Intensive Care: September 2nd - 16th, 2004

09/16/2004
An uneventful week so far... it's nice to be able to say that! Nikki continues to improve. She's eating better this week, and has had her tube feedings reduced to 6 hours daily. The docs really want to remove the tube before her discharge, but she must be taking in at least 75% of her total nutrition needs orally before they'll do that.

Dressing changes continue every morning, and are still somewhat painful. She still receives 8mg morphine I.V. just before each change. Some bandages still stick in places, and the wash downs still hurt sensitive areas. Nikki still has some small open wounds scattered around her back and shoulders, and on the sole of her left foot. Everything is healing, though.

Great news today... Nikki is expected to transfer to OSU Hospitals on Monday, Sept. 20th! That's about 2 weeks earlier than first expected, and 5 days earlier than we thought just last week. Good attitude and rapid healing are the reasons. Bonnie and I plan to return to MetroHealth on Friday evening, and return on Monday with Nikki, taking her directly to OSU Hospital's Dodd Hall. She's expected to remain there for 4 weeks, and then come home.

Nikki gets to go outside the hospital today, for the first time in 8 weeks. She was very excited about this when I left her this morning, and we're looking forward to going outside with her this weekend. The staff at MetroHealth is already getting sad about saying goodbye to her. I'm sure there'll be some tears all around this weekend about that.

We'll be taking all of her cards and letters to Dodd Hall with her, to put up on her new walls for the next month. There's well over 100 cards taped to her walls, so this won't be an easy task. There are also a couple of large plastic bags full of stuffed animals making the trip. Most of the cards and several of the animals are all courtesy of you wonderful folks, and they really brighten up a place. I would suggest that anyone still wishing to send cards or other items to Nikki wait until I have her new room address at OSU next week.

I'll continue to post weekly updates on Nikki's rehab, as well as keeping everyone informed on future surgical procedures. Thank goodness the critical phase is past, but there's still plenty of misery ahead of her. She'll need more procedures on her face, and more on her back. If that newly grafted skin around her armpits and elbows can't be loosened enough with therapy, it'll also be necessary to surgically release it around the joints. But, one thing at a time. For now, we'll all enjoy the successes.

Thanks to everyone who keeps asking about Nikki, and I'll have more later.

09/11/2004
A brief one today. Nikki is back to her usual good-natured self now. She's up walking again after last Friday's surgery, although she's still a little cautious. The grafts to her back seem to be taking well, and her thighs are healing quickly. She's eating pretty well again, probably better than before the surgery. Pain is well controlled by oral medications.

Spoke to a case manager this past Wednesday, to begin planning- DISCHARGE! It’s coming, folks, in 10 - 14 days. We're all very excited, and I'm digging into the necessary arrangements. We're setting Nikki up for transfer to Ohio State University Hospitals, here in Columbus... 15 minutes from home. Nikki will stay in Dodd Hall, the rehabilitation center at OSU, for 4 weeks or so. This will involve at least 3 hours of intense physical and occupational therapy every day. Also, wound care will be provided while she's there. She was very disappointed to learn that she couldn't go straight home, even though I knew that she couldn't. She's accepting it now, though, and I've tried to give her a good idea of what's coming. Rehab patients typically stay in rooms that are more like pleasant hotel rooms. The patients usually just wear street clothes, conditions permitting, and have free reign of the center. Dodd Hall has a library, several recreation areas, community eating, community activities, etc. There's even a pool. I'm digging into all of the details, including Social Security Disability, Medicaid and so on- lots of complicated stuff. MetroHealth is being a big help here, coordinating the transfer.

Nikki had another minor surgery yesterday (Friday), probably her last at Metro. They separated the flap on her right eyelids, and her eye is now open. Its working, but blurry... still lots of medications going into it. The eyelid will take some time before it works properly. The plastics doc also cleaned her damaged right ear very thoroughly, and around the right eye. I had to leave before she came back yesterday, but I'm told that all of those areas look much better. She had little pain afterwards, and ate dinner & visited with friends last night.

We'll be visiting Ohio Basset Rescue's Waddle picnic for a few hours today, then heading back to Cleveland. We attended the pizza gathering last night, which was very enjoyable. I'm afraid that I was pretty tired, and wasn't the life of the party. I think that everyone understood, though, and I'll make up for it today at the picnic. Another milestone- our 11 year old granddaughter Erika (who lives with us) is going to Cleveland tonight to see Nikki for the first time. We thought it was important for her to see Nikki before she came home to us and both Nikki & Erika are very close.

That's it for now. Needless to say, cards and letters are *still* coming in, and Nikki really enjoys them. She hopes to correspond with some of her wonderful supporters when she gets home and back on the computer. Financial aid also continues, which we deeply appreciate. We've been able to make ends meet, which is really all that we can hope for during this time. Many, many thanks to our supporters for their generosity.

More later.......

09/06/2004
Back from spending the holiday weekend with Nikki. Several more cards, letters and other contributions arrived this week. THANK YOU to all of you who continue to support Nikki and us during this time. It all means so much to all of us.

Nikki had surgery on Friday... hopefully, her last burn surgery! It was her shortest procedure to date- about two hours. Skin was harvested from her thighs, and grafted to her upper back, shoulders and backs of her arms. The burn director, Dr. Yowler (a great name for dog lovers!) examined the grafts for the first time today & pronounced them good. He even put a little skin on her right ear, unplanned, because he had some skin left over & didn't want to waste it. To you and me, the grafts look like hell, but to a surgeon, it's a great piece of work.

