November 6 2008

Day 3
Dennis slept better overnight, but this is actually a cause for concern, as he seems more lethargic and less responsive. It's also a sign to the neurosurgeons that the swelling in Dennis' brain is continuing and so an additional CAT scan is ordered for early morning. Before the start of mid-morning visiting, Dennis was moved out of his room and into the general Trauma unit area , so that he can be more easily monitored. The neurosurgeons decide to place a monitor and drain in his skull, to control the intracranial pressure that is building due to the swelling. Today at 6 PM will be the end of the second full day after the accident, still looking forward to that magical 72 hour deadline for maximum swelling. The ICP's are ideally supposed to be below 20, hopefully never above 30, because this is the edge of the danger zone foe Dennis. For the first time, the team of doctors begin to talk about options to control the injury, which include medication, activating the drain and removing a section of the left side of Dennis' skull (about 4 inches square). For today, the plan is to use the meds and hope. Again, the nurses, particularly
Drew, are seemingly more positive about his condition than the surgical team, as the team describes the details of the procedure, the effects on recovery and the likelihood of this option. (The family {again that secretive part} decides not to discuss this possibility at this point with anyone, because it is too frightening to contemplate.) During the daytime hours, Dennis' pressure readings fluctuate from low teens to the 30's, causing one of the nurses to comment that watching the numbers constantly will drive you crazy. (She's absolutely right, because we're almost there at this point) Dennis continues through the day, somewhat responsive at times with certain nurses, doing the thumbs up, knowing his name; less so with others, particularly the neurologists. The most difficult parts of the day are updating others on Dennis' condition and prognosis and the drives home.