Friday & Saturday

Ok so I many of you have been wondering about Billy and what's going on so I hope to get caught up again. Billy says the days are dragging, which I can totally understand because he's the one in the bed in pain, being stuck and asked a million questions, but as much as I want this to be over the days are going by really fast because of all the things I am trying to get done.

Friday, October 28, 2011

Today was another up and down day. It started out pretty good. Billy was answering all the questions correctly, physically responding to all their request and making sense most of the time. As I have said before they tell me there will be good days and bad days, but lately it's been more like good half of the day and bad half of the day. So Billy is still in pain, but was trying to eat and he got up and walked. He is very frustrated with all the tubes and mostly the catheter, which I personally know is very uncomfortable. He is having a hard time getting comfortable as well. His body is sore from all the laying and all the pokes and stcks he comtinues to get daily. Later Friday night 2 of Billy's sisters and their husbands came up to see him and he was on a roll. He was making everyone laugh. The real Billy would come out, but we would lose him here and there in the middle of what you think is a normal conversation. I can't help but laugh at him because he says some goofy things, but has no recollection of it. That night he was stuck on using Chinese Food as references to all kinds of things. Some of it made sense and worked with a joke he was trying to tell, but others were just out there, so I've learned you never know what your going to get from one hour to the next. This is all normal from what I've been told and he will continue to have short term memory issues for a while, but that he should eventually regain all of his memory.

Saturday, October 29, 2011
Today didn't start out well at all. Around 5:00am Billy was kind of restless and hurting pretty bad. I was trying to help him get comfortable but no matter what I did he was moaning. As I was talking to him he became confused and his head was really hot (like a low grade fever). The nurse came in and I told him that I thought he was acting different and more confused. The nurse told me that was normal and that sometimes patients have dementia spells because they get woke up so often for so long and they get confused. I could see I wasn't getting anywhere with this particular nurse so I just help Billy get back to sleep, but I knew in my gut that something was changing. I know Billy better than anyone and by this time I've been here a week and feel like I know what to look for now. Shift change was at 7am so around 7:30 the new nurse came in and did the same neuro test they do many times a day. Billy answered all the questions right and physically did everything they asked him to so on the surface everything seemed great. I told the nurse my concerns again and he thought it was all normal, but then Billy started to ask me why they wanted him to play football. I told him no one was trying to make him play football, but he was convinced he had a helment on and they were bugging him to come play. BIlly then said, "I think they are confused and think I'm Logan." (I had to laugh about this so I don't cry) I would exlain that he was in the hospital and he didn't have to play football. He would stop and think and then he realized he where he was. Thankfully the nurse witnessed all this and said, "ok I see what you mean' so I'll talk with the doctors." Shortly after this episode he was talking normally again and ate breakfast like none of it ever happened. Then he got really tired and dosed off to sleep.
Ever since the day of the surgery I have held it together really good. I feel somewhat numb and scared to get too excited about his good days because I don't want to be disappointed. I feel like i"m in surveil mode because I not only want and need to be here with Billy, but I still have my kids to worry about (even though my mother is here which is wonderful, but as any of you parents know, you always worry about your kids), bills still have to be paid, etc. , etc. So I have felt like I have to be strong for everyone and life must go on in a lot of ways. Well this morning I couldn't hold it in anymore. I started to feel overwhelmed and closterphobic and like I had to get out of the hospital. While Billy was a sleep I went and walk around the outside of the hospital and cried to my mom. I felt frustrated , sad, scared and thankful all at the same time. After a good hour of talking and crying I felt better. I felt like I could go back in there and face the day. There were still challenges, but I kept pressing on.
Later that evening they pulled the lumbar drain out of Billy's back because they had shut it off 36 hours prior to see how he would do. overall he had done good, but they did suspect that he had some pressure building up because of his confusion, but the pressures weren't high enough to warrant the drain anymore. Billy was glad to get it out because it's one less tube. He also had to have his ART line redone as well. (The ART Line is an artierial line that is similar to an IV. It is in an artery so it takes his blood pressure and it gives them access to draw blood without sticking him so much.) He has a lot of problems with his ART line so they have had to try to fix it with wires and start a new one on the other hand. Overall he's making good progress, but it's very up and down.

