I sat here procrastinating typing the next portion of this story. Writing this out is hard, it makes me process through all the things we went through, which to be honest I haven’t done. I was doing the typical scroll through Facebook and stumbled upon a video of a girl with an absolutely amazing voice. Eugene and I love music. Often times when I am not in the best of moods, or when he is in a great mood he will turn on music and dance around the room. When I’m grumpy, he’s been known to make me unwillingly dance with him. The result, I always end up in an amazing mood with another wonderful memory of being silly in love with my handsome hubby. That video reminded me of that. So here I sit now with a smile on my face and music playing in the background as I work through the next bit of the healing process of Eugene’s accident, and how we survived this crazy experience.
The morning of the 25th of January Eugene was still in the ICU. It had been 5 days now and we were still figuring out the extent of damage done to his body from the crash. Moving the line for dialysis to his chest proved to be successful which was great because his potassium and creatinine levels were climbing. His kidneys were quickly getting worse to the point that they completely shut down. When Eugene woke up that morning, around 6am, I stood up next to his bed and held his hand. He asked me how baby Ryder was doing and reached out his hand to try and touch my belly. I remember I had to lean forward for him to be able to do so. It was just for a few seconds as he quickly got tired out and went back to sleep. But little things like that moment are ones I will remember forever.
They took blood in the middle of the night every day so that when his doctors got in first thing in the morning they would have his results back. Typically the night surgeon would order it and review it with day shift before they left in the morning. Eugene had received 12 bags of blood in his first surgery when he got to the hospital, as well as other blood products such as iron and plasma. The blood work the previous night had shown that Eugene’s hemoglobin levels had dropped scary low again. So he needed another transfusion. He got two more bags of blood that day. We met Eugene’s physical therapist that morning. She showed us how he could sit his bed all the way up into a chair position. We tested it out and Eugene even stood up for a few seconds! He had dialysis for 4 hours and it seemed to go well. During the treatment he sat up in his bed and ate a few bites of pancakes. Sitting was really painful for Eugene because of where the bulk of his wounds were so he did not stay in that position for long.
Later that day they took Eugene down to the operating room and put him to sleep so they could clean out his wounds on his butt and left thigh. They drained a few pockets of fluid that had built up and took care of a large hematoma that had formed. Then they cut off the necrotic (dead) tissue, checked on his stitches, packed the tunneling in the wound with sponges, and dressed it with a wet to dry dressing. Wet to dry dressing is basically gauze soaked in medical saline and then layers of dry gauze with tape over them. They packed the wound a bit less than the original time and Eugene said he felt less pressure on the area and was pretty dang happy about that. They let us know that day that Eugene would need to go in the OR (operating room) every 2-3 days for an unknown amount of time to clean out and repack his wound. We also were told that he would be on dialysis for an unknown amount of time, at least a few weeks. The good news we got from the Nephrologist was that we would be able to continue dialysis outside of the hospital if needed. The downside of the operations was that we would need to continue to be in the ICU for the monitoring of his wound and care after each surgery. The wound was large and we had no idea the amount of time it would take to heal.
The days seemed to start to become a bit routine. Blood draws around 4am doctors and nurses starting to shuffle in around 6am or so. 9am rounds with his whole medical team. This was actually something really cool that I appreciated the hospital did. The nurse, nutritionist, trauma surgeon, physician’s assistant, respiratory nurse, physical therapist, occupational therapist, and anyone else involved in his care gathered outside the door and went over Eugene’s case. What had happened so far and what the plan of action was for the day. Family members in the ICU were welcome to join in and listen to everything from updates, medicine, diet, breathing plans, surgical, and anything else regarding care you could possibly think of. Plans would sometimes change throughout the day based on results or changes but for the most part once the rounds were done you had a good idea of what you could expect for the day.
The morning of the 26th Eugene started off with physical therapy that went unbelievably well. He stood up and with the help from his physical therapist and his walker he was able to take 25 steps! This was the first time and last time that he walked for a great amount of time. Once he got settled back into bed the dialysis nurse was there to start his treatment. Eugene was really struggling to eat. He would take one or two bites and not eat anymore. He was losing weight at an alarming rate. I was able to get approval from his nutritionist to bring in one of our favorite protein shakes and he actually drank a good amount of it. To say we were happy about it is a huge understatement. He tried to eat dinner that night and again just a bite or two before giving up and going to bed. He was on a special diet for his kidneys and the food was pretty lackluster… I, on the other hand, was getting meals brought to me every single night from church friends!! I can’t tell you how much this meant to me. I was eating really well for me and the baby between the snacks that friends dropped off, the yogurt bar in the cafeteria for breakfast, and dinner dropped off every night it was one less thing to have to worry about and it truly meant the world to me. I honestly felt guilty eating around him though. I often would try to wait until he was sleeping. I remember apologizing for eating around him when he wasn’t allowed to eat the good foods I was. He responded with thanking me for always being there, for taking such good care of him, Ryder, and myself. He was so unbelievably sweet to me. There were many times those first few days that he apologized for getting into the accident, thanked me so much for being by his side, and shared how much he loved me.
