Thursday, July 10, 2014

Waking Up on Her Own . . Baby Steps to Some, but Giant steps to Us

Hi. It's Alexis' dad. Alexis  thought she would take care of this post herself. when I went to check on her, she was sleeping so restfully that I couldn't bring myself to wake her.  There were aspects of her surgery she didn't wish to share , with particular in regard to anesthesia.

Just a few days before her procedure, she underwent a sigmoidoscopy from the same physician who would perform her surgery by colonoscope.  When she learned that  the surgery was to be performed by  the same gastroenterologist as before, she was adamant that this was not to happen.  Keep in mind that the gastroenterologist is very highly-regarded, and I would much prefer to have him operate on her than probably any gastroenterologist in the nation, but  a funny thin happens when a child turns eighteen, which is that the child is allowed to make her own decisions, stupid as they may seem to the rest of us. All Alexis knew was that the gastroenterologist hurt her during the sigmoidoscopy, and that this procedure stood to cause significantly  more pain. She didn't trust the doctor through another procedure.

The gastroenterologist came by our house the night before and promised her that he would not hurt her at all costs. They discussed various drugs. Some drugs used for these procedures are essentially just amnesiacs;   they keep a patient cooperative, but the patient, within a few hours, remembers every bit of the pain.  This was not an option for Alexis' procedures, as it involved cauterization of at least two significantly ulcerated spots in her transverse colon. It's not a  form of pain that one should expect a nineteen-year-old to go through life remembering. Alexis has enough sources of nightmare as it stands.  The gastroenterologist discussed various drugs. Significant pain-killers,  in addition to Valium for relaxation, were mentioned. Alexis agreed to propofyl, fentanyl, and valium.  If she any changes were to be made, she would be given increased fentanyl and valium.  At one point she did appear to be in obvious pain. To keep her comfortable, the gastroenterologist  gave her the drugs as agreed, doing so cautiously because of her size.  Once the pain safety was under control, the gastroenterologist and the assistant continued and finished the procedure with no further incident. We brought her home three hours after the conclusion of the procedure.

The anesthesiologist had allowed her to remain asleep for maybe thirty minutes or so longer than would typically be allowed for the procedure, primarily because she  hadn't received any quality of sleep whatsoever  in the four days before the procedure. At that point, the anesthesiologist woke her to ensure that she could be woken up. She was able to be awakened, though she was very uncomfortable. Painkillers were switched. There wasn't any point at which Alexis could not be awakened, though she was in pain, so we continued to give her as much as was needed in order to keep her comfortable. We continued to  awakenen her every  thirty minutes.  With each awakening, there was slightly less complaining of pain or anything else.

She's now looking at me.  She says she's not in any particular pain, she says.  I suspect that will last for maybe ten minutes, but that's ten minutes longer than last time, so it's progress.

The deal brokered between her and the gastroenterologist and, to a lesser extent, the anesthesiologist, was a legally binding contract. Had Alexis not held the status of legal adult, I would have signed it for her.  She's mature enough to understand the concept of pain and to know just how much of it she can tolerate. No one should have to tolerate more than he or she can tolerate when there are medical alternatives available.

Today was the better.  First she woke up on her own. I expect her ratio of wakefulness to sleepfulness shall improve for the better at a noticeable rate in the next few days.  Next we have to get her to eat and to walk, but she's somewhat clinically hyperactive, though she lacks impulsivity and inattention, so she has no ADHD diagnosis. In any event, getting a hyperactive child or young adult out of her bed is not usually a majorly difficult proposition.

I have to admit that I was concerned that she  might have been hit with too many drugs the second round, but I'm now convinced everything was handled perfectly and she'll  be fine. She's trying to look over the top of my keyboard to see what I'm typing. I'm turning the keyboard to make it difficult for her to see, but more than anything, I'm relieved that she even cares what I'm writing

Alexis is seriously better.  It hasn't occurred to her to thank anyone yet, but I thank you on her behalf.  I recorded "Judge Alex"  last night and will turn it on in less than twenty minutes. She'll be thrilled to reconnect with the real world.



 

5 comments:

  1. Thank you for another positive update. I'm grateful that the gastroenterologist was able to manage her pain appropriately. It sounds like Alexis is on the mend. She has a whole host of people out here in cyberland who miss her!

    Get well soon, Alexis!

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  2. First thing I did when I awoke this morning was to check on how you were going. Great to hear that you are waking too. Sleep is healing. Hope you get all you need.

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  3. Thanks for forwarding the update. She has been on my mind all week. I look forward to her writings, the next few should be doozies.

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  4. Thanks for the update. I hope she's better soon!

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  5. As long as she's heading in a positive direction, that's all that matters. Keep on keeping on, Alexis!

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