Aneurysms

I've had a few people ask me about what exactly an aneurysm is and what causes them so i'm going to share what I have learned so far:

An aneurysm is a weak area in the wall of a blood vesel that causes the blood vessel to bulge or balloon out. When an aneurysm occurs in a blood vessel of the brain, it is called a cerebral aneurysm.

Causes and risk factors for aneurysms are a severe head injury, smoking, high blood pressure, family history and sometimes, but rarely you can be born with a defect. Then there is the spontaneous (basically unlucky) group that have no risk factors, but have an aneurysm which is the catagory Billy falls into. About 5% of the population have aneurysms and never know it because you only show signs if it ruptures.

So If someone has an aneurysm and it ruptures many people die quickly unless it clots or their able to get into surgery asap. Thankfully Billy's rupture clotted very quickly and the reason we know this is 1. he's alive 2. within 15 minutes of the first severe head pain he felt, he passed his neuro exam 100% 3. his hearing came back and 4. his blood pressure was normal. These were also all of the reasons we waited to go to the ER. I believe with all my heart Heaven Father was watching over Billy and our family.

So hopefully this helps some of you understand more about aneurysms.

Updates

I am little behind on my posts as far as day to day so I'm hoping to get caught up tonight.

Wednesday, October 26, 2011
As I said before, I spent the night at home Tuesday night and Billy's dad slept at the hospital. I called Billy's mom to see if she would go to the hospital in the morning so I could get some stuff together and make some much needed phone calls. Billy's mom said he did really good all morning and even walked up and down the hall with the physical and occupational therapist guiding him. Even though it hurt his head, he did great. He then stood at the sink and brushed his teeth so he really made a lot of progress. I finally got to the hospital around 3pm (word of advice: do not talk on your cell phone when you are not quiet sure where you're going. I knew I was headed in the right direction, but I'm pretty sure I took a few unnecessary turns, but I did finally get here.) Once I got in the room, Billy's mom, brother and his wife where there. When he woke up he was like him old self. His head still hurt, but he was talking, cracking jokes and had us all laughing for about 3 hours. We even took some pictures and he really looked good considering he had brain surgery 3 days prior. After they left, Billy began insisting on having his cell phone. I told him he didn't need it and to rest, but he kept insisting, so I gave in. He started checking messages and called his sales manager at work. He is having some short term memory issues, which is totally normal and at sometimes really funny.

Shortly after he got off the phone, our bishop came by and Billy talked with him for a while. Again, most of it made sense, but he would repeat himself on certain topics, but had no idea he was doing it. Then my mom brought all the kids. I went to the waiting room to see Karsyn & Landon while Logan & Paige went to visit with their dad. Paige made him chocolate covered strawberries and they all made him "Get Well" Posters. By now Billy is getting pretty tired and sleepy so once my mom and the kids left he was trying to settle in for the night. He started to get a little confused and asked me lots of funny questions. (I have to put them in here so I don't forget and so he can read about this whole experience when he's better) First, he asked me what I was doing like 3 times, then in between he would ask me if I had his phone. I would tell him and he would say ok. Then about 10 minutes later he ask me if I knew where his phone was and he told me he didn't want the kids playing with it. I assured him I had his phone and we were at the hospital and the kids were at home so they couldn't play with his phone. Then I was helping him get comfortable in the bed and he tells me, "I don't feel very good, but I still think I can go to Logan's football game tomorrow." I told him he couldn't leave the hospital, but again he insisted that he would feel better tomorrow and he was going to the game. I just agreed with him and knew he would forget what he said by morning if not in the next few minutes. After a few more funny questions and comments, he finally settled in for the night and slept pretty peaceful.

