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Sunday, August 23, 2015

Even Less Sugar: Hon, I Think My Brain Is Leaking: 1.0

Dripping Water is kinda fun; it makes that "ploop" sound. *  

         It's a catchy song on a Chumbawumba album: Drip Drip Drip

It's verse in Proverbs that made us giggle when we met at New Wilmington Missionary Conference in 1994. Proverbs 19:13b: A nagging wife is like water going drip-drip-drip. (GNT)

It is NOT, however, something you want to come from your husband's HEAD.

At home.  At 9pm.

Sure enough, there was a little "sweat" spot on his pillow as he sat up from resting.

"Can you look at my head? It feels wet."  A wave of nausea washes over me as I recall our last episode.

The incision site is damp, the skin discolored, right at the joint. Right over the missing bone piece, where it split last time. I don gloves and dab the area with gauze.

Clear. Doesn't look open, or infected, just wet.

Is this how the infection started last time, but we didn't notice it? What if this is fluid under the scalp that is going to erupt? What if this is the tumor pushing up on the brain and shoving liquid out? What if this is "normal" for head wounds? What the heck?!

  • Call the home health nurse line.

   "My husband's head is leaking from the incision site. He does not have a fever, he is alert and has no other symptoms. No headache, The liquid is clear and odorless."
   "We can get a nurse to you tomorrow morning. In the meantime, call the surgeon and see what they have to say."
   "When can the nurse be here?"
   "They usually make their calls around 8 to let you know when they're coming."

  • Call surgeon's answering service, wait for a call back. Replenish "Oh-Sh*% Bag"

ring ring ... "How much is it leaking?" (How the hell do I quantify an amount of liquid on a pillow? The speed of liquid flow? I AM NOT A MEDICAL PROFESSIONAL.)

   "Uh, I don't know ... it made a baseball-sized wet spot on the pillow." [typical questions to assess whether infection is present]
   "Well, I would say if it soaks three gauze pads over night, you should get him to us right away. It could be spinal fluid or another infection. Or any fever or chills or neurological changes. If not we'll see him at his appointment Monday."

I'm not kidding. That's the way that phone call ended.

  • Tape down a square of gauze. At Ian's demand, take a sleep aid and go to bed.
  • Wake at 6:30a, when a neighbor decides to do some motorized lawn care. I reach over and touch the gauze. Soaked. He gets up to use the bathroom. I touch his pillow. Cold. Soaked. I remove the bandage. The site looks "normal" and dry.
We go about our morning, waiting on the 8a phone call. Ian feels good, and is preparing to have breakfast with a friend. I give him his antibiotic injection. My dad arrives on his way to work. His breakfast date arrives. I haven't heard yet, so I call the home health line again.

   "I was just wondering when someone can come and look at my husband's head."
   "Did you call the doctor last night? And what did he say? We can put him on the schedule for tomorrow ..."
   "No, m'am, if the doctor told you to keep an eye on it and he has no other symptoms, you can do that and we can send someone out tomorrow."

Was I supposed to call them back last night, after I talked to the doctor? Did they REALLY not think I wanted a call in the morning from a nurse who could come and evaluate him? How could that NOT have been conveyed? 

So now here we are, the four of us, sitting in the living room, wondering what to do. Ian's stomach is growling. We've all looked at the incision site, which is not separated but slightly damp. Do I cover it to prevent infection? Does covering it harbor bacteria? What if the gauze sticks to the skin? I should protect it if he's going to leave the house. Should he leave the house?

  • I put out a txt to all my nurse friends for advice. I take a picture of the incision. 
Ian decides he will forgo the bandage and go to breakfast; if he's going to have to go to the hospital, he might as well get a meal in first, he determines, and he feels fine. I give my hesitant approval and instruct his friend to go DIRECTLY to the ER if "anything bad" happen at the restaurant [I list all of the possibilities and transfer medical authority to a fellow church member and relatively new friend. Poor sap].

He stands up to put on his shoes, and the faucet returns; the drips are running down his bald head onto his ear. ["Give me something to take with me to catch the drips," he says.] We all take another look. Friend calls surgeon friend of his. We're now leaning heavily toward the "Cerebral Spinal Fluid" diagnosis, which albeit not life-threatening in itself does not bode well for a brain surgery patient with recent infection and an unhealed head wound.

Off to the (local) ER.

They swab to culture the liquid, they do a CT scan. They call the "big" hospital and are instructed to send him there.

We wait. And wait. It's now close to 4p, when he should receive his next antibiotic injection. I inform the nurse. She doesn't have a record of the medication in his chart, so she needs to know what it is. I can remember the name, but not the dosage. I have her call the medicine delivery service, which is affiliated with the home health care company.


I have no car at the hospital, or I'd have driven down and gotten the stuff myself. I'd have a friend do that, but we have to be all sterile and careful with syringes and whatnot and I don't want to put that responsibility on someone else ... it's stressful enough for me to do it, hoping I didn't contaminate something unwittingly. So I do the only thing I can think of: I have a friend go take a picture of the bag of syringes in the fridge, with the dosage info. I show that to the nurse, meds are ordered and given. Done.

Only two hours later and we're off to the hospital in town. (Yup, we spent 10 hours at the local ER. It would have done us no good to travel to the "big" hospital on our own, as our wait was for a bed there. We would have just waited THERE for 10 hours, with the added bonus possibility of something going horribly wrong on our commute to the hospital, with I-AM-STILL-NOT-A-DOCTOR-Rachel at the wheel.)

Even at the hospital, nothing is to be done until the morning. But at least now we've confirmed that the leak is, indeed, CSF, and Saturday they will put in a drain elsewhere to divert the flow.

*My bathroom faucet is leaking. It's annoying. But I'll take an leaking bathtub fixture to a leaking brain any day.

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