The 27th was another hard day. In Eugene’s words “this really sucks”. That seemed to be his motto for the day. He woke up in the morning to be told that he couldn’t eat or drink anything. He begged for ice chips, but being that he was getting put to sleep with anesthesia he couldn’t have anything. He tried to do physical therapy but his body was too tired. As soon as PT was done they took him to a dialysis room. They had done all previous treatments in our room and unfortunately I was not able to sit with him. This was unbelievably hard for me. Dialysis was 4 hours and since I was not able to be in there with him for that time, I took the opportunity to run home, shower, change, and grab some more clothes. My friend Darby had taken the time to go to our house and keep up on my laundry and other things around the house for us while we were in the hospital. It made these runs home quick and much less stressful than they could have been. Her husband Jake and I also took this opportunity to go pick up Eugene's bike from the impound lot it was at. The bike was in a lot better shape than I had expected. Jake was in contact with the owner of the lot before we got there. He had everything arranged and ready to go so we could quickly go in, pay the fees associated, and leave. Something that could have caused a bunch of unneeded stress was yet again taken care of by amazing friends that we have. I will forever be grateful for her and her husband Jake for all they did during this time.
I returned to the hospital before Eugene was finished with dialysis and settled in his room antsy for him to get back. It seemed like as soon as he got done with dialysis and was brought back to the room they whisked him away and down to the OR for his wound clean out and debridement. Eugene was really starting to struggle mentally with all that was going on, he was even a bit grumpy toward staff at times which is pretty out of character for him. He said he felt like he was being told what to do all day long. It was just a really hard day. His surgery went well and he made it back to the room sleepy as could be. After a bit of rest he woke up and was finally able to have some food around 6pm at night. Anyone who knows Eugene knows he LOVES juice! That night I got special approval to give him Snapple and as silly as it is, such a small thing can make a huge difference. He was a bit happier after that. Later that night, his breathing had gotten to the point where they felt comfortable taking him off of his breathing tubes and he was able to breath on his own. We finished that night on a positive note.
The next day we were really looking forward to a day of rest. No physical therapy, no known surgery needed, and no dialysis. Unfortunately our bubble got majorly burst. The dialysis was not working the way doctors had hoped. His potassium and creatinine levels had not seen improvement at all, if anything they had gone up. And he had a few other levels, that as of the day before, had begun to rise. It was then that they let us know that Eugene would need to be put on continuous dialysis. We would start with 24-36 hours to see how it goes. The nephrologist said this would give his kidneys a complete break and hopefully the break they needed to kick their butts into gear. The downside to this was physical therapy was no longer allowed and he would likely be unbelievably worn out all the time. For those who don’t know what dialysis is, I will explain the best I can in layman's terms. Eugene was specifically on hemodialysis. For hemodialysis, a dialysis machine and a special filter called an artificial kidney, or a dialyzer, are used to clean the blood. To get his blood into the dialyzer, the doctor needed to make access into the blood vessels. This “access” is the catheter that started in Eugene’s neck but didn’t work so they put one in his chest. The dialyzer, or filter, has two parts, one for the blood and one for a washing fluid called dialysate. A thin membrane separates these two parts. Blood cells, protein and other important things remain in the blood because they are too big to pass through the membrane. Smaller waste products in the blood, such as urea, creatinine, potassium and extra fluid pass through the membrane and are washed away and the clean blood is cycled back into your body. The waste is collected in bags that sit at the bottom of the machine. Through this cycle they are also able to remove any extra fluid in the body. Eugene had a lot of swelling due to the extra fluid he was carrying from not peeing. The bags of dialysate would empty and the bag collecting the waste would fill about every hour and of course never at the same time. When they did a loud beeping alarm would go off, the nurse would have to come in and change out the bags. Sleeping in a hospital is already hard enough and then you add alarms going off 24/7; We were miserable.