Thursday, October 27, 2011
Today was not a great day for Billy. He was really lethargic (sleepy) and said his head was hurting worse today than before. He didn't want to eat and continued to sleep, but moaned a lot in his sleep. Between 10am-11am he got his normal pain medicine, but it wasn't working as fast as he needed it to. So they gave him another pain medication that acts very quickly and usually helps relax him enough for him to go to sleep. Right after they gave him that last medication his heart rate dropped to 35, which is extremely low. They thought it was from the fast acting medication so they decided they would not be giving him that anymore. Well as lunch came and went, he continued to sleep, not eat and was really sensitive to light and touch. He complained about his head and that his neck was hurting really bad again. These are all possible symptoms of swelling or vasospasms. With a lot of prodding he got up and walked down the hall, which got his heart rate up, but it still remained low. Once he got back to the bed, his heart rate dropped again and stayed very low all afternoon. Finally the doctor came in and ordered a CT scan to make sure the brain wasn't swelling. The doctor also said to stop the lumbar drain and see how he did. The CT came back ok and after not draining spinal fluid for an hour he began to perk up. They decided they were draining too much spinal fluid so they were going to half what they had been doing. I immediately saw a difference in him. He finally really woke up, ate dinner, began to carry on conversations and the headache wasn't as severe. The brain is such a complex and amazing organ. Just by decreasing the drain by 5 cc he became a different person. Today, was like one of those days they said I needed to prepare for. We were very lucky and had a good outcome by the evening, but it was definately a trying day emotionally. I'm very impressed with all of the staff here at the U in the Neuro ICU. They are all very well trained and very approachable, which makes a hard day just a little bit easier.

Recovery

So i know a lot of people want to know how long he will be here and do they expect a full recovery. These 2 most important questions are the 2 they can't answer completely. He has made great progress and the doctors say they really expect him to make a full recovery, but they will be able to give us a better answer between day 14 & 21. This to me has been one of the most frustrating things, but at the same time, I totally understand because anytime someone has brain surgery the outcome is so unknown.

Like I said, Billy is doing great, but the reason he has to be in ICU for a minimum of 14 days is because between day 5 & 14 he is at risk for Vasospasms (which is when the blood vessels constrict and cause stroke like symptoms and if not treated within 45 minutes to an hour can cause permanent brain damage) If he begins to have a vasospasm they will take him down to interventional radiology, where they would go through the femoral artery (in the upper thigh) up to the brain and inject a medication to dilate the vessel. I asked one of the Neurosurgery Residents what were his odds of having a vasospasm. He said they rate aneurysms from 1-4 (4 being worst) and Billy's was a 3 so he said he has a 95% chance of having a vasospasm. But like everything in this situation we just have to wait and see.

So if Billy gets out of ICU around day 14, they will then move him to a step down floor (normal room) for 2-7 days before he can go home. So if all goes really well and he's home in 3 weeks they tell me it will probably be about another month before he can go back to work, but possibly longer. (I think I must need to learn more patience. Here's the hint, "It will be at lease 14 days before we can tell you if your husband will be completely ok".) I'm trying to keep some humor is this situation or I will definitely go crazy.

One of the other hard things about this situation is that my two youngest kids, Karsyn & Landon can't see their dad until he's out of ICU, which like I said before, we have know idea when that will be. Time concept is hard at their age especially for Landon. He asked me the other day when dad was coming home. He was also very upset that dad was going to miss Halloween. I told him we would take lots of pictures of them in their costumes and show dad. He liked that idea, but misses his daddy very much. All the kids do and really just want their dad back. It's been hard explaining what is going on with their dad, but it's the hardest when they ask if dad will be ok and will dad still be able to play with me like he did before?? Those are answers that I still don't know myself. I've tried to tell them that dad is doing really good and the doctors think he will be just fine, but it will take a long time for him to be completely back to normal.