Nikki was a little down Friday and Saturday. Remember, she's had almost two weeks of feeling pretty good, including eating real food and walking a lot. After surgery, she was on bed rest for three days, her thighs hurt a LOT, and she was on around-the-clock tube feedings. I suppose this seems like a step backwards for her, even though it's really a huge step forward. We just worked hard to be supportive and loving, trying to cheer her up. She had a lousy night last night, mostly due (we think) to fear of her first post-op dressing change this morning. As she was told, though, it was really pretty easy. They didn't touch her thighs, and only lightly washed the graft areas, before wrapping them back up again. Afterwards, she had some anxiety, causing some gagging around her feeding tube. After getting her suctioned and medicated, she slept for a few hours, and then woke up feeling much more herself. Her thighs were feeling better (just don't TOUCH ME!) and she ate a little. When we left this afternoon, she was in good spirits again, and had her best girlfriend with her, with her boyfriend coming soon.

We'll have her back up again in a few days, and will continue to work on getting her to eat more & eventually lose the tube. There will be more concentration on her physical and occupational therapy over the next few weeks, to get her in the best shape possible before discharge. She will still need one more surgery, to separate the flap between her right eyelids, sometime in the next couple of weeks.

Nikki's really looking forward to getting out of the hospital (of course!), and is starting to talk about what she will wear. Her old roommates in Cleveland have already packed all of her belongings for her, and they're in a van on the way to our house right now. I still need to know if she can be upstairs when here, or if I must arrange something downstairs for her- minor stuff, to be sure, and a pleasure to deal with.

I'm back to Cleveland tomorrow, and I'll be there until I come home for the Ohio Basset Waddle this Friday. Bonnie and I are looking forward to meeting many old AND NEW friends during our brief visit to the waddle this weekend. I'll also find time for another update then.... thank goodness, they're getting shorter!

Thanks to all of you again, and take care.

9/2/2004
Home for a night, to catch up on some business and much-needed work around the house. The cards continue to come in very steadily, with Nikki reading each one with delight. I'm going to take a picture of her hospital walls, so everyone can see the outpouring of concern over Nikki. I firmly believe that all of this helps Nikki to maintain a positive attitude, which in turn helps to speed her recovery. Sincere thanks to everyone for their help.

Nikki continues to do well, exceeding expectations. She has another surgery scheduled for Friday 9/3, and this should be her last burn procedure. This will be a "touch up" surgery, with skin from Nikki's thighs being used to graft several small spots where previous grafts didn't completely take. Most of the grafting will be on her back & shoulders. The director of burn and trauma, who does all of her surgeries, told Nikki on Monday that as long as this surgery goes well, she can expect to leave MetroHealth in 2 or 3 weeks! Friday is her 6th week there, and she's chomping at the bit to get out of there.

Maxillofacial was in to see her early this week. Their opinion now is that the facial fracture repairs will be largely up to Nikki. Of course, the broken bones have healed now, in whatever haphazard way they were laying. The facial docs say that as long as the healed bones don't interfere with her eyes, nose or sinuses, it's probably OK to leave them that way. The doc commented that her right cheek looks a little off to him, as does her nose. However, neither she nor I could see a problem. The doc pointed out that any such work could be done at any time, so there was no rush. Quite a change from our initial report!

We're still unsure as to what happens next. We were originally told that she would probably be transferred to a rehabilitation facility for a time after discharge. However, she's very mobile, and has some use of her hands and arms, so now the physical & occupational therapists are saying that she might be discharged to home. She would need to visit a local burn clinic almost daily for ongoing wound care for a while, and could possibly handle rehabilitation as an outpatient. Needless to say, this has her (and us) very excited.

Yesterday (Wednesday), Nikki was given a mirror for the first time. This was done in front of an audience, consisting of a priest, social worker, physical therapist, 2 nurses and a burn doctor. It was pretty anti-climactic. As I mentioned in the last note, Nikki had already had a pretty good look at her face in the reflection of a dark painting in the hallway. The mirror just added color & a bit more detail. She didn't shed a tear or act afraid, but asked a few questions concerning healing and future work. Her only comments were "I'll look pretty good in a year" and "I sure have a funky hair-line going there, don't I?" I was so proud I could bust. When everyone continued to tell her how brave, how strong & how positive she was, she was so embarrassed that she teared up a little. She said she doesn't do well to an audience, and everyone laughed- which made her feel better. Now, Nikki still hasn't seen her back, which is her worst burn area, but that will wait for a while.

Once again, Bonnie & I offer our sincere gratitude for all of the support and aid that we've received. Without the help of many caring people, we couldn't devote 100% of our time to helping Nikki recover. My job is still up in the air after all of this is over, and I'm trying to plan accordingly. We're also starting to deal with what we need to do to our house in order to accommodate Nikki's needs. I might temporarily convert our dining room into a bed room, since her bedroom is upstairs.

Stay tuned for more good news as it occurs. It's now a pleasure to talk about this stuff, rather than a painful purging of emotions. Hopefully, good news will be all that I have to report as Nikki finally nears the end of her hospital stay.