If this is your first visit to this page, maybe look at the photos first. Then start reading at the bottom of this page.......if you are interested in the beginning of the story. Or start where ever you like :-)

Also visit

http://amitabhahospice.org.nz/messages/index.php

if you would like to post a "get well soon" type message. (Hit the "Sign" button at the top right)

11 Feburary 2009

Today was a red letter day, Ecie has been going to Hydrotherapy quite a bit, she loves the pool. If there are not too many other people, she sometimes gets to swim at the end, and today she completed 42 lengths (it is a pretty small pool). But that is not what inspired me to post again after such a long time. Every time the therapist is getting her to try and walk up the steps out of the pool without holding on. Of course, when she first started, she couldn't let go the grab rails either side when walking down into the pool until she was right up to her shoulders - and needed both grab rails to even lift the first leg at the bottom when fully emersed, to start climbing out - and had to hold on both side for grim life as she dragged herself up out of the water.

But gradually, ever so slowly, she has learned to walk up under water without needing to hold on, step by step, week by week....and today she got all the way to the top - that is she was standing, dripping water with a huge grin at the very top of the stairs having walked all the way up and out without needing to hold on at all. Momentous moment!! And she did it twice more - even after swimming all those laps. Far out!

 

Thursday 26 December 2008

Ecie wrote this:

Dear fellow brothers and sisters,

Some of you may have read this already but if not: Thank you so much for saving my life when I had the nearly fatal car accident on Jan 21, 2008.
I heard that hundreds of people, many I don't even know, recited the Diamond / Vajra Cutter Sutra following the kind request of our father Lama Zopa Rinpoche (those who are disciples). Others sent positive thoughts and prayers in their own faith. It all helped immensely.
Even now kind people are still following my husband's journal and many are still reciting the sutra, dedicating and praying for me. I sincerely believe all this merit is what is healing me. I am making slow progress, learning to walk, dealing with pain and disability, grief, sadness, fear like I never had before (in this life)!
All these difficulties will help me be a kinder, more compassionate, more knowledgeable, more helpful person in the future. It would be wonderful to be able to make all this suffering meaningful and beneficial for all sentient beings.

I hope you all have very joyous, restful and peaceful Christmas holidays. And may you all have good health, rewarding experiences, happiness and laughter everyday in 2009!

With love, hugs and deepest thanks from the bottom of my heart!
Ecie

 

Sunday 2 November 2008

I forgot to say - Ecie can hobble around now with just a stick but prefers to use one or even two crutches as that is so much easier - but we all hassle her to try and just use the stick. She has also managed to get onto facebook so if you are on that you can connect to her directly here.

 

Labour Day - Monday 27 October, 2008

Such a long time since I wrote anything, been trying to encourage Ecie to write now she is using the computer again and slowly working her way through emails. You can write to her directly at eciely which is what she uses at gmail.com. I have also added a couple of pictures taken yesterday, at the bottom of the page here, this has become a highlight most days - the three of us go out in the late afternoon sun and play a sort of badmington - well, we don't use a net much, or try to win, rather the aim is to keep the ball going back and forth as long as possible - me and Ecie on one side and Joe on the other. Jo is now very good at hitting them back to Ecie in the chair or me elsewhere; and we are getting much better at hitting them back to him. You can see the very odd blue ball in the air in the first photo, about one o'clock from her racket just under the tree tops. It is very soft and in the wind takes unpredictable side trips or just stops dead. It is amazingly good fun, so satisfying to return really tricky shots and keep it in the air for long periods - well, maybe 10 - 15 hits. We play about an hour a day and it never ceases to amaze me how good Ecie is at it - she used to play lacrosse as a teenager and those skills tend to stick. Great exercsie for all of us. Happy times, the only other things she likes as much is going to the mall, which is (of course) hell on earth for any normal male, and I am very normal. Joseph is more tolerant so takes her quite often. And going to the pool twice a week for hyrodtherapy. Hard to get her to do any other exercise tho.

Still lots of pain and lots of tears, recurring cycling thoughts that offer Joseph in particular and me to a lessor extent endless opportunites to talk dharma and recite ACT slogans (well, they are one and the same, actually). Seriously though, I was talking to Jo about this unexpected consequence of the accident yesterday - it really has improved my practice no end, as I spend (it seems to me) so much time trying to think of helpful things to say to her, that forces me to forget myself, however briefly, and what other definition of happiness is there? Beyond that, it means we have to think endlessly of how to use new / different words....we all know the same of stuff about recognising thoughts and feelings as transitory, the consequences of identifying any thought as The Truth, losing perspective, the inherently flawed nature of antidotes, the problems with good and bad, right and wrong, where meaning comes from, the differences between the Christian and Buddhist notions of consequences.....but words don't cut through so easily when the physical and emotional experience is really strong, so actions have to fill in the gap - no matter what happens there is always space, always a gap to be seized as an opportunity. Practice what you preach and the world will beat a path to your door. Words only beget more words, we have an election coming up and this could not be a better illustration of how taking words at face value is........just silly.

Sunday 30 August 2008

Sorry it has been a while, I was hanging out for something decent to write about and finally it happened - Ecie took her first steps using only one crutch instead of two! Very careful, short and somewhat painful steps - but with the right arm in mid air, NOT leaning on a crutch. Great stuff!!

ACC (NZ government run agency that helps people who have had accidents - a difficult concept for US readers, but true) provided a very cool trolly which is almost like a walking frame and Ecie has also been walking around the house behind that a bit too, proudly displaying items she can move in this way herself, rather than relying on others to carry for her. Yesterday was her birthday and we all went out to see "Earth" a BBC movie on the big screen - sad but beautiful doco on the planet. Then the boys made a cake and I took a couple of pictures (at bottom of the page). A few people called to wish her happy birthday which was really nice, she is quite a social person and invariably perks up when talking on the phone. On the down side, still lots of pain and heavy duty hot flushes accompanied by anxiety. Who'd be a woman?

Thanks again for all the kind words and thoughts, so much appreciated.

 

Sunday 3 August 2008

Such small changes nowadays, much harder to notice, the rate of improvement is so much slower it is especially hard for Ecie to notice and she has been getting a bit depressed lately - not helped by the fact that is is the middle of winter and seems to rain every day. But the rest of us certainly do still notice progress - last night I passed the bathroom and she was standing at the sink brushing her teeth. That sounds so ordinary, but it is definetly the first time she has been able to do that - to not only stand unassisted, but feel sufficiently stable to be able to carry out a task as well! Up til now teeth cleaning has always been performed sitting down......And she showed me yesterday how she can now extert a little more contol over the dead foot - we attach a long bit of rubber to it which is wrapped around her back when sitting or lying, uses the rubber to hold the foot in the upright / fully bent at right angles position, and then pushes against the rubber band to straighten the foot out - been able to do that for a while now, but the new trick is, instead of just relaxing after each push and letting the rubber band pull the foot back, now she can use her gradually recovering muscles to control the rate of that release / return. Big deal, I hear you say....well, yeah it is :-)

 

Monday 21 July 2008

Six months today since the smash and we spent a lot of it hanging around in a hospital again...well, not a hospital in the strict sense, it used to be a hospital but now they call it a clinic. We had a 10 am appointment and all four of us got there by 10, in different vehicles. And then waited. A good thing we are practiced at that as it went on for some three and a half hours. Got a couple of xrays of the hip and then finally saw the numero uno surgeon who was quite tired by 1:30 having been on the go non stop since his 7 am hospital rounds.
He could get Ecie to move a few things and was fairly positive, pointing out he could definitely say she had recovered more sensation in the leg and foor which had not been there 2 months ago, just after the hip operation.
I have been doing a bit of reading on sciatic palsy - but none of the links make for fun reading. Turns out that nerve is both big, fragile and in the way when doing hip operations...and it is, of course quite a mess in there during the opeartion, so not surprising it gets damaged sometimes. Anyway, still hopeful it can recover and meanwhile Ecie was given permission to put as much weight on it as she can bear - which isn't very much - and he was happy with the way all the wounds and bones have healed.

 

Monday 7 July 2008

Anxiety, fear, anger, hopelessness, depression, blame..........euphoria, joy, peace, happiness, hope.......

These are not like masks or costumes, as such analogies imply someone who is wearing them. Nor are they discrete states connected by a thread, like beads strung on a mala string - much as we would love to see that continuity.

Rather, they are like a flame that passes from one candle to another, each one sputtering out just as the next one lights.

Who could doubt the fragility of what passes from life to life, when this is so starkly revealed moment to moment?

So much pain, how much pain? Pain is the ultimate example of subjectivity - the princess and the pea, the warrior sewing up his own wounds. Pain is solitary, solitary confinement in a self made prison. Fuck it hurts.

"This will pass"
"I don't like this"
"This will pass"
"I don't like this"
"This will pass".
We sing a chorus at dawn.

 

Saturday 28/6/08

Ecie came home last Wednesday and the first couple of days have been good, Jo put her in the car yesterday and took her to the local shopping mall in the wheelchair, which was a great suceess - new, big comfy shoes with a velcro wrap which hopefully she will be soon be able to get these on and off with the stick. The stick is a very cool aluminium tool with a trigger that controls a lever at the bottom, it is really an extension of your hand, complete with opposable thumb. She can get around the house on her crutches, and this morning managed to lift the crap leg up off the bed for the first time which was an exciting start. Baby steps.....

 

Friday 20/6/08

Five months tomorrow since the smash. Sorry I haven't written for a while, especially as it has been an exciting time: the walking frame has been left behind as Ecie has gradually gained confidence on crutches; the Rehab physio is just great and has her climbing up and down little stairs now, very impressive. No new/more "normal" feeling in the leg below the knee, or control over the foot - those brief flickers in the toes don't seem to be getting more frequent as yet - but walking definetly getting better, no doubt about that. I spent yesterday afternoon / evening there and she walked on crutches all the way from her bed to the dining room which is over 45 meters - I know this because in the rehab place, such things are sufficiently important to justify prominently displaced signs on the wall at strategic intervals showing exactly how many meters you have manage to traverse down the endless hallways....

Pain seems to me to be generally less; there are long periods where it doesn't appear to be preoccupying her. We had a totally delightful visit from young friends last night who brought along their three month old baby, an extremely skilful individual who tolerated being jiggled, hugged, rocked, kissed, and cooed over for at least an hour by Ecie whilst exhibiting a most impressive level of tolerance.