The last thing I wanted to tell everyone is that the doctors and nurses all keep telling me the next couple of weeks will be like a roller coaster. It's very normal to have really good days and then really bad days. He can even have 2 or 3 good days and then decline. They tell me to prepare myself for constant ups and downs because unfortuantely this is the nature of Aneurysms and brain surgery. I'm just trying to plan for the worst and hope for the best. One of the biggest advantages Billy has is that he is young, strong, healthy and a fighter. He will work hard to overcome this trial and I truly believe we will be a stronger family because of it.

Many Thanks

On behalf of my entire family, I want to thank everyone for their thoughts, prayers, texts, Facebook posts, etc. etc. We are truly blessed with the most wonderful family and friends. I am so overwhelmed by the love and support from so many people. Every prayer, thought and message have been felt and will leave a lasting impression on our entire family!! Thank you again!!

How Quickly Life Can Change!!

Well where do I begin. Saturday, October 22, 2011 started out like any normal day, but how quickly things change. Billy went to work out around 8:15ish, then about 9:00am he called me and said he almost passed out and he had a severe headache and the paramedics were at the fitness place checking him out. . I asked him to tell me exactly what happend before he almost fainted and felt the pain. (Billy had been given some energy powder that you add to your water bottle at a work Trade Show. He knew some guys that had been using it before their work outs, so he thought he would give it a try. He drank his drink and started to do toning reps, which was not really heavy so he wasn't straining real hard. About 30 min. after he drank his drink his ears felt muffled and then he said he felt a sharp pain in the back of his head and thought he was dying. He knew he needed to tell someone so he walked up to another guy lifting and bent down on his knees and said "I'm not feeling well, will you get that guy on the treadmill because I know he's a paramedic." They called 911 and the paramedics show up and give him a through exam. The paramedics told him his blood pressure, blood sugar and neuro exam were all great.) I then show up with some fig newtons thinking he needed something on his stomach. The paramedics helped him to my car but said it would be a good idea to go ahead and have him checked out by a doctor just to make sure.

Billy’s brother is a doctor and was actually coming to our house so I called him and asked him if he would mind checking him out. I got Billy home and in bed then his brother came and did a full nuero exam and checked all his vitals which were all normal. He then gave Billy something to help his head and to rest. I thought in an hour or so he would be feeling much better and the day would go as planned. Boy was I wrong!! A couple of hours went by and Billy still had no relief from what he called the "worst pain of his life". The pain started at the base of his neck and went up the back of his head. No matter what he did, he was getting no relief and it was getting worse. So about 3:30pm Billy said he couldn’t take the pain anymore and wanted to go to the ER, which is a big thing for Billy because he doesn’t like taking any medicine and will only go to the doctor when he feels really bad.

We arrive at Davis Hosptial ER, we get in pretty quickly , but the doctor didn't seem too concerned, but said he would get an IV started, give him some meds and order a CT Scan just as a precaution. Billy was shaking because he was in so much pain. I really thought he was having a bad headache because of the "black powder" he took, again WRONG!!! It took a little while for the nurse to start his IV and inject the meds. but I thought he will finally be able to relax and sleep off this massive headache. The doctor didn’t seem too concerned, but honestly I wasn’t extremely concerned either. Billy had his CT scan, came back to the room and was pretty loopy, but said his head still hurt. Shortly after, the doctor came in and I expected him to say everything looked good and we would go home in a couple of hours, but instead he said Billy had a Subarachnoid brain bleed and he wanted us to go to the University of Utah Medical Center by ambulance and Billy would probably have surgery that night.

At the U of U ER a neuro surgeon came in and said Billy's CT scan didn't match his neuro exams. By the amount of blood and the enlarged ventricles they expected Billy to be disoriented, having possible seizures and even unresponsive, but Billy was completly coherent and answered all of the questions right, etc. After this exam they ordered a contrast CT scan so they would be able to see exactly where the ruptured aneurism was. Billy's aneurism was at the back side of the frontal lobe, but down about 3 inches. By the time this was all completed it was late evening on a Saturday night and since Billy was stable they decided to do the surgery on Sunday when all the surgeons were fresh.

