by Elaine Miller
I returned home and looked about me. The yard had been freshly mowed and there was a sack of vegetables sitting on the porch as if everyone knew I was coming that evening. I went to bed exhausted, but peaceful for the first time since the accident. I called my supervisor, set up my schedule and returned to work. Every day off I drove to Iowa City and back. In-between my visits, other members of the family went. My parents went. Her father went. The other two children opted to stay at the in-laws for a visit. There was a friend Marie’s age next door to them that she was close to. Marie said later to me that she would sit and cry and worry about her sister. She was afraid too. Our son Seth was close to his grandfather there.
By that time Mary had shown rapid progress at staying awake. She was moving around in the bed. She was lifting her broken leg up and down in the traction when she was not supposed to. It was throwing the femur slightly out of line so that it was healing the bones slightly overlapping. It caused her leg to heal and remain one centimeter shorter than the other.
Mary had been moved out of intensive care and into a room on the neuro floor. All the I.V.’s had been removed. She still had a foley catheter into the bladder and the nasal gastric tube into the stomach. They were feeding her formula through her tube into her stomach for nourishment. She had a delayed reaction with swallowing. Her trach was in place in her airway, but capped off as she was breathing normally on her own. I had gone several times and the head neuro resident had promised me that "tomorrow" he would remove the trach.
Mary’s attention span was a half a minute or less. She would smile when she saw members of the family and move around more in the bed. Mom and Dad went and she said to Mary "here I am, your Nana banana." She said she laughed real hard, but no sound came out. When she smiled the right side of her mouth drooped like with a stroke. We noticed that her right arm was drawn up to her chest. If she wanted to move it, she would take her left arm and move it about. She had paralysis down the right side of her body, which affects speech and swallowing. The most assault had been to the left side of her brain causing the right-sided damage.
Brett had returned to The Smith Company to work. One weekend I worked and he went to Iowa City to see Mary and meet his parents with Seth and Marie. They were ready to come home. Marie had seen Mary just once in intensive care before being taken away to her grandparents. It was only a brief glimpse of her.
They all went to her room. Marie stood and looked at her. She asked her father what was in her leg that was holding the traction. He explained that it was a screw through her leg and bone. No one was paying attention to Marie. She said she continued to look and she could feel her world dimming. She went over and leaned against the wall. Still no one paid any attention. Suddenly there was a sharp sound and it was Marie’s head smacking the floor with a resounding crash. Marie had fainted dead away. She awoke on a gurney with lights overhead and hospital staff looking down at her. She was in the emergency room. She was taken to x-ray, her bump was iced and she remained there for a couple hours. She was released in time to return home to me. She was all right. I was once again in a fury with her father for not keeping an eye on all his children.
It seemed that almost every time my ex had our children something happened. The month before the accident our son had such bad tonsils and adenoids that they had to come out. My ex refused to allow him to have the surgery where I worked. He took him to another hospital. I hated him. My son had an adverse effect from the anesthesia and came out fighting so hard he had to be strapped down. Attention deficit disorder people react differently to drugs than other people do. Then my son hemorrhaged and hemorrhaged from his nose. He was a nose bleeder anyway and had been cauterized several times before. He was taken back to surgery. He finally went home and was to remain quiet with no jostling around for two weeks. Five days after surgery my ex decided to go see his girlfriend in Iowa City that Jack had fixed him up with. He told me if I didn’t take him back he was going to marry someone else right away. I begged him to leave Seth with me. He refused.
Seth ended up in the emergency room again right after they got there. I was in a rage. They cauterized and packed his nose and told them to come directly back to be admitted back into the hospital. I told my ex he’d better bring him to the floor where I worked on a general surgical floor or else I was calling my attorney. He did comply and I took care of him. We finally got through that ordeal and he healed, but not before two more trips into the operating room.
Mary had been at Iowa City now for three weeks. It was exhausting to have to run over there every day off. I spent five to six hours on the road on my day off. I arrived at the hospital close to noon one day. I went into Mary’s room and I had my lunch. I had a large glass of soda. She kept looking at my soda. I looked at her and decided to test her. I had looked at the chart at the foot of her bed and had seen continually " no response, does not respond to name or faces." My blood boiled. She turned her head and looked at us every time we talked to her. She understood what we said and smiled. What was wrong with them?
I knew I had to be brief using as few a words or commands as possible due to her limited attention span. I said "Mary, look at me." Her eyes turned to me. I continued "do you want a drink of soda? If so blink your eyes once. If you don’t blink your eyes twice." I sat and waited. Slowly she blinked her eyes tightly shut one time. Then she moved and looked away. Her attention was gone. I repeated my commands. She turned again and re-acted the same way again. I was excited. I was elated. Yes! I rolled the head of the bed up a little higher. I placed my finger over the top of my straw thus keeping the soda captured within. I sternly invoked my commands. "Mary, look at me. Open your mouth." I dribbled a few drops onto her tongue. She held it in her mouth. I invoked "swallow!" She swallowed the soda. I repeated the process several times. Now it was time to educate the staff.
I marched out to the nurse’s station. There was a nurse sitting there and the friendly resident standing there reading a chart. With determined resolve I told them to bring a straw and a can of soda and come with me. Without a word the nurse got the soda and the straw with a glass of ice. Both followed me into the room. I stood by the bed and said "Mary look at me! Do you want a drink of this soda. If so blink your eyes once." She squeezed her eyes shut. I filled my straw, placed my finger on top and repeated my other commands. I released the soda into her mouth and commanded her to swallow. She swallowed.
I turned to the doctor and the nurse and said "do you see this? Did you see how she looked at me, answered me with her eyes and followed my commands?" They nodded yes to me and the doctor smiled and said he just couldn’t believe it. I told him to write an order for her to have a pureed diet and liquid with a straw. He asked me if I would stay and feed her. I told him I would. I picked up the chart from the foot of the bed and told them their comments about her not responding to her name or being unresponsive were erroneous. They agreed. I discussed how the rest of the staff needed to be educated on how to get her to respond appropriately, reminding them that her attention span was minuscule. They agreed.
I turned to the doctor and told him I wanted the trach out. He tried to tell me later, but I told him why not now? He caved right in. He went out, wrote the orders, came in and took out the trach. He told me she needed to be close to me. I told him I wanted her transferred to my hospital. He told me he would talk to the orthopedic doctors and we agreed on a specific time that I would call him in three days time. I had to line up an orthopedic doctor, a neurosurgeon, and an ambulance that could take her in traction from Iowa City to Peoria. The other agreement was that I was to be the one to ride attendant in the ambulance.
I was on cloud nine. She had responded to cues, drank and when her tray came she ate for me with the cueing. I drove home that day laughing and crying with joy. I called Mom up as soon as I got home. She said, "see I told you she’d be all right." Brett just said "good." No one was as excited and elated as I was. It was like when she first cut a tooth, or first walked.
My mind flew back to the words spoken to me in the car. I thought about how I told the staff what to do and without any argument, they complied right away. Now the monumental task was the two doctors I would deal with at home. I knew these doctors well. No nurse told them what to do. The orthopedic surgeon had set Mary’s arm when she broke it while roller-skating, when she was nine.
I went to work. I ran those doctors down in the hallways. They agreed to accept her case. They wanted her x-rays. I told them when I was going. They told me there would be a doctor waiting to place her in traction upon her arrival at the hospital. I called the ambulance service. I requested a driver that used to come to the nursing home to pick up patients when I called. I worked there for several months’ right after completing nurses training. They told me we’d need to take the van to accommodate the traction set up. The plans were made. Everything was falling into place. Thank you, God.