But still with the upredictable shooting / stabbing nerve jolts which give rise to appropriate expletives. An appointment has been made for us with the Pain Team at the big hospital on Monday.

Ecie will be coming home for the weekend again today and hopefully getting expelled / released for good as early as next week!

 

Wednesday 11 June

Well that Friday night at home was pretty terrible - Ecie didn't get to sleep for more than half an hour all night which meant I didn't either, reminded me of when our first child was born but I was a lot younger then. But we both slept very well saturday, sunday not so good again - not really out before 4 am and I had to get up 5:30, that was hard. All nerve pain, like a knife, she says.

Back to rehab on Monday and they changed the drugs to try and target the nerve pain a bit better than the morphine family does. Into the pool three days in a row, yesterday a really exciting breakthrough - tiny movements in the foot...well, in two toes anyway, I saw them myself this evening, the second and third toe will now move about one and a half or would you believe two millimeters on command. That sounds funny, such a tiny movement, but it is a Very Big Deal, after weeks of no movement at all. It's the light of dawn, light through the keyhole...or, the first glimmer of Bodhichitta. The Start of Something Big.

Enough with the capitals already! But you get the idea - exciting!!

 

Friday 6/6/08

Home again for the weekend! We left hospital yesterday and after just one night at Rehab Plus are home for a few nights....back to rehab on Monday. Still lots of pain and now on some slow / long acting morphine, walking on a lighter frame but still one that enables as much weight as you like to be taken on the forearms. There have been several versions presented of how much weight can be put on the new hip, but the one now generally accepted is "not much for a while". The pain seems to be nerve related and as nerves grow so slowly that doesn't seem likely to dissappear overnight. When I had a go at Ecie for feeling sorry for herself she quite rightly pointed out she hasn't done that, actually - not in the sense of "oh woe is me, poor me, why me?" - nothing like that, at all. But she does spend quite a lot of time noticing she is in pain, as in "ow, ow!" and generally wishing it wasn't :-)

 

Queen's birthday - Monday 2 June 2008

Bummer, the pain soon came back, with a vengance. So now we live a somewhat schizophrenic existence, happy when there is no pain and miserable when there is - which is quite oftern. Walking remains the same basically - sometimes painful, sometimes not, but only short walks with the serious frame, not ready to move to anything lighter yet. There was supposed to be an xray today, then if that was okay, back to the rehab place tomorrow - but no xray (it is a public holiday, after all) so not much chance of leaving here in the immediate future. Two weeks tomorrow since the operation and no change in the lack of feeling in the leg so short term change in that department also looks increasingly unlikely. Sigh.

 

Saturday 24/5/08

A few days have passed now, Ecie has remained remarkably positive and has been sleeping really well; at least part of the reason is: virtually No Pain, which after all this time with the very painful hip, is a wonderful relief for her. She is back on the heavy duty walker once a day which supports the whole forearm each side - so you can really take the weight on your arms, and with this is able to again walk short distances but says the foot is rather disconcerting - the only sensation is pins and needles, a few little jabs from the knee and no control at all of the foot so it is in a little boot to stop it "drooping" when at rest. But enough thigh muscle control to swing the leg forward for each step. It seems there is quite a good chance of the nerves recovering and once again will power is going to be important. Looks like it might be a rather long haul but you never know.....still no word of how long we will be in hospital this time, hopefully back to the rehab place before too long. Drips, drains, and almost all lines all out now so more freedom coming all the time.

 

Wednesday 21 May - 4 months today since the smash

They kept her in recovery for a long time after the operation, eventually letting me and Jo in to hang out with her after about 5 hours. Recovery is this very intense area where visitors are not welcome - the place patients go straight after they come of surgery, to be hooked up to numerous machines and have one on one monitoring until everyone is happy they are stable enough to go back to ward. After a while it became obvious why they were keeping Ecie here - she was not regaining feeling in the foot below the operated on hip. The explanation might be the epidural: this was put in before the general knocked her out, this was done so it would be there afterwards to keep the pain at bay, rather than going back on to the dreaded morphine / methadone trip (which last time led to nasty times when it was stopped). They figured they might have put the epi in slightly wrong. So they cut back the flow through the epi to see if she could feel / move her legs......and she couldn't feel/move the foot at all. So they kept waiting / hoping....eventually released her to ward but during the night the loss of sensation spread up her body so they figured the epi definetely must have gone into the wrong place and they stopped it altogther - bringing pain, but still no sensation in the foot. Ecie is back in the same old ward, very nice to be there, the nurses were so happy to see us and we know everyone but this time in a room with four others and during the night one of these died, that always brings lots of drama with resus teams and such.....So after very little sleep the surgeon tells us this morning he must have damaged the sciatic nerve when pulling out some of the metal. Not it the same catagory as dying, but still a bit depressing...They gave us the bag full of stainless steel - all the stuff they used 3 months ago when they rebuilt the pelvis.

He says it may recover, but that might take up to 2 years. Meanwhile, no movement in the foot, but the leg moves a bit. And Loz (who smashed up his foot in a motorbike crash a few years ago) says he didn't have any movement in his foot for weeks and it fully recovered. Also, this is the surgeon who is always gloomy - if he says it may recover, I take that to mean it almost certainly will! So staying positive but a wee bit shaky...

For anyone who wants to know more: the essence from this page is:
# When the nerve sheath is intact (compression and traction injuries), there is a good chance that the nerve will reconnect with the area it originaly supllied. There is also a lower risk of sciatic neuroma formation.
# As injured nerves re-grow at the rate 2 mm / week, it can be many months before nerve reconnection is completed and the final extent of the injury known.

 

Tuesday 20 May 2008

The Big Operation has just finished - seems to have taken over 6 hours - we have just been told she is out of surgery and in the recovery ward so going in to see her soon.

 

Monday 12 May 2008

Just finished the second weekend at home and it was very nice, although a lot of pain from the hip on Saturday. On Sunday had several visitors including the one and only grandson with his mom which was especially nice, so cute at 2.5 yrs - running around and talking, very polite, a great distraction / entertainment for Ecie (and me). 'Cos we don't see him very oftern we were happy just to sit around much of the afternoon while he played very happily, it reminded me of when our kids were that age and I was able to pass a lot of time doing that - just hanging out with them, that being the priority for hours on end, everything else put on hold - it was so cool to do that, so much harder for parents nowadays, lives so much busier, sigh...

Put Ecie in the car this morning already dressed in togs to go back to rehab and get in the pool first thing - such a contrast to a week ago when she was so anxious about that, freaking out; this week relatively relaxed about it, able to crack a smile at us making fun of the owls. What are owls? Owls are what she apparantly sees a lot of, as she constantly remarks: "ow, ow!" when moving....

Got a light weight walker now, much better, a much smaller frame she can move easily, it only provides support for the hands, rather than the whole forearm support, but it works fine. Tomorrow the physio is bringing her home again, just for a visit to check out the house and see what she might need in this environment....so I suppose that means cleaning a bit today. Boring.....And then, straight after that home visit, back to the clinic for a "preadmission" session with God and his minions. Then the operation on the 20th - but only if the surgeon doesn't have to operate on another emergency in the meanwhile - which would push her opration off into the distant future.

 

Wednesday 7 May 2008

We had a big meeting last Friday afternoon at the rehab place and told them we were bringing Ecie home for the weekend; had to sign a form absolving them of all responsibility as they had not been out to look at our place first; the nurse kindly rushed off to get a doctor to write a script for some of the drugs they couldn't just give us, and we chucked her in the car about 5 pm. Had a pretty relaxed weekend; I have decided the rehab place is basically like work, so the weekend should be to relax. As our house is so small, there is very little room for a wheelchair and no room at all for her walking frame so we mostly moved her around by one person each side taking the weight on the elboes, acting like the frame. Worked fine and she really, really didn't want to go back on Monday. This weekend forced us all to face up to the fact that while the hip is wretched and the pain very boring, the smack on the head just might take the longest time to recover from. Ecie gets very fearful / anxious very easily now, which is a completely different experience for her - this is the girl who bought a motorbike while at a strict catholic girls school where they had all these rules about girls not riding pillion on a boy's bike - but nothing about a girl having a bike herself as that possibility had just never been conceived of in the nineteen sixties.

But now, so many things make her frightened, and Monday morning was extreme - she was due to go in the pool for hydrotherapy as soon as we got back to rehab, which previously she had refused to do (too scary) but at the Friday meeting she had been subjected to such a barrage of enthusiasm from me and all the staff, she had, in a rash moment, committed to do it. Now the time of reckoning was upon her and it was scary as. "I don't want to go back, let me stay here, I'm scared...." heart rendering stuff. Loz took her back and the staff is so great, they are very used to dealing with exactly this type of fear and in one sense it was easier with Ecie as she is (was) a super water baby - always loved the water, swims like a fish, even she, in her more rational moments, could see it was crazy to be so terrified of getting in the pool. They put her in this seat on a little crane which goes out over the water and gets lowered in, and it worked....after all that drama, she was happy to be in the water.

So that creates a great precedent : "Remember, you were so scared of the pool, yet you managed to overcome that fear, so you can do (whatever) too...."

 

Thursday 1 May 2008

Well, we went to the clinic today which was interesting: into the wheelchair and into a van - one of those cool ones which has a platform out the back which comes down to the ground whilst remaining level, on hydraulics, then rises up with the wheel chair on it - inside the van we strap the wheelchair down with vaguely S&M themed ties; then take off for the half hour trip across town. The "clinic" is huge - a rabbit warren of corridors connecting crowded waiting rooms supervised by seriously aloof receptionists and filled with a generous assortment of the disabled: all ages and ethnicities, exhibiting varieties of decrepitude. For some reason I kept thinking of that early scene in the first star wars movie where they go onto the bar to look for Harrison Ford. I didn't see him here, but the company was certainly fascinating. We were (yet again) lucky enough after one and a half hours to be greeted near the finish line (the culmination of the two hours spent there was obviously meeting with the Chief Orthopod) by a truely outstandingly helpful nurse who not only intrepreted the Great One's words for us mere mortals but also interceded on our behalf - and it is very comforting to feel you have an advocate who understands the upper echelons of the public health system. The short version is: xrays show hip no worse; bone on bone always gonna hurt like hell: take lots of drugs and don't let the pain stop you moving, move lots while we wait another few weeks until 3 months have passed since the bone in the pelvis was plated back together; on or around the 20th of this month you might be lucky enough to get a new (artifical) hip but don't hold your breath as the sugeon is off for a month just after that in which case it wont be until July. And you can renounce the moon boots. And you can go home for the weekend - maybe. We returned to the rehab place quietly happy and we boys played pool while the girls talked, no doubt both groups doubly relaxed by the perfect proximity: in sight but beyond conversation.