Sunday, October 23, 2011
Billy had a pretty bad night because they are very conservative on the pain meds. they give him because the pain medication can mask his neuro symptoms, therefore, he continued to hurt. Even though he was in severe pain he continued to pass his neuro exams with flying colors. That morning the doctor said they were not sure when the surgery was going to be. Finally at 1:00pm they came in and told us they would be coming to get him around 2:00pm for surgery. Well finally around 3:00pm they came and took him back to surgery. 6 1/2 hours later he came back to the Neuro ICU. The doctors said he had done well in the surgery, but the vessel was in a difficult spot so it took longer to get to than expected, therefore, they had to put his brain in a deep coma in order to complete the surgery trying to prevent brain damage. Therefore, because he was so sedated they had to leave the breathing tube in. I have never seen anyone with a breathing tube so it was very emotional for me to see my strong 38yr old husband in such a vulnerable state. Around 1:00am the nurses loosened one of his hand restraints just enough so he could turn to his side and then some how around 3:30am he managed to pull the tube out completely. That didn't surprise me one bit, but he doesn't remember it either. Luckily he was breathing well enough on his own they were able to just put an oxygen mask on him.

Monday, October 24, 2011
Billy still had a headache, which they tell us he will have one for at least 14 days, but he said it was a different headache than before the surgery. Again they are trying to keep him as comfortable as possible even though they were still limited to the amount and types of pain meds. they can give him. He rested fairly well most of Monday day, but Monday night was a different story. As they were asking him the same questions they ask him about 10 times a day, i.e. (Where are you? What's the date?, What kind of surgery did you have?, etc, etc) he began to get a little confused. He said we had 6 kids, he was there to get his teeth fixed and it was 2012. This is not uncommon to happen, but usually means something else could be going on. He started running a fever and then started having some kind of anxiety attack. He began to thrash in the bed, he wanted to sit up, lay down, sit up, lay down. Then he said he needed to get out of the bed and wanted all of the tubes and wires out of him. He then opened his eyes really wide for the first time since the whole thing started and had tears in his eyes and told me, "I can't do this, I just can't". Billy's sister Becki was in the room with me and we both just wanted to cry, but we were trying to be calm and strong for him. The nurse came in and gave him a medicine the acts very quickly, but leaves quickly as well. He finally settled down and had an ok night.

Tuesday, October 25, 2011
That morning Billy was a little confused and got some of the questions they asked him wrong again plus he was more groggy than he had been and he didn't have any more pain medication than before. The doctors came back in and told me they thought his ICP(Inter Cranial Pressure) monitor wasn't reading correctly so they were going to do a lumbar puncture to drain spinal fluid and blood to see how much there was and if it changed his ICP. Ideally they want is ICP to be 20 or below and for the most part it had been staying below 20. The doctor came in to do the lumbar puncture and they let me stay and watch. It took a while to find the right spot, the surgeon had to keep sticking him over and over, which was very painful and he had to remain still. Finally the doctor was able to get the drain in the right spot and the spinal fluid and blood began to fill up this tube. When they were done they got 35 cc of fluid. The monitor was saying his ICP was 17, but in reality it had been 35 which was very high. Once the fluid was drained Billy was almost instantly a different person. He finally really woke up, started taking, making a few jokes (which if any of you know Billy, you know that is the real Billy) He was asking questions and actually retaining most of the information I was giving him). I had already planned on going home this night because I haven't been able to see Landon or Karsyn since Saturday because they will not allow them into ICU, therefore they will not be able to see their dad for at least 2 weeks. Billy was doing well and his dad said he would sleep at the hospital all night so I went home and spent the night with my kids and my mother, who flew in on Tuesday afternoon. It was nice to be home and be with the kids, but I felt guilty being away as well. The doctors and nurses keep telling me I need to pace my self because we have a long, long road ahead of us, but I feel like he needs me. This has been one of the hardest things about this whole thing because Billy needs me and I want to be there, but my kids need me too. I'm praying for guidance and peace so that I make the decisions at the right time for everyone.