Eugene got all set up with his new hemodialysis machine and things seemed to be going well. Around 3am the next morning, his blood started clotting like it had been doing with the previous line in his neck. The nurses spent a lot of time trying to get the machine to continue to work and Eugene’s blood to stop clotting, but nothing seemed to work. After an hour or two of trying different techniques to get the machine and Eugene’s blood to cooperate the nurses ultimately had to give up and wait for the nephrologist and dialysis nurse to come in. While we waited for this, we got a visit from the surgeon who did Eugene’s first surgery when he arrived at the hospital. The trauma surgeons do a week on and a week off and rotate between day and night shift. There are a total of 4 trauma surgeons we worked with while Eugene was in the ICU and they are all wonderful. During our visit with him that day he let us know Eugene would be going in for another wound clean out in the OR. Before the accident Eugene had never had surgery before. This would be number five since he had been there. The surgeon let us know depending on how the wound looked he may try a more permanent dressing that wouldn’t need to be changed every day. If you read the last post on the blog, you know how painful it was for Eugene to have to go through those daily changes. We weren’t hopeful for the possible new wound bandage but sad to hear that he would yet again be going under anesthesia. Once they were finished with his wound debridement they would start him on a new medicine to try to help with the blood clotting issue.
His surgery went well, they were able to remove all the dead tissue and get a really good cleaning done. This is the day that Eugene got his wound vac. The wound vac was a device that would decrease the air pressure and create a vacuum on his wound. We were told that this helps the wound heal more quickly. The gases in the air around us put pressure on the surface of our skin. The wound vacuum removes that pressure over the area of the wound. We were told that this would help his wound heal in a couple different ways. It would gently pull fluid from the wound over time and disperse that fluid into a canister on the machine that got changed periodically. This would reduce swelling, help keep the wound clean, and remove bacteria. The wound vac would also help to pull the edges of the wound together with the possibility that it would stimulate the growth of new tissue that would help the wound to close more quickly. Eugene’s specific wound vac set-up was pretty intense and a large area to cover.
Eugene’s wound spanned from the inside of his butt crack all the way to the side of his left hip. There were portions of skin that were intact and large areas of muscle and tissue that were exposed. There were tunnels that went through the left butt cheek and thigh that connected to each other. In between the tunnels there were areas where fluid would pool and create a “pocket” and just sit, this was a huge concern for necrotic tissue and infection. The wound care nurse and surgeon worked together to pack the tunnels and pockets with a grey sponge. The sponge helped the tunnels to not collapse. This allowed them to heal over time and regenerate the tissue instead of collapsing and never filling in the lost tissue. The sponge also allowed those areas to be drained continuously. The bare flesh and muscle on the surface of the area was also covered in a thin layer of this same grey sponge. Then on top of the area the wound covered, a layer of tape that is like saran wrap sticks to the skin and sponges that are exposed. After that layer is on, they would cut a small hole in the saran wrap/tape stuff over an area of sponge to place the suction cup that sucked out the fluid and provided the negative pressure. All of the sponges in the wound were connected. Once they turned on the wound vac, it would suck all the air out of the wound and sponges pulling everything together. Eugene was in quite a bit more pain after this specific visit to the OR. They removed a lot of dead tissue and the wound vac suctioned on the most painful areas but we felt positive about the potential it had to help in his healing process.
After he was awake from his surgery, they were able to put him on a blood thinner and get dialysis started again. We were starting to feel like the day was winding down and we could try to get some rest and then we had a visit from Eugene’s nurse and nutritionist. Eugene had dropped around 20-25 pounds already in the short amount of time we had been there. They decided he needed to be put on a feeding tube. Making sure that Eugene was getting an adequate amount of calories and protein was really vital for the healing of his wounds and organs. He was actually happy about the potential it had to provide the nutrition needed and more energy. They still allowed him to try to eat and drink as much as possible on his own as well. Though this day was a tiring one, Eugene seemed to be in much better spirits than the previous.
I had been home to shower twice now in 9 days. In the ICU rooms, family members are not allowed to use the toilet in the room so I had to walk down a long hallway. I did this several times a day. In the waiting area there was a pebble ice machine and I became obsessed. I would use the restroom, fill my cup to the brim with ice and sit and chew the ice. I spent a lot of time in that little bathroom stall. I had a backpack with clothes and toiletries in it that I would bring with me on my morning walks down the hall. I’d change clothes, use a face wipe to clean my face, brush my teeth, and throw on a little deodorant. I never spoke on the phone around Eugene or in the room, so on my walks to the bathroom I would often call my mom and talk to her for a few minutes. She did a good job of just listening and telling me how much she loved me. She kept asking to come and help out. I didn’t know how it would help so I kept turning her down. The phone calls alone made a big difference.
We were told that every day in bed is a week of recovery time. We’re on day 9 at this point and had no idea when he would get out of the ICU. We began to realize the road we were on seemed to be a long one, but we were still very positive that he would have a full recovery. After all, he is Superman. :)