 

Sunday 27 April

Well, now we have been here a few days, it is very different from the hospital, very relaxed and spacious, the nurses even more attentive and the pool table another definite plus. We have already had a few visitors which is always very much appreciated, Ecie invariably brightens up and nowadays seems pretty much her old self when individuals who are not part of the immediate family turn up; which is great. For lunch and dinner she gets up on to the walking frame and starts off down the immensely long hall way to the dining room, trailing her familial entourage complete with wheel chair for when it all gets too painful. Which, depressingly, it increasingly does. The next major event is a trip to a hospital on Thursday to take some more xrays and talk to our old orthopods at their weekly clinic - meanwhile it does seem as if the muscle is calcifying around the repaired hip as she can no longer lift that leg when doing the exercises while lying down and all the pain comes from the same hip. Google has so far failed to point me at anything helpful to get a handle on why this is happening or what could be done to reverse the trend - or even where it will all lead to but it feels like tears before bedtime. sigh.

 

Tuesday 22/4/08

No surprise it didn't happen yesterday but believe it or not we actually moved out this morning - three months and one day after the smash we are now officially out of hospital and in the rehab place. It does, however, remain to be seen how long we will be staying there :-). Just settled in today, tomorrow is the first day to see how it will really be but we had a good time - there is a pool table and us boys shot some pool with the locals whilst Ecie watched and made appropriate noises from her wheelchair.

An emotional last night as we had Anna Lisa who was our very first nurse when we arrived in that ward about 2 months previously, she was the one who soon started calling Ecie Mom and last night she sat holding Ecie's hand while we were mouching around all sad about leaving - especially Ecie! Such outstandingly great nurses at that place, enough to restore one's faith in human nature. So easy to see why nurses always score near the top in any rating of occupations.

 

Thursday 17 April

Well, as has happened before....a bit of an anticlimax. The xrays this time didn't show any change, latest plan therefore is to to do nothing to the hip for three months (after the last operation). Meanwhile, lots more walking on the big frame. Very exciting, I was there when Ecie walked all the way down the hall to the nurses station for the first time and she was just so thrilled: "Look at me! I'm walking" she greeted everyone. The other big news is it really does look like we are moving out of hospital and into the rehab place on Monday....but I am not holding my breath. None of us who are directly involved are as thrilled about this prospect as a "normal" person reasonably would be: we have been in that room at that hospital for so long now, the other day I walked down the hall and saw about seven nurses one after the other....and I knew all their names, and even a bit abut their lives outside of hospital......it is ever so friendly and comfortable and *known*. Sigh.

 

Tuesday 15/4/08

One giant step for man(woman)kind - Ecie lifted both arms off the supports and stood unaided vertically for a moment, to rapturous applause. Ahhh, impermanance, the roller coaster of recovery continues to provide extreme experiences of all sorts. After some 35 years of "meditating" Ecie has got around to actually watching the breath for five minutes at a time, after receving instruction from Jo - just in case there is anyone reading who doubts the efficacy of this technique, I have witnessed it transform an agitated, whinging child into a calm adult in a flat five minutes, struggling for some ferrari type analogy here, 100mph to complete stop in 2 seconds?

Sense of humour continues to save us all - yesterday while she was particularly frustrated but we were charging on through the prayers anyway, like walking in a storm; she stopped and looked at me very seriously and said:" Hang on, I need some time for whinging". I just looked at her, as those words hung in the air between us and then we started laughing......

The hip is getting worse, sigh, no use denying that. The rest of the body getting better, but the hip is getting worse. More xrays on Thursday, that has become the latest Big Deal on the horizon - what will these show? Time to operate again, I suspect.

 

Friday 11 April

A red letter day - kitted out in two massive moon boots, Ecie swung her legs over the side of the bed and sat there for a while doing arm exercises before Jo lifted her onto her feet. At that moment a physio walks in, turns around and leaves....then returns moments later with the mother of all walking frames - a gigantic metal contraption with horizontal supports to be adjusted to take a forearm on either side of the body when standing; complete with hand operated brakes.

Ecie was lifted into this and made her own way over to the door of the bathroom and back, to much applause. However, there was an anticlimax in the sense that she subsequently was plunged into gloom at the thought of how much time and work was obviously going to be required to regain truely independent motion. Also gloom as the surgeon, having studied the xrays of the hip taken after it became obvious pain in this area was increasing, told us: "you are losing bone there, it looks like you might need a hip replacement sooner, rather than later - but go ahead and prove me wrong!" Fortunately such moods pass fast enough and it is a real thrill to have quite literally taken the first step!

 

Wednesday 9 April,

The operation went fine, very short (although they still knocked her right out to do it), now fitted with a "moon boot" which is basically just a plastic back slab (half cast) which can take weight - only still no word from the orthopods on how much either the foor or the repaired hip can take: so we have to wait. The next move is to the rehab place but currently they have no beds so each day the charge nurse here rings them and see if one has become available. Had a really nice few days with lots of trips outside and lots of visitors and general good spirits most of the time - but still a bit miserable at night, Ecie cheerfully tells visitors she tends to "whine" a bit at night. Which is true. A few people have commented on that link to the inspiring story (Randy) I put up a while ago, well here is another one, this time a woman who survived a stroke and "rebuilt" her brain. Gotta love that determination.....

 

Sunday 6 April

Another week slipped by, tomorrow it will be 12 weeks since the crash and we are getting very near the end of the stay in hospital. On Tuesday the K wires get taken out out of the left foot. As a couple of them are deeply buried, there will be another general anaesthetic, which Ecie is worrying about (when she thinks of it), despite everyone reminding her she has had "heaps" of them (about 8, I think) already with no problems. Arm exercises going well, left arm now almost as strong as the right, she can move herself around on the bed quite well. The left leg is also very agile now, but the right one considerably less so, due to that hip repair which gives her both physical pain and anxious moments when she thinks about how unlikely it is that the bone will all grow back so perfectly smoooth that the ball and socket joint works without friction. So there have been some tough times, especially in the evening, but also some really great days. The day an old friend from my university period turned up, the first kiwi friend I introduced Ecie to in 1973 when we arrived, and who she hasn't seen in many years as he lives overseas - that was a very good day, she was telling everyone how happy she was that day. And today, I was there all day having stayed the night and in the afternoon we went out into the park where lots of family groups were hanging out and enjoying the (still) late, very late summer. It is the first day after daylight savings, but still very pleasant. Went right up to the muesum and an alert security guard leapt out as we approached and invited us inside via a side door which has a throw down wheel chair ramp - so suddenly we were in the cool, dark interior, love that spontaneity. Ecie and I did some on line personality test a while ago (google Myers-Briggs) and found one thing we have in common is being far more at the spontaneous end than the planning end. Anyway, it was So Cool - we spent ages looking at old stuff and then found a whole new wing with tons of new displays, just so much fun. Best of all, having a wheelchair makes everyone So Nice, they get out of the way, open doors, hold lifts, amazing!

 

Friday 28 March

No trip outside today, still a bit sick and weather not so nice anyway; but I did come across this really quite inspiring story and printed it out to read to Ecie. Being only human, we need reminding how lucky we are and the story does that admirably. The other day we had our own little reminder - one of our nurses from DCC called in, she had looked after Ecie the second night after the accident I think, anyway, very early on when the lifeforce really wasn't that stable. Man was she a breath of fresh air: "You wont remember me!" she said to Ecie (who of course didn't), but me and Jo did. Those life and death nurses are just so different: "You made me work hard one night", she said: "I had you on a higher level of norad than I've put anyone on in a very long time - and then the pump crapped out!" Laughs (hard).

Mmmm, laughs at death. Good.

Since then: "You got a second chance!" I shout, when dancing at the end of the bed as coach to get her to do more exercises: "What ya gonna do with it?"

Inspiring story

 

week ending 23/3/08

Many more rides outside in the wheelchair; the weather continues to be surreally perfect - now into an "Indian Summer" where only the time of dawn and dusk suggests autumn must be getting closer, plus the oak leaves do look a bit dusty and tired. Each trip outside takes us further - from the duck pond to the wintergarden and then right up to the museum at dusk. For those who don't know, one thing almost all Aucklanders can agree on is that our museum is a very, very impressive building on the best site in the city - on the very top of a hill, with views out over the harbour. Breathatkingly stunning that evening, the scene was straight out of a chick flick with the white robes adorning the patient on her wheelchair fluttering in the breeze as the last rays highlight her resolutely poised head as she gazes heroically out over the city at sunset....ho ho :-)
And then running down the road, pushing the wheelchair at full speed and taking all my weight on the handlebars and just riding, using the soles of the shoes as brakes. Exhilarating! Also did that in the hospital corridors a few times - push faster and faster and then leap on, who hasn't done that with a full shopping trolly in the supermarket? So much more fun with a (slightly apprehensive / dissaproving yet still) appreciative partner and Really Big Wheels. The legs sticking out in front are a suitably imposing battering ram and the various other users of the corridor scatter before our charge.

After we stopped the methadone a few days ago, inevitable sickness from withdrawal. Very boring, tiring, generally yuck. Waiting for that to pass, meanwhile exercises with weights for each hand / arm; the current aim is for Ecie to be able to get herself into the wheelchair unaided - still a way away, that one, but she can (more or less) now manoever herself around the bed on a good day. Loz (oldest son) has come to stay again, very very welcome.

 

sunday Monday 17 March 2008

A very beautiful run of weather at the moment here, perfect late summer / early autumm days, not a cloud in the sky; we got into the wheelchair about 11 am and went out into the park to sit and say our prayers, listening to the circardas and watching the birds and various examples of persons who were also out there enjoying the day. A bit of pain in the legs afterwards as a result of them not being kept "above the heart" - we just keep 'em horizontally out in front, which is the best you can do in a wheelchair. But worth it, lifts the spirits wonderfully being out there.

With the cast now off right arm there is not a single wound left that needs a "sticky" bandage - oh except the foot long one up the thigh after the hip work - but all the rest now just have pads (where inside back slabs (half plaster casts on the legs)) or nothing but Bio oil and sunshine. The k wires don't come out of the foot for another three weeks which is a bit depressing as it means can't even think about that one being weight bearing before then. Not sure about the other - not clear how long the hip at the top of that leg needs; it was not a conventional hip operation at all, the top (weight bearing) part of the socket was basically rebuilt with bone so that has to get strong enough which I suspect might still take a while.

