8:05 am - Krystal (my daughter) called me (Jerrall) about 8:30 am on her cell phone and
told me that her and Debbie (mom) were in a car accident and mom was not conscious.
They were flying Debbie via Air Vac helicopter to the Intensive Trauma unit at Carolinas
Medical Center (CMC) in Charlotte, North Carolina. Krystal was in unbelievable shock. I
called Amber (Krystal’s sister) at home to ask her to go pick up Krystal and both of them
meet me at CMC.
I got to CMC first and about 10 minutes later I saw the helicopter land on the roof with
Debbie. The staff would not let us see Debbie for a few hours. They were doing everything
possible to save Debbie’s life. The staff took me to a private waiting room and when I
opened the door Krystal and Amber were inside with family friends Gerald and Helen
Callahan, Gene and Betty Ward. I could not believe all of the closest people in my life were
in the waiting room before I was. We were all in shock and did not know what was going to
happen next. While I waited on the doctor to brief me, Amber, Gerald and Helen took
Krystal down to the emergency room to be examined. Krystal was in the front passenger
seat at the time of the accident. The only physical problems Krystal had were; bruising on
her chest, arm, torn sternum and shoulder were the seatbelt was and where she hit the
door. Psychologically though; the sound, smell and taste will be with her for the rest of her
life.
A few hours later, Krystal, Amber and I got to go see Debbie. It was a trauma unit like you
would see on the TV show MASH. Family members gather in a 14 x 40 hallway every 4
hours and when the double doors open everyone rushes in, washes their hands, then has
15 minutes to visit their loved one. If someone new comes in or someone dies we will not
get our 15 minute visit and we’ll have to wait another 4 hours. It does not get anymore real
than this. Waiting in the hallway I could feel 100 lbs of pressure on my shoulders pushing
down to the floor. It was all I could do to stay standing. A lot of the time I would have to
kneel down in the floor, waiting to see if we would get to go in each visit.
The first time we got to visit Debbie we were told she had multiple fractures to her pelvis
bone, a lacerated kidney, crushed and broken ribs on the left side, a collapsed left lung,
and a 5’’ cut about an inch behind her left eye that went over her ear and toward the back
of her head. The doctors said all this did not matter because Debbie had a closed head
injury and we could only wait to see how much pressure would build up inside her skull.
The first thing saw was a pressure bolt the doctors had installed through Debbie’s skull on
the right side of the hairline with a wire going to a monitor box at the head of the bed.
Debbie had a drain tube in her left lung. She had all kinds of wires and monitors on her
body. She had IV lines in her arm and a main IV line in her chest. There was an air
breathing tube in her mouth connected to a ventilator.
Debbie unconscious and was not moving. I was in so much shock I did not realize what was
really happening. Today is 5/3/04 and it has taken me over a year before I could even
write about this.
Every 4 hours all day until 11 pm, we could see Debbie. Every time we saw her she was
swelling more and more, where it was hard to recognize her. Later I found out the doctors
control the swelling by fluids to help the patient’s body with shock and to ease the trauma
the body is going through. For all of the next two days the doctors said to take each hour
by hour, only god knows if Debbie will live through this hour.
Debbie had her own private nurses that monitored and charted every 10 minutes of her life
for the next two weeks. I learned fast that when we came into the trauma unit, to take a
reading of all the monitors. The ICP monitor was the most important and when the pressure
rose above 20 the nurse had to inject Monatall into the IV to try to minimize the damage to
the brain cells. The pressure would be 12-16 then jump 18-30 and then back down. We
would panic when the pressure would get to high. But the nurses were the most
professional I have ever seen. From what I understand Monatall is a drug that shrinks the
brain like a prune in the sunshine. Because of this every time the ICP goes over 20
Monatall can not be given Morphine is the drug of choice and was given in a constant drip
through the IV.
