weekend as we were able to discharge 7 patients on Saturday and Sunday and perform one urgent procedure. Removing a swallowed coin (quarter) lodged in a 3 year old girl’s stomach is very satisfying … fast, dramatic, and increases its ‘value’ by an estimated 20,000-fold. It’s a lot to run a nursing home at home and work at the hospital during the day.
I exercise at the club before returning home where I begin Teri’s evening IV meropenum infusion and her oral medications. This weekend, Grace (niece from CA), Phyllis (niece from IA), Judy and daughter Meleah provid the food supplies and support, cook regularly spiced fare for the group and bland unsalted fare for Teri. Grace makes a panko-encrusted baked chicken thighs but accidentally drops them on the floor. Taking a cue from the famous dish Drunken Chicken, I promptly rename this new dish Dropped Chicken to the guffaws of all.
Teri gives me a tie as a father’s day present. Rachel and Ben give me a massage. Yes, perfect, just what I need. Stop by my father’s apartment to wish him happy father’s day. Check on his medication. I help get Teri into bed, administer pain and sleep medication, position her feet above her heart. She continues to have bladder urgency and I am up until 1:30 am pushing her in the walker to the bathroom.
Overall, a nice day – Teri had a pretty good day – a nice Father’s Day.
Pain beyond pain
Teri tolerance to pain may have declined. For example, she barely flinched during her first nine bone marrow aspirations, but during her 10th, she screamed at the top of her lungs.
I’ve thought about this and there may be several concepts that apply. There may be ‘central sensitization’ where hypervigilance (hypersensitivity) in the brain heightens the perception of pain. There may be a ‘cumulative’ effect in which the total amount of pain has exceeded a maximum threshold and now all pain becomes unbearable. It also seems likely that there are the added effects of post-traumatic stress. It just seems as if her body has undergone too much physical torture and no longer can bear even usual bodily sensations.
I’m hoping these gradually reverse.
Little wonders
On little Jack’s last day here, Rachel demonstrated ‘baby yoga’ seen in the picture. She warms her hands by rubbing them together and gently placing them on his head and limbs while saying a rhyme. It is amazing to watch how calm and centered he becomes during this. What is next? Infant Montessori (Teri does it) … fetal massage …
Little Meleah enthralled us with her musicality, her powerful full-bodied vibrato notes on her new half-sized cello and her delicate and deft notes on the piano. She enjoys performing. What one can see after three years of piano and one year of cello (“always room for cello” Bill Cosby) is her clarity of tone, her expressiveness, and her love of music … and one son of a gun Tiger Mother. Whoops, I wasn’t supposed to say that.
It is amazing to watch the next, next generation … who will they become?
Teri and B--I did not realize, until I happened to see the URL at the end of one of your e-mails (which Cindy always forwards to me) that you had a blog that I could follow on a frequent basis. I am so glad to be able to know specifically about Teri's progress as well as the other happenings in both your lives. I continue to think about and pray for both of you. Your blog enables me to pray for specific things, for example, an increased pain tolerance for Teri. (As if God doesn't already know what you need specifically, but what the heck.) I'm now bookmarking your blog so I can follow it as you post. Continued healing thoughts and energy your way! Suzanne K. (Cindy's sister)
ReplyDelete