And we have (limited) lift off from the bed with the other leg now, which was rewarded with thunderous applause from the coach (me).

 

Week ending Friday 14 March 2008

Up and down, up and down. I don't like writing about the bad times - apart from saying they are less frequent - but yesterday was a good day, and a very good evening and night. The plaster came off the left arm on Wednesday and the wrist does have enough swivel for her still to be able to make the right sound with the bell (no, not that sort of bell - we are talking about a meditation tool here) so that's good. On Tuesday put her in the wheelchair and went outside again, unfortunately that was on a bad day and it just made her a bit sick, you can't win 'em all. The latest version of the future has her on bed rest for another week or two before moving out to the "Rehab-Plus" facility - they want at least one leg weight bearing before accepting her. Meanwhile, bed exercises are getting more vigorous: she can now lift one leg completely clear of the bed with just with her thigh muscles which is pretty cool, (they are quite heavy with the plaster casts) and we very nearly have lift off with the other too, any moment now.....

 

Saturday / Sunday 8/9 March 2008

Wow, hard to believe so much time has passed. A couple of days ago Ecie started telling people she has got her sense of humour back and it is true, she is getting everyone who comes in to smile, especially with her adaptation of some of the uppper body exercises she was given, which now have a distinctly disco look. Another nurse has stayed long enough to tell us her life story and the first one has settled into calling us "mom" and "dad"; which is very sweet.

Yesterday was the very best day yet, after a good sleep the night before and a nice wash Jo and a visiting friend put Ecie in that adapted wheelchair after lunch and Sabine turned up just in time to not only go on a tour of the hospital but then right outside into a perfect late summer afternoon to the park to watch a little of a quiet cricket game from the hill amoungst the trees, quite idyllic. So when I arrived just after that, no prayers had been done which took us the rest of the afternoon and evening then another good night's sleep.

Still some anxiety attacks in the evening, they are remarkable to watch, the whole face changes as the "storm" comes across but it can be seen to have peaked by about 5 minutes so long as one of us can talk her down and get her doing exercises: it turns out that pain doctor was right on the money when he said "Time and Movement" are the way to control pain (no matter what sort) - I just didn't understand at the time. It works by recognising/labelling the anxiety as a passing storm, rather than identifying with it: "Time" means remembering it will pass and "movement" is an amazingly powerful distraction and much more - it gets different currents flowing which disperse whatever causes the strange and unsetttling effect...she says there are no words, no pictures, nothing at all to point at as a cause or object, it just comes like (for those post menopause women readers) like "a mental hot flush".

She says again most emphatically to thank everyone for the prayers and messages, she is really quite happy quite a lot of the time now. It does help to have pain reduction medicine virtually on tap - despite the sleeping pills, she does always wake up after a few hours each night and need more (as well as exercises) before she can go back to sleep again. But we are down to relatively soft pain killers - the morphine is a distant (pleasant) dream :-)

 

Tuesday 4/3/08

Very good day today, Ecie was awake and cheerful a lot of the time and actually noticed improvements herself in the range of movement of her head, "I've almost got a neck back again" No more hunching forward, unable to straighten up, great stuff! Another highlight was a visit from the trauma co-ordinator who had assembled a respectably thick folder of photocopies of notes so we can see the history, especially the early history, there was one scary thing there on one of the first pages, a score of 6 in a place for the brain and she dramatically told us: " 4 here means..." and she banged the wall - indicating thick as wallboard = basically brain dead. So a fairly miraculous recovery from that to get to where we are now.

Another visitor was a nurse who told us a couple of orthopod jokes which those of you who have read most of these posts might enjoy. Me and Jo laughed very hard and Ecie chuckled but added disapprovingly: "That's terrible!"

Question: Where do you hide money from an orthopod? Answer: In the patient notes.

Question: What do you call two orthopods looking at patient notes? Answer: A double blind study........

In the folder there were also graphic before and after xrays of the (in)famous foot that waited (for various reasons) almost 6 weeks to be operated on - and the after shot looks great. Full of wires, but basically foot-shaped. Compared to the squashed up thing in the first xray which looked like a chinese woman's foot from 100 years ago, when foot binding was the fashion - and the women couldn't walk. The surgeon who did this told Jo it would probably be pretty close to normal with just a bit of stiffness. Amazing!

 

Monday 3/3/08

Sorry it has been a while, a few private emails and phone conversations have reminded me there are still some people out there who would quite like updates!

Ecie also today asked me to say how much she appreciates the support, especially as she finds it inspiring and motivating now we are entering the next phase - the rehab. Knowing that people are thinking / praying / reciting for her is a great comfort and encouragement. And she gets to rejoice!
One of the pain team who came around today gave us a very sobering statistic (although, ever the cynic, my first thought was: "what is your authority for that?" Not that I voiced it.) Anyway, the statistic was: "Muscle loss is up to 4% a day if you don't move". This followed a day or two after a very cute young English boy-doctor (the head of the pain team) who had came around the other morning and asked Ecie: "What are the two most important ingredients in controlling pain?" It was, of course, a purely rhetorical question and again I was touched at the child-like acceptance of the audience, who responded with appreciative "aaahhh"s when he answered himself: "Time and Movement!"

Time and movement....mmm....where is this going? Where it was going was to give her a whole bunch of very tiny movements to do very rapidly with all kinds of different parts of her body, to be repeated every half an hour with ever increasing enthusiasm. "Coach!", he said, pointing at me. Which I have done, it has been quite fun!

This is in addition to the more serious physiotherapy movements to be done three times a day. Good. When you add all the prayers, dressing changes, bed washes and general toiletaries.....there is very little time for any naps nowadays. Busy, busy, busy. Which also reminds me I haven't spelled out that for the last 3 weeks or so either Joseph or I have been with her 24 hours a day. Mostly Joseph. But with a full day and a half off every now and again for a decent break. Pleassssssse don't send a SINGLE email / guest book post or phone call telling us how important it is to take care of ourselves, take time off, blah blah blah. Really. I can be violent.

It is just much easier to do a lot of the stuff yourself than wait for a nurse and of course the nurses love it that we do and that makes them even nicer to us when we do need something. Totally win-win.

Ecie's short term memory is as just about good as ever now (which isn't, of course, saying much) and today she sat up for the first time from a reclining position without needing to pull herself up on the bed sides which made me very excited.....and that again is rather nice, to find pure delight in such little advances.

But still a long way to go. This morning the orthopod was "thinking outloud" during rounds that maybe the next thing would be to ship her off (in a week or two) to this special rehab facility (live - in) where they have a serious regime of physio for the seriously traumatised. Ecie knows of the place and was not displeased at the prospect.

 

 

Friday 29 Feb 2008

Well, the operation did go ahead yesterday and is said to have gone well, but no details from the orthopods yet - but there are no external fixators (that metal scaffolding) on the outside, which suggests maybe that was the last operation.

 

Sunday/ Monday 24/25 Feb 2008

A few visitors on Sunday which was nice. And Ecie is getting more into doing the little leg exercises the physio gave her: bending toes five times, trying to lift each leg (yeah, right), trying to squash down each leg, each exercise five times - good to see muscles actually moving again. Monday was special, we had a male nurse who was a real "we can do anything" type so when I begged him to find me some kind of mobile device I could put Ecie in which could hold her legs up straight / high but still allow me to move her - I was thinking of a lazy boy chair with big wheels - he came back with a fairly conventional wheel chair which we adapted with a bit of wood and surgical tape and lots of cushions. Just the two of us lifted her in and found places to attach the suk vac (which can run for a while on its battery) and the other attachments - and I triumpantly wheeled her out of the ward on this impressive robed chariot festooned with medical accoutrements. We went of a tiki tour of the hospital for half an hour, very exciting!.

When we came back that nurse was gone and several lessor nurses were needed to take his place - but we got her out of the chair and back in to the bed without mishap or every slightly strained backs so altogether satisfactory! But quite a mission and also did make her legs hurt (they are supposed to be kept up above her heart level really) so it might not be a daily event just yet. But a nice precedent.

 

Friday /Saturday

A fairly quiet couple of days, although every one has it's highs and lows. The last tubes came out of the right arm, making it the first limb which is now officially finished and entirely free of encumbrances, so Ecie takes every opportunity to wave it around triumphantly. Likewise last the main line with its five little tentacles came out of the jugular and the drain out of the hip repair - that last one really was most impressive. In the few days since the hip operation, the sizeable plastic bottle at the end of this tube had virtually filled with dirty looking blood - just like the chest drain had filled a much larger container a few weeks ago. The nurse was quite enthusiastic when pointing out how, without this miniature suck vac ('cos it also has a little vacuum), all that yucky stuff would have been trapped inside the tissue and just imagine how swollen and painful that would have been! I could be wrong, but maybe it is not so long since someone came up with this bright idea? Well, "long" is relative I suppose - for sure this remarkably simple yet effective technique is less than one or two hundred years old.....which is good to remember: We must concentrate on how far medical science has come over the last 500 years.
Good to remember when occasionally incredulous at how crude it still is :-)

Speaking of which - I was there when the plastic surgeon called in to check up the "skin graft". This is the bloody great hole in one leg. The last time I had seen it, it was a (relatively) small hole - before they cleaned it up, which means, so far as I could see, removing huge amounts of flesh all the way around it. Like, I suppose, when replacing rotted timber framing, you have to cut back well beyond the last sign of decay. Then this extremely thin layer of skin cut from nearby is pressed into the now very clean (and very large) hole and a hunk of black sponge is squashed down into the hole, to hold the skin in place. The suk vac is attached to this - the positive suction has two purposes: to remove the leaking fluids and encourage new cells to grow. Check every three days. According to the surgeon, it is "filling up very nicely". To me, it appeared as a Really Big Hole. Still we are assurred that it will fill naturally, in time. Good.

 

Thursday 21/2/08

Well, the op did go well but quite a lot of pain afterwards and then, having signed up everything for the next op today - it has been cancelled. Or rather, postponed - until next Thursday (this particular top gun bone cutter only works one day a week here, so it has to be Thursday). Which pissed me and Jo off no end....but Ecie was rather relieved. She had a fairly rough afternoon yesterday but the positive consequence of that was she slept really well last night, pretty well best sleep ever, which was (also) very nice for Jo. Quite different from the previous night, up very frequently to move a limb or something....

