Here's What We Got

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Any daytime hospital drama worth its time contains a few subplots. We've had our share here. Now that they're all a few hours old, we've had time to sort through and figure out which of the subplots means something. The clear winner on that count would be Ro's Left Foot.

Every hour or less, a nurse comes in to the room and does all the heroic things PICU nurses do. Among these tasks, they check Ro's extremities for good response to touch, good reflex, and movement. Last night, around 8:00pm, nurse Rachael did just that. After she left, Ro told me that her left foot was feeling a little weird, as though she were not able to make it do everything she wanted it to do. This of course seemed an important bit of news, but it was in with an awful lot of other news, all very important. We were scheduled to transport to x-ray floor and for a CT scan as well. Questions arose as to the risk of moving her at that time, versuses the now even more vital need for the data the x-rays and scan would provide. This is why it took every bit of three hours, two nurses, four scan technicians, four orthopedic MDs, three transport staffers, and one highly stressed dad to accomplish the goal.

Some major decisions had to be made. If we did the CT scan, we would have to take Ro out of traction. With no support rods in place, what are the risks? Would it be better to wait a few hours? When we move the plate under her for x-ray, should she be log rolled, or slid? The techs had a lot of opinions. The on-call orthopedic doc had not arrived. A trauma patient was en route at that moment, and the CT scanner would be needed. The techs wanted to move us through the process. The Dad was voicing his extreme displeasure. We maintained this standoff in the freezing cold scanner room for a half hour. Our PICU nurse united with me to stall for time and hog the room. Finally, the orthopedic MD arrived. Then a second, then a third. The three M.D.s confered with each other and on the telephone with our own Dr. Abel. Ro was now unable to move her foot, along with her left knee. The docs reasoned that the CT scan was top priority, and outweighed the risk of removing traction. They needed and asked for my permission to do so. I wnated to call Ellen, but my phone had lost all it's data, maybe when we walked past the MRI machine. I borrowed a nurse's cell and made the call. The traction weights were removed and nine of us worked together to slowly move a backboard under her and transfer her to the scanning table.

It was decided that we would re-apply traction when we got her back to PICU. By that time, it was nearly midnight. As we returned to the unit, Ro was able to move her toes again. So, more huge news. Her motor skills were returning. The docs chocked it up to "spinal shock". Ro and I marked the minutes for the rest of the night. The moving and jostling were painful for her, and the morphine was starting to cause her itching and rash to get worse. There was a general feeling that moving her may have actually helped her regain her motor skills. Then, around 3:00 am, she said to me, "Dad, I think I'm losing that foot again." This time, it happened even faster than before. This time, we had a cavalcade of residents, nurses, pediatricians, rsdient assistants, assistatant residents, assistants to the residents come in and perform the same basic motor skills tests. "Do you feel that?"
"Yes."
"Can you wiggle your toes?"
"No."
Etc. Each would come in, ask the same questions, shrug and try to look pensive-yet-brilliant, and leave.

Just before 7:00 am, Ellen and Vickie returned, as did Dr. Abel. I took the opportunity to crumple to the cot like a sack of dirty laundry. The whites, Dude.

This trio, these fresh horses, might as well have stormed through the doors and declared, "what the HELL is going on here, people?!?" Ellen and Vickie took over patient care. Dr. Abel looked at the CT scan and x-rays and came to talk to Ro.
"How are you feeling, Ro.?"
"Not awesome."
"What hurts?"
"My head and my right foot. My left foot still won't move."
"Your head hurts? Let's remove that traction and take off the two-point halo. And your right foot hurts?"
"Yeah. I think it's because of the things they put on my legs."
They had place compression cuffs on her calves to help prevent clotting.
"Let's take those off too."
This guy was amazing. If she hadn't been so relieved already, Ro probably would have next asked for a pony.

Dr. Abel thinks the left foot issue is due to too much straightening of the spine in one go during yesterday's surgery. It simply isn't used to it. He removed traction to allow it to bend back a little bit. After her right foot stopped hurting, he replaced the cuffs, only looser.

Guess what - by noon, Ro was wiggling her toes again, in both feet.

So here is the Plan as of now: We have scheduled the followup surgery for Monday, April 6th, but that date will be scrubbed unless Ro has completely regained all motor movement. If indeed that happens, the rods will be placed on the spine, but they will be more open to allowing some curvature to remain, even with the rods in place. In other words, they will psh the spine as straight as they can, but they won't risk insulting the nervous system.



Ro is feeling much better, but there's a long way to go. Her big sister came this afternoon and read to her for a while. She can now be rolled toward either her left or right side, thus allowing for more relaxing bed rest. She is sleeping right now, and it's the first really good sleep she's had.




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