It really is no wonder nurses always poll up near the top of most respected professions. Just like all of us can remember a really good school teacher from our childhood, I am quite sure I will never forget Ecie's really good nurses.

 

Wednesday 20/2/08

The op is said to have gone well, this morning they took the suck vac off the skin graft (on the other leg) and it looks good - the foot surgeon boss is coming to have a look, he will decide if that is healed enough to get started with the foot, if so that may happen sooner than next week. Could that be the final op???

Well that has all happened already - foot surgery tomorrow, consent all signed. That's a whole saga in itself, so many checklists (these are a Very Good Thing, I might add); first the surgeon and then the anethesist have to very slowly and carefully go through the immensely long disaster list, spelling out the (seemingly) infinite number of things which Could Go Wrong, resulting in (ultimately) Death.

Reminds me of my childhood, when I heard about girls suffering "a fate worse than death". This was discussed with considerable enthusiasm, yet in hushed tones, by old (to my eye) women wearing dowdy clothes gathered in a closed circle, and my fertile imagination came up with fantastic possibilities. No need for such creativity here - they spell out everything in graphic detail.

 

Tuesday 19/2/08

So today started very early with me driving in to have a meeting with the surgical team prior to the hip op; that was quite full-on as I had done lots of research (via google) the night before and so had many printed out pictures of hips and pelvises and even more questions (I heard later it was an "interrogation"). He told us brain injury causes the body bone making processes to go into overdraft and the muscles around the hip were already turning to bone which is one reason they wanted to get in there. We heard all about the stainless steel plates they have on hand of varying sizes, plus the benders to make them the right shape. They separate the muscles like peering through a Venetian blind and cut as little as possible: here they had to cut away the broken out chunk which was already settling in (growing into its new position) above, a bit too far from the socket; then move it more or less the right place and support it there with the plate on the back, screwed in either side. Again with the crude metal ware. See the .pdf picture of the area here - it is amazing how small the socket is, just a part socket really - so it needs huge amounts of muscle to hold the femur in there. When I asked what chance there was that this "repair" would result in a mirror-smooth socket for the ball of the femur to again turn smoothly against he was cautious (Doh!) and said that the body was capable of amazing feats of recovery - but in any event this surgery was needed to create a sound foundation for a later hip replacement if (when, he suspected) needed. I asked about Ecie being able to sit cross legged again. "Not a chance" he said "Forget that". Well, I thought, he never met Lama Yeshe:

"Our problem is that inside us there's a mind going, "Impossible, impossible,
impossible. I can't, I can't, I can't." We have to banish that mind from
this solar system. Anything is possible; everything is possible. Sometimes
you feel that your dreams are impossible, but they're not. Human beings have
great potential; they can do anything. The power of the mind is incredible,
limitless.
~~ Lama Yeshe ~~"

 

Monday 18/2/08

Many important visitors this morning: the hip is really going to happen tomorrow; the leg and foot can wait a while - no one is fussed / thinks it's too late, the two top guys (one each for hip and leg) all quietly confident. Going off for a CT scan of the hip shortly so they have even more idea of what to expect when they cut it open tomorrow. Four weeks today, almost to the minute, since the crash.

 

Sunday 17/2/08 Early

Jo texted me to say Ecie had slept well and was "rather perky" this morning and they had already said lots of prayers. Ah, that's what I call a good start to the day!

Yesterday afternoon was nice, just her and me, almost reminiscent of when we first met and spent 23 hours a day together for a year whilst travelling, that same sense of intimacy and comfortable-just-to-be-with-you feeling. When I remarked how the accident appears to have been such a positive experience for just about everyone involved, she replied thoughfully: "It really does seem that way..."

Our nurse yesterday really likes us and stayed long enough at one point to tell us her entire life story after which Ecie became quite enthusiastic about "finding her the right man" and there were more jokes later in the evening in the same vein. Always the match maker. One of our favourite quotes from Shantideva (anyone who knows me knows I can find a quote from Shantideva for *any* situation) fitted perfectly: "Whenever I meet anyone, may it never be meaningless for them".

Don't get me wrong - there was still plenty of discomfort and lack of concentration and all the inevitable samsaric suffering of not being able to move your own body; having to rely on others for everything.......but yet, do-able. A good night's sleep is a miraculous support!

 

Saturday morning, early, all good news - Ecie slept best yet and

King pin orthopod turned up at the crack of dawn with only one minion, aformentioned lesser mortal removed plaster from right leg, that all looks good, stitches to come out and dressing to go on. Numero Uno was mildly interested when Jo showed him the (gross) movement either side of the joined tib: "We'll get some more X-rays of that. "
Hip to happen this week, foot next, not terribly forthcoming about the foot, but good to know at least it is not abandoned.

 

Friday night 11 pm 15/2/08

Big day today, I got there about 11:30 this morning so Jo could go home after a 36 hour shift; by then the nurses had pretty well adopted him :-)
Ambulance came around 3:30; a really great woman driver, so friendly and dinkum kiwi, made me and Ecie all dewy eyed and proud to be citizens of this fine country. There is so much bad publicity about the health service here - and I do understand why - but pretty well without exception all the nurses we have shared time with have been more than wonderful and any problems with the hierarchy higher up invariably come down to poor communication - don't they always?

Those problems arise from the fact that no one works continuously, everyone works 8 - 12 hours and then hands over to the next shift. And that is where things can and do get lost: at hand over. Not so much between the nurses, but definitely between hospitals and most especially in amongst and even within the various "teams". For instance, the orthopedic "team" here is huge, and there is virtually no continuity in whom we see, so that can get a bit scary: starting from scratch all over again so often. I sometimes think Joseph probably knows Ecie's notes as well as anyone in the hospital system.

When we were shifting Ecie from the ambulance stretcher to the bed, the ambulance driver warned the three assembled nurses: "Be careful of this one, she is an RN". (Registered Nurse). "Oh", said one of them politely; "What branch?" When Ecie replied: "Palliative Care", there was a collective "Ahhh" of appreciation and then they all got into discussing how hard that was, yet rewarding. I got the impression they all thought it ranks near to the top of the nursing status ladder. Perhaps not so coincidentally, not long after that we got moved to a much smaller (more private) room and "our" nurse was soon making arrangements for Jo to be able to stay the night in a lazy boy chair, so cool!

Once he arrived at 8 ish I went walk-about to find all the stuff required to give Ecie a wash ("bed bath") and we got started with that (old hands at it by now); when the nurse arrived to find us half way through she was even more impressed, especially with Joseph. Funny that. She wanted to know how old he was, what he did, and when she got that answer, could he get married? Sorry sweetheart :-)

So tomorrow we start again to try and find out what is happening to the hip: more X-rays were taken at the last hospital and a promise of more surgery made - but this was news to the latest orthopod who greeted us at this hospital. Mind you, this dude is fairly lowly (by definition, as he is working 10 pm Friday night). And of course more questions to be asked about the foot, always wondering about the untouched foot with its uncountable numbers of broken bones. I gloomily suspect that now nearly four weeks have passed while they procrastinated, they may decide it is just too late to attempt anything. Sigh.

 

Wednesday and Thursday

Looks like the skin graft has not been rejected, not so easy to find her a bed back at the original hospital so waiting on that.

 

Tuesday 12/2/08

Yesterday the "plastic" surgery did finally happen - and they took out the tooth which had been knocked loose in the crash, and the nose ring. Great stuff! Then she slept all afternoon....but as a consequence, never for more than an hour at a time all night, making it a very rough night for Jo. We have to stay here a few more days as there is another suk vac on the skin graft. So cool what they do nowadays - they take a "split skin" graft from somewhere else which is a shaving so thin that what is left underneath at the donor site doesn't have to be closed over and stiched up - there is just enough "skin" left to simply grow back out, and the bit they have harvested is also thick enough (despite being so thin) to grow more on the new site...so long as it "takes". That is the next wait, to see if it takes (isn't rejected / doesn't just die) . I had to sign a form acknowledging that it might not work.

 

Monday 11/2/08

Yesterday was better, although quite hard on the poor girl having no food or drink for the second out of three days as surgery booked....until 7pm when it was finally cancelled. Same plan today, except hopefully more chance it will actually happen. She slept quite a bit and was more on to it when awake - but also very much more conscious of her broken legs. It is a bit disturbing to still see, after three weeks, the separate bits of bone click clack around just under the surface when she moves. At one point when sitting up and able to (almost) stay there by herself she raised that fist (as in the photo below) and shook it gently saying: "Ecie is back...(falling back) .....well, nearly".

A few days ago when the nurse was trying to guage her mental abilities Ecie was asked the standard questions: do you remember what day it is, what the date is - the month, the year? Of course she got the day of the week and the number of days wrong....but who can do that anyway? I know I can't. She did manage February which impressed me as the accident happened in January. And she knew it was 08. So much happiness! Unable to stop there I prompted her for Jo's birthday, then Lozang's, then mine, after which she volunteered to produce my father's birthday too, indicating by gesture that I wouldn't be able to do that (she is right). But what fascinated me was how it took a very long time - in each case there was a long pause between each number, i.e between the year, the month and the day for each. No mistakes though - each one came out right first time. "Why?" I asked her, "Why does it take that long to answer?" She said something like: "There is a lot of stuff in the way". But obviously less stuff every day - yesterday she wanted her full mala, rather than the wrist one, and managed a whole round of some esoteric mantra for the first time. The good parts are so good!!

 

Sunday 10/2/08 Morning

They did move her to a smaller room yesterday, they are all just so nice and helpful here. It is amazing that at this place where so far as I can see one nurse looks after about 15 patients with only a couple of (equally nice) nurse aids (we used to call them that but now, of course, they have a more exotic title, maybe "health care assistants"?) she is steady, calm, unrushed, methodical and when present, totally present. Gotta love that dedication.

Anyway they put a lazy boy chair in this room next to her bed and Tenzin (Joseph) was able to stay the night on that. She continued to wake every hour at least - but having him there made a huge difference to getting her to doze off again. Still enough pain to be a drag some times, but more cheerful this morning and (he says) "more on to it". I could even have a short conversation with her on his cell phone. We have determined that she is less distressed if one of us is there (Doh!) and this place is accomodating enough to allow that to happen 24 hrs a day, despite the very large and very prominently displayed notice limiting the visitation rights of family. I guess so long as we don't rock the boat.....

Also, big news is that the feeding tube is out (actually, she managed to extract it herself - when no one was around - later on in the same night she had proved she could unbutton my shirt all the way) and while the nose ring is still there while the dietitians determine if she can really manage to get in enough via more conventional methods; it looks hopeful. Jo says she is laughing at little bit at his jokes this morning too. Cool!! I am going in soon so he can come home and crash.

Jo just texted me to say off to surgery today - anytime between now (10 am) and 10 pm tonight, with half an hour's notice. Or tomorrow. Sigh. Embrace that insecurity! There is an "affirmation" type thing which I say every morning evolved over the years from a casual comment by Trungpa Rinpoche way back in the seventies, it goes something like: "whatever happens, there are three possible ways to respond, listed in ascending order acording to how together you are feeling: 1) Joyfully even; 2) Cheerfully arrogant and elegant; 3) Ecstatically committed to whatever unfolds ".

 

Saturday 9/2/08

No operation today. New hospital very, very large; but nice. We might even be able to get a little room where one of us can stay with her, rather than the boarding school type dorm where she is at present. Communication breakdown between the hospitals: I stayed with her all morning in the old hospital ('nil by mouth') while she waited to be transferred, we were told she would be operated on that afternoon; went with her in the ambulance (fun!) but on arrival had to get into serious "dealing with bureaucracy" mode as they had no plans to operate any time soon. The first hurdle was finding someone higher up the food chain to answer questions. Being politely persistant can be so effective. In the end we had four visitations from different plastic surgeons at various times that afternoon, politely gazing at the gaping hole in her leg with varying degrees of interest.

All, however, were equally eloquent in describing the almost unsurpassably mountainous obstacles to be overcome before anyone could actually raise a knife over that leg. I know so much more now, about how lists of critical and acute surgeries are organised and in particular how large the lists are (unimaginable, unfathomable, limitless) and how gathering the essential members of the required superteam into the same spot in the space-time continuum is only made more difficult by the endless competition for theatre space. Doubtless due to the even more vast field of merit created by all your prayers and sutras, surgery may happen on Monday. Cool!

I added a couple of xrays below - the floating around bits of the smashed up fib are said to be "not a problem" by all: one orthopod (yes, I captured one briefly) even got quite enthusiastic about explaining how unnecessary this bone is, (apart from each end) they sometimes take away the middle bit altogether to use for bone grafts in (say) the arm and the leg is perfectly happy to do without.

 

Friday 8/2/08

Big day yesterday as away all afternoon for surgery on right leg (the easy one) which may possibly even be finished now. Haven't been able to talk to a surgeon since. Tough evening (pain) when waking up after surgery but reasonably good night after some drugs; the nurse also tried a few times to wean her off the oxygen but blood oxygen level dropped each time below 90% so plugged her in again. Not so suprising after heavy surgery. And another big day today: off to another hospital for a bit of plastic surgery to that gaping hole in the other leg: they will chop out a bit of buttock and stop it up with that. Will probably stay there for a few days. This hospital is *really* far away :-(

Don't think I ever mentioned that the fire truck crews who cut the car to bits and jacked it apart so she could be extracted safely were all volunteers; pretty cool considering she has been working full time as a volunteer for 10 years. Spent a bit of time writing a thank you letter which was quite emotional.....

 

Thursday 7/2/08 Morning

The Bone Woman

In Tibet there is an oft repeated tale used to illustrate the power of faith and devotion: an old woman lived in a distant part of that remote land long, long ago. She had a great deal of devotion for the Buddha, but unfortunately this was not passed on to her only son who became a merchant. This merchant's travels even took him as far as India, which at the time was very unusual: while India was the Holy Land for Buddhists, it was extremely difficult to get to. Despite this, the young man managed more than one trip, each entirely taken up with profit meaning he completely forgot his mother's heartfelt request that he bring her back a Holy Relic from the Holy Land for her altar. When he was in sight of his mother's house upon returning from his third trip (and each one took over year), he suddenly recalled that he had yet again neglected his filial duties. His eyes fell upon some scattered bones, the result of vultures tearing apart some hapless small animal. He chose a bit, cleaned it up, found some rich Indian brocade in his bag and presented it to mom with great ceremony, allowing her to believe it was an actual Holy Relic. The mom, of course, was overjoyed and placed it in pride of place on her altar, and did not hesitate to spread the good word throughout the sparsely habitated valley. Before long the fame of the Holy Relic had spread, and the people's faith and devotion increased wonderfully. As did the quality and sincerity of their dharma practice. Some even said the bone started radiating light.......

I reminded Ecie of this story yesterday, when she suddenly felt the burden of being the centre of so much attention from around the world: "Relax mom, you're the bone. No worries."

Still no word on when the operation today will take place - maybe in an hour or so?

 

Wednesday 6/2/08 Morning

Waitangi Day today (National holiday) so nothing happening, but it does seem increasingly likely that the orthopods will gather around her right leg tomorrow, knives drawn. The left foot is still said by most (but, confusingly, not all) to have too much tissue damage to start as when they try to stitch up the flesh again after working on the bones, it just isn't strong enough to sew back together which could be very messy.

Yesterday, like everyday, was very long. Every day she is awake longer, which is seldom much fun except for very brief moments. The good news is the day started with them taking out the trachy altogether (having told me they would leave it in for the surgury, which did make sense). So the whispered words are easier to hear and generally more than one per breath. And, more importantly, it means she can drink! And maybe even take soft stuff like yoghurt!
The nurse in the afternoon was an older woman who told me she had been working there for 28 years and after a while she recognised Ecie, and could even remember the ward they had worked together in about 10 years ago (Ecie is also a nurse). Ecie told me later, in a very serious whisper when she remembered and recognised the nurse, "she is a very powerful woman" (I knew she meant in a good way). So that was nice. Then there was a lot of moaning from one of the other beds in the ward which in a sense was a good thing as Ecie's attention went there and she spent a (relatively) long time doing vajra sattva. In the evening Melissa came and there was again much smiling for a while.

 

Tuesday 5/2/08 Morning

For the first time in 15 days she had a good night. Only one hit of morphine and no interest to getting the nurse to call me. Happiness!

Ecie was told yesterday the geshe from DCI is coming to see her. He has just finished a retreat and perfectly fits Lama Zopa's description of 'such a person' :

"Recite in her ear when you can … even she is not conscious … Buddha's name mantra and Maitreya mantra . If the person who recites this for her has done well Nyung Naes or recites mani mantra more than 10,000/day … then that has the most effect for her. If there is such a person, then after reciting the mantra's they can blow on her body."

She was immediately taken up with thinking about preparations: where could we get appropriate chairs, she must get out of bed, we must offer tea etc - all, of course, painstakiningly drawn out in one word per breath whispers. Joseph did his best to convonce her the hospital was a unique situation and protocols could be relaxed somewhat but I suspect that this morning she will have formulated more definite plans to be executed by her fan wavers. If she remembers he is coming.

Monday 4/2/08

Another somewhat rough night last night, with Ecie determined the nurse should contact me immediately but from morning on things got steadily better. The nurse released the cuff first thing; this is a little collar around the trachy tube that is inflated with pressurised air between the tube and the throat to stop air leaking past - so it ensures all air passes through the trachy. Releasing this is the next stage in the weaning process, it means less support from the humidified and oxygen enriched pipeline as some is now slipping past the trachy and into the lungs. This makes her work a bit harder and the blood oxygen level therefore dropped which is a bit alarming for those of us who have got used to it being kept between 95 and 100%. When it drops below 90% the reading turns an excited red colour and I nervously ask the nurse what is to be done. This is New Zealand, the nurse is male: "No worries, mate". He was right, she soon started breathing more deeply and the level went back up.

The other thing that little bit of air does is reach the voice box each time it goes past. So we had a series of drawn out one word per breath whispered sentences, e.g. :' It.........took.........you..........guys...........forever............to..........get..........here".

She also wanted to talk about the American Election but that appeared to be based on a dream and included several references to "the.....big......picture". She was so easy to make happy by reading some of the posts from the guest book, that is such a delight to see. When Melissa came in the evening, having not seen her for four days, tears were shed on both sides at the improvements with Ecie happy to mirror Melissa's joy. And when I introduced the (male) night nurse she spun out: "I.......had....you....marked....out.....as....the.......cute.....one".

She also managed to spend more time with her prayer book, making an effort to prioritise and for the first time able to get through one of the basic ones she knows by heart (after a look at the page kickstarted the memory) without dropping off before it was finished. Much rejoicing by me.

 

Sunday 3/2/08 morning

I've decided the lung is very much like that other bag connected to the outside world via a tube, the one a little lower down the female body. What we have seen with the lung healing is like what the womb does each month - first it sloughs off heaps of bloody gunk, then it grows new cells / wall linings very fast. Likewise Ecie had a tube coming out of her lung for the first week or so, filling a large container with dirty blood and small chunks of broken lung after the various ribs had smashed their way through the side in the crash. The healing process was incredibly fast - soon after the tube was withdrawn all that she coughs up is flem. But from her point of view, amost totally in the present, with only very sketchy memories covering the last two weeks, it is really horrible coughing and must be quite bizzarre having us cheering her on and trying to convince her coughing is good - when it is so very obviously painful and altogether yucky.

The memory thing is quite strange. All the nurses and indeed apparantly everyone in the whole hospital hierachy is convinced it is nothing serious and will pass; nothing more than a side effect of getting a substantial smack to the head. I suppose in a sense it is comforting that while at the beginning they were all doom and gloom about her eye, legs, hip, foot and even, for a couple of days, her very life....they were always quite happy to be fairly confident her brain was okay. Presumably because the skull wasn't actually smashed in. But it must be very disconcerting for her - and obviously scary when she wakes up after three hours in the middle of the night, wide awake and all alone and can rapidly and perfectly accurately write (for the nurse) my work number, my cell phone number and the hospice web site URL ....but needs reminding we were there all day and are now at home asleep and will be back soon. Then she notices the legs hurt and the nurse slips in another hit of morphine. The drugs, of course, add to the confusion, which makes it all the more impressive when she fully surfaces which she certainly does, if only momentarily, for instance to ask Sabine how her husband Mike is and tell her she has a present for Sabine's child (all still without a sound, we have become accomplished lip readers).

 

Saturday 2/2/08 night

She managed to read some of her prayers today, in between dozing. You aren't allowed (electric) fans in this ward so we take turns using first the girl's fan Anne Marie thoughfully brought in and then writing folders (after we wore out the fan). It is always hot in here, unless I am very careful I keep seeing flashes from that Tom Cruise movie: "Born on the 4th of July". The notice board by her bed has a large picture of HH the Dalai Lama which of course all the staff recognise now he has become so famous, it blesses the whole ward; there are also lots of get well soon type cards but my favourite is one done by some young children which has a very cute unicorn.

Saturday 2/2/08 morning

Well, we finally rode out of the life and death ward in style at the 3 pm changeover yesterday afternoon, following Ecie in a grand procession as her bed was wheeled to the new ward. Which is actually just across the hallway. The main difference is that since in the new ward patients are generally considered less likely to inconveniently stop breathing if you take your eye off them for a moment; less eyes are needed so here there are just two nurses looking after 5 patients in one room. For the mathematically inclined: a drop from a ratio of 1:1 to 1:2.5. Not tooooo scary - although, actually, I was in fact both shit scared and very depressed when I saw the complete lack of all the constantly attached monitoring equipment I have come to find comfort in. But after a night's sleep the positive side is on top: not needing constant monitoring is Good. The nurse just rang me up: "your wife is writing, where are you?" Sounds more like Ecie, she must want me to do something.......

 

Friday 1/2/08 late morning

Went off to for a CT scan. Orthopods playing ping pong with the intensivists (means no one really knows when the next op will be) Maybe next Thursday now, meanwhile we might be moving out of the criticial care ward and across the hall...which would indeed be very exciting. We'll see. Some people asked for photos so I added a few at the bottom.

 

Thursday night, 9 pm.

So much better today - she was awake a lot more and able to ask more complex questions: like where are my prayers and my mala and what's happening at the hospice. She also managed to write a bit now her right arm is free, but that was quite taxing and she would crash out after each short burst, not always having produced something worthy of publication. Lots of smiles for the nurses, Joseph and Anne Marie and even some for me; it was a nice feeling to be told by the nurses when we arrived she had been mouthing "where's my husband". But still her short term memory is mostly just not there and lots of discomfort, especially when coughing, so much suffering then; after each such cough the nurse sticks down a tube to suck up the flem - but after a while this tube irritates the wind pipe leading to the lungs and it starts bleeding. Hard to see that screwed up face, easy to wish you could change places. The lack of short term memory means that as recognition of her condition grows, that situation can seem increasingly dire, rather than (as we see it) wonderfully improved - she takes some convincing that she is improving rather than deteriorating; because all she knows is that (frequently) she feels really terrible and she has no memory of what it was like to be much worse. But most of the time she is still sleeping or awake with an almost child like appreciation of all the care she is getting which is quite touching to see - a friend who is a surgeon came by and Ecie shook her fist at him while smiling, a bit like in the first photo below, which I had to explain meant (in his case) something along the lines of : "right on, you rock, great job..."

 

Thursday 31/1/08 10 am

Good news first: she got through the night on the cpap, (which is directly connected to the trachy) that is, without needing the venitilator at all for the first time so this means the lung is healing very nicely, respiration rate down from 33 to 28 (breaths per minute: normally in the range of 15 - 25); blood pressure in the normal range. But she got an infection so they are pumping in antibiotics; also she is quite agitated which they put down to this infection. They also gave her an infusion of red blood cells as the bone marrow activity was getting a bit supressed due to the low count. Or something. It is an amazing experience trying to get information, and the higher up you get, into the more specialised areas, the trickier it gets. When talking to super specialised specialists, like the surgeon who just does upper limbs and regards lower limbs as another world...at that level there are only two alternatives: if you reveal even a hint of any emotion or ask a dumb question they snap shut, just like sticking your finger in a sea anemone. But if you manage to manifest cool detatched intelligence they will expound at great speed which is impossible to keep up with. So either way you hang up knowing very little more than before the conversation.....

They also rewired the art line. I can't believe I just wrote that. Every trade has jargon; if this place is analogous to a (car) body shop then the orthepedic team are the panel beaters. So what does it mean, that sentence? "Art" is shorthand for "arterial" - they always have a pressurised (because arteries pump, remember - have to withstand that) line stuck into an artery, a little flow of saline solution keeps it free and this line is used for major monitoring processes, as well as taking (frequent) blood samples. Unlike veins which you simply stick a needle into, with the art line they inset a wire up inside the artery and then slide the plastic tube up that wire, then withdraw the wire, hence "wiring" it. But such lines frequently block and have to be rewired...slide the wire back in, withdraw the existing plastic tube, replace it with a longer one and again withdraw the wire; simple, really. Anyway, this time it wasn't that they just rewired it - they moved the whole thing to the other arm. This means her right arm is free! Yippee!!

Latest news is they may get stuck into the major work on the legs tomorrow. Yeah, right. I've heard that before. In reality They (capital intended) really do decide on the spot, standing next to her bed in tight little inpenetrable groups, so that means: waiting until the gathering tomorrow morning. Must be somewhat taxing for the poor people trying to organise use of the operating theatres.

 

Wednesday 30/1/08 4 pm - so closer to three hours than to one.

Good news - the bone surgeon (whom I swear never to call an awful-pod again) just rang after coming out: the broken bits of the radius were big enough to screw to a plate (see below). This means they have taken off the rigging and she is in a cast. However the ulna was seriously smashed to bits. They spent ages drilling through many of these little bits and sewing them together with synthetic thread which means they should grow back together in more or less the right position - but that bump you see on the outside of your wrist if you look when your palm is facing down, that knob was pulverized. So there will be some limitations on movement which I didn't quite understand the mechanics of.
Next step is, hopefully by next Tuesday the swelling in the left foot will have gone down enough for them to get started on more permanent repairs to both legs.
Meanwhile, back to the Twilight Zone of DCC where the lights never go out and the effort to resist death is equally uninterrupted. I can see why there is a bit at the bottom of the paper handout for families about this unit that describes how to make donations: inevitably, amongst the swirling emotions felt, at least occasionally gratitude surfaces with varying degrees of intensity. It is comforting to believe Ecie is getting very high quality care from dedicated individuals and wanting to repay that kindness is only natural.

One of the most significant benefits I can see from this accident is all the wonderful, virtuous acts so many people get to practice with respect to her - so many reciting sutras and mantras, praying for her, looking after her, fixing her body etc - "immeasurable, unfathomable" benefit. Even the most cynical would have to admit: it is nice to feel you are helping, contributing, doing something positive; and so many will be experiencing that feeling right now. Even the (presumably) non buddhist surgeon can rejoice, or at least feel the quiet satisfaction of a job well done. Many people get to be a bit happy :-) Cool!

 

Wednesday 30/1/08 1 pm

Rough night last night - back on the ventilator to provide some relief for a couple of hours, more upset bowel. Anne Marie said she looked exhausted at lunch just before they wheeled her off to theatre.
I spent all morning at home on the phone trying to get to talk to the awful-pods (orthopods in what the nurses call the orthopedic team, I just went one step further). Drove me f***ing crazy!!. But finally the one who was about to operate called me - literally from theatre, although not quite knife raised - they were just waiting for her to be rolled in. So I got a first hand account of what he was hoping to achieve. It helps to have talked to mechanical engineers. So long as you can talk that language, no problem. Just don't express emotion. So I learned the CT scan showed a few fairly decent sized bone fragements where both radius and ulna were smashed - but you can't rely on that and when they cut away the flesh and look with their own eyes, they may find lots of tiny fragments which would be a drag as all they have to fix the area is a metal plate and some screws. So decent sized chunks they can screw to the plate, but little ones...forget it. Too much of that and they will just have to close it up and leave the external rigging in place which in turn means it is most unlikely the bones will regrow as one would wish; whereas if they can screw enough chunks to the plate, that rigging will be redundant and the arm will be put in a cast.
So now we are all hyped up to see the arm when she returns: cast = good, rigging still there = bad.
Needless to say I was most supportive of his undoubted skill in screwing *really* little bits of bone to steel plates.

I also learned they now always put these plates under, rather than on top near the wrists, because underneath there is a bit of muscle between the bone and the tendons while on top the tendons slide directly on the bone - so a bit of steel there (and remember, despite it's infinite purity and almost incalculable cost, it is still a foreign chunk of metal) is Not Good. And there are sometime complications. Of course. Sigh.......

 

Tuesday 29/1/08 8:30 pm

A Good Day, generally; more of that I say! The nurse took out all the facial stitches: a series of lines around one eye and a few lines on the forehead, all of these have healed very well and she will have quite a cool "warrior princess" type scar/white line near the middle vertically, from the eyebrow to the hairline, while I think the others will virtually disappear. This nurse came with a different way of supporting her when rolled on one side which worked much better so she was more comfortable. She also woke up enough to be quite definitely telling me what to do at one point: it is quite fun figuring out what she is wanting to communicate, a bit like charades, she will mouth a word or two you can lip-read, then you keep asking yes / no questions until you move on to the next bit she can mouth. Using this technique we figured out she was worried about something which I needed to take care of and having sorted that she relaxed. Didn't need the ventilator all day, but blood pressure up and down - basically it goes down if her head is raised, and as she wants to sit up all the time and occasionally gets her way - the blood pressure dropped a few times.

The visit from the orthopods was a real anticlimax - they came during "rounds" so we missed them, it was promised someone would ring me afterwards but it never happened so there is just conjecture; but it seems likely they will whip her off to theatre sometime tomorrow to take the external rigging off the arm and replace that with plates screwed to the bones and a cast - and possibly make a start on the foot too.

 

Tuesday 29/1/08 6:30 am

Some difficulty breathing through the night so the nurse put her back on the ventilator. Much fluttering anticipation re the orthopedic team's visit this morning......

 

Monday 28/1/08 8:30 pm

The nurse today really was exceptionally good. I don't like to pick out any one individual as they are all so good, but.... this guy used to be an engineer, then became a nurse; he was so happy to answer questions and explain everything, it was just great. He took off all the last remaining bandages so all the various collections of stitches are visible; all look pretty good. The right hip was bothering her a lot today so they took some more x rays 'cos they thought it might have popped out again - a bit (variously described as a "chunk" or "slither" or "splinter") of bone came away from the socket - as usual it took me a long to figure out, based on what they say, that during the crash some mighty force pushed the femur out of the socket - smashed its way out really - shattering a bit of the socket out of the way as it went. Which means there isn't much to hold the femur in at present. They say, though, that the broken-out bit is not big enough for them to dive in there and somehow reattach it; rather the idea is we all just wait and the pelvic bone miraculously (if gradually) heals itself. That has been a big surprise to me: to learn that generally the orthopedic team basically just lines broken bones up again, via various cunning (and yet, I have to say, manifestly very crude) mechanical contrivances such as pins attached to external frames and/or metal plates screwed directly to the bones - and then we all just wait. No stuff to inject which makes them grow back together twice as fast or anything like that. So far as I can see: no improvement in getting the actual bones to re grow since we started walking on two legs.

In the case of her left leg where both tibula and fibula were broken in two places (so a considerable length of each was simply flopping around in the middle), during the first go they cut open the knee and shoved a stainless steel pin down the middle of the tib (the larger of the two) all the way to line up all the broken bits - but left the fib alone. This has the somewhat disturbing effect (for me and Jospeph) of being able to clearly see the separate bits of the fibula crunch back and forth freely just under the surface when we fail to persuade her to keep that leg still.

They also took her off morphine which acts fast and is administered constantly and put her on methadone - which means one hit at 9 am that lasts 12 hours; so she was very sleepy this morning but woke up this afternoon and gave Anne Marie a big smile which was very nice to see.

 

Monday 28/1/08 6:30 am

Another "shitty" night but the good news is she doesn't need the norad infusion anymore - she is maintaining her own blood pressure.

Vale of Tears
The DCC (Department of Critical Care) is a totally self contained little world. You approach down this long corridor and reach two extremely solid fire doors, resolutely locked. No flowers are permitted beyond this point. There is a little window on the side with a sliding glass panel and an intercom for when there isn't anyone guarding the doors in the little room behind the (thick - bulletproof?) glass. The corridor continues on the other side of this formidable barrier, this time with "family conference" rooms opening off it. This passage way is indeed the "Vale of Tears". Much time is spent in limbo in this area while the staff do things to your loved one they wont let you see and here one inevitably meets others, it was here the mother of the boy in the next bed said matter of factly: "This is the place of tears". Every day new families flow in and out of the "conference" rooms, in varying states of distress and shock, supported by each other as they try to comprehend what the surgeons and doctors are telling them. People of all ages suffer loss, every day, it never stops, it is such a powerful teaching on how everyone has a story of pain. And all the while the perfect summer sun shines down in immaculate impartiality. Hard not to see that as an analogy for compassion.

 

Sunday 27/1/08 late at night

Good time around lunch - she was quite awake when the "intensivist" (yes, really) was giving us an update. They changed the ventilator from automatic to assist - so instead of fully breathing for her, it just adds a bit of pressure at the bottom of each breath to ensure the lung doesn't collapse and adds a bit of humidity - but apart from that, she gets to breathe herself (still through the tube which prevents speaking, eating and drinking).
When Loz showed her a medicine buddha picture she started "saying" (mouthing) the mantra and when he was telling her about the prayers and texts sitting on her chest she was interested and very clearly mouthed "what mantras" - she wanted to know exactly what was there. But apart from that, really out of it most of the time, often wanting to communicate but not being able to to and very uncomfortable a lot of the afternoon and evening. We only found out today her right hip was also dislocated in the crash and the socket fractured a bit - this hip was really hurting her today. Loz had to go back to Nelson tonight to start his final placement (nursing) very sad to see him go - he would have stayed but I pushed him to go as I am sure Ecie would want that. But sorely missed.
Now the nurses are saying ("don't quote me") a few more days in critical care then maybe 4 - 6 weeks in an orthopedic ward then x (maybe 5?) months rehabilitation at home.

 

Sunday 27/1/08 6 - 9 am

Feel free to skip this post - not for the squeamish. Especially not for anyone thinking recovery is all "getting better every day".

It was a crap night - literally. It is (we are told) quite common. After a few days of constipation combined with liquid food via the nose drip, the body finally gets around to shitting - and this can lead to periods of diarrhea. Really yucky and quite painful. It seems to have stopped over the last couple of hours so *maybe* the body has adjusted. She is also more awake and obviously uncomfortable.

The next few months are gonna be ...(long list of words deleted)...a string of moments, each one open to experiencing in an infinite variety of ways. Prayers are for reminding us we can choose how to respond to every situation, second by second.........sigh :-)

 

Saturday 26/1/08 8:30 pm

No surgery or other significant medical intervention today so a bit more relaxed and this afternoon her GP came and she managed a smile for him. But also a fair bit of grimacing and short term memory is obviously not great which makes it confusing for her and means repeated explanations. But long term memory is fine: when she was showing some pain (but declining a hit of morphine) I asked her if she could remember what Tong Len was and she nodded and them obviously did that for a while. (For non Buddhist readers - you might want to find out here). We started reading the sutra Lam Zopa Rinpoche recommended to her today and got through a few, the nurse said it seemed to calm her. More information about the foot: many if not most of the small bones are "smashed"; the orthopedic team is still hoping the swelling will go down and postponing starting remedial work until Tuesday at present on that basis. The main bandage is off the left arm fully revealing the impressive external scaffolding (stainless steel rigging to hold the bones in place). She wanted to try and write with the other arm today (the only limb that has no broken bones) but while the spirit was strong the flesh was unwilling and the pen remained frustratingly still. Maybe tomorrow. Thanks very much for all the supportive posts, much appreciated.

 

Saturday 26/1/08 5:45 am

A good night - the nurse said she was relaxed and foot looks good, blood pressure stable (still requires the drug to keep it there). I forgot to say they also took out the drain from the lung yesterday, together with the bucket of blood on the floor which I was happy to see go but they still have to suck out bloody gunk through the ventilator tube every hour or two which is really yucky and also obviously very uncomfortable. They have dropped the morphine level a bit so hopefully she might wake up a bit today.

 

Friday 25/1/08 10:30 pm

Good day today - they did all that stuff described below; so incredibly much nicer not to have that wacking great tube down her throat. Several times during the afternoon after the general anesthetic wore off we could get her to answer simple questions like: "Are you in pain?" (to which she nodded sideways no) and even more complex ones like:"Do you remember Lama Zopa Rinpoche?" to which she nodded yes and she opened her eyes very briefly to look at his photo. We also got a few little kiss movements when were were telling her how much we love her - she would purse her lips a wee bit in an attempt to kiss back. Definitely Ecie but only for very brief moments. Basically they have to keep the morphine up or the pain from the "massive" injuries would be something awful. The swelling in the foot has gone down but it still looks very puffy. On the down side I had not realised so many of the little bones in that foot are smashed and they haven't attempted anything at all on those yet - still concentrating on the bigger injuries further up.

 

Friday 25/1/08 10 am

Okay - she is off to theatre for the orthopedic team to clean the major wounds, change the suction bandage (an amazing thing like a giant black leach that perpetually sucks one large area of completely wrecked raw flesh and encourages new cells to grow under it) and they are going to photograph that wound and send the photos to the plastic surgery team for them to consider.

Then they are going to do the trachy - stick the ventilator directly in her throat so they can pull the yucky great tube out of her mouth - all of which is supposed to be done by 11:30 am. Even with the tube in the throat (rather than down through her mouth), she wont be able to talk - but easier to mouth words.

 

Friday 25/1/08 6 am

More little improvements last night and one big thrill yesterday: while Lozang and I were there "Ecie" resurfaced briefly - like in a movie where swirling clouds of dust coalesce into a ghostly face which speaks and then fades away - anyway, she was there and understood us and even mouthed the words "what happened?" and seemed to understand our explanations before going under again. Very exciting! Looks like they might postpone the throat thing a bit longer, hoping more swelling will go down. The foot looks a bit better, easier to get a pulse so all good news this morning!

 

Thursday 24/1/08 9 am

Looks like they will do the throat op sometime today (see below). Leg not so good. Officially raised the possibility of having to amputate, they are all working very hard to save it but not sure if they can.

 

Thursday 24/1/08 6 am

Ecie made very slight improvements yesterday and last night, at one stage not needing any of the drug that regulates blood pressure. She was in surgery again for about 4 hours where more work was done on her legs and arm (her right arm is basically undamaged, the only limb of the four). This is all still just preliminary stuff. All the many bone breaks are quite rough / not clean so not easy to fix (One doctor cheerfully described them as "munted"). Not surprisingly, after surgery they had to put her back on the blood pressure drug and keep her knocked out with steady morphine. During the night she manifested a little activity a few times - briefly opening her eyes and keen to pull the ventilator tube out. But not what we would call conscious. She is booked in for more surgery Friday. Mostly the doctors tend to be (again, not surprisingly) very cautious when asked leading questions about recovery but the nurses are more willing to speak (always prefacing with: "don't quote me") and now I understand she will remain in this critical care unit at least as long as she needs the ventilator and as the crush injuries to her chest were worse that I originally understood (multiple broken ribs and one lung fairly seriously mangled) this will be "some time" - at least a week. It seems likely they will do a little operation to insert the ventilator tube more permanently / directly into her throat, which will make it much more comfortable for her as she gradually regains consciousness as her mouth will be free.

So, on the whole good news - not deteriorating, very slight improvements, but still plenty of high risk features which I just edited out as the list was too depressing!

 

First post 23/1/08 5:30 am

Ecie sustained "massive injuries" in a collision with a 40 ton water tanker just after mid day Monday 21 and is in critical care which means round the clock nurses and surgeons circling not too far away. She is still on a ventilator.

Has both lower legs broken, one very badly; this will need plastic surgery.

Right arm also has both lower bones broken

Broken ribs /collapsed lung; this still has a drain but is still working at least a bit

Multiple lacerations to the head; these have all been cleaned and stitched back together, one eye badly bruised / shut / not sure about possible damage to that.

Internal organs, spine and brain all seem to be okay; but they don't consider her stable yet. The orthopedic team has had one 4 hour stint doing temporary work on her legs and is booked to have another go this morning.

This morning they stopped the medication that has been keeping her unconscious since the accident and she is just starting to be sufficiently aware to respond to commands from the nurse...this is very good news but not what we would call "conscious". Brain scan shows small bruises; jury still out on what that means.

No visitors to the critical ward; hopefully she will be moved out of this ward once they get her stable (off the ventilator); I will let you know when that happens as then she will be able to have visitors. Also no flowers - they wont let them into that ward 'cos of possible contamination.

Thanks so much for all the prayers and support, much appreciated, lots of love

William, Joseph / Tenzin and Lozang

 

Photos moved to here