A year has past and all of this seems so long ago. While I waited for the 4 hours between
visits to pass I would go to the doctor’s research library to find more information about close
head injury. Then during our 15 min visit I would ask one more question so I would know
what to research on the next trip to the library. This only way I know how to deal with this is
knowing and understanding what was happening. This is the most helpless feeling knowing
there is nothing I can do and not understanding what is happening. Between the internet
and the library, after three days I learned too much. The main thing to know is that no 2
Traumatic brain injuries (TBI) are the same. So with all the knowledge available, no one
can say how it applies to Debbie. The books say all of the percentages are against
Debbie. If she lives through one thing then it could be something else; an organ could fail,
blood clots, or respiratory problems could take her away at any time. This is in gods hands,
so I quit reading until Debbie came out of the coma. I just tried to enjoy the time we had
together, where Debbie goes from here is better than where she is now. I can say good
bye instead of just going to a funeral and never having this time together.
I remember the Callahan’s going to almost every visit with the girls and me. When the visit
was over we could all reflect and evaluate the visit. Some visits were very positive and
some were not. Gerald and Helen; I don’t know how we could have made it without your
support during this time. On about day 10 Debbie’s ICP seemed to be stabilizing. Still in a
drug induced coma every breath was from the ventilation machine. The nurses work 12
hour shifts so for the next 24 days when I did not spend the night I called and talked to
Debbie’s nurse at 5 am to find out if Debbie lived through the night and how high ICP, blood
pressure ,ventilator, and temperature was through the night. Debbie; hang in there every
step of the way you have always been a fighter!
4/9/03- I was asked to sign a release form for the doctor to install a main line in the return
valve of the heart. A Vena Tech Cava Filter is being installed to help prevent blood clots
from going to the heart if they develop. As of yet, no clots have formed.
Debbie is still in a drug induced coma. The ICP has seemed to peak, but on the high side.
She is still only breathing on ventilator. Her body is so swollen she looks like she is wearing
a rain coat and rubber gloves and someone filled them with air. She does not look like
herself. She has a feeding and a drain tubes in her nose and air tube in her mouth. When I’
m alone the staff gives me more time with Debbie. Still all I can do for now is rub her hands
and talk to her.
4/14/03- This was a long week. Debbie was still in the Trauma units in critical condition
and ends up being move intensive care on Friday. The doctors still have Debbie in a drug
induced coma, but they have removed ICP bolt monitor from her head. Debbie’s vital signs
have stabilized. The staff implies they want to get her ready for the nursing home and wait
to see if she will ever wake up. There is nothing more the hospital can do. It did not take
me long to let everyone know how Debbie was coming home with me. This week I had to
sign more releases to have trac installed in Debbie’s throat so she could be hooked to a
ventilator easier. I knew when this was done I may never hear her voice again. This was
like being hit with a ton of bricks but it had to be done. The staff said people live with trac
every day and that was a way of life. Also a feeding tube was going to be installed in her
stomach. This would be Debbie’s new way of nutrition, since she is in a coma. I could tell
the staff was getting Debbie ready for long term care, but I still did not know if I’d get to
bring Debbie home.
At the first of this week the drugs to induce her coma were taken away and the nurse said it
would be up to Debbie if she wakes up again. By the end of the week we knew Debbie was
in a real coma. This week Debbie began to shake from time to time like her brain was trying
to turn on then it would short out. She never opened her eyes.
4/18/03- The nurse said she saw Debbie open her eye for a little while. This was the first
time since 4/4/03. At 5 am I called and Debbie’s nurse said she made it through another
night. She had a slight fever and some shakes. When I got to trauma unit at 7 am
and Debbie was gone. I could not believe the staff could move her and not even tell me. I
had to find out on my own. The staff told me where I could find her new location. It was a
large dark room 50x70 the hospital used it as an overflow intensive care unit. Debbie was
in this very dark large room in the far back corner still in a coma. There was a different
nurse there that had never seen Debbie before, watching her vital signs and monitors. She
said I could stay with Debbie till they got Debbie’s other room ready. Debbie only had to
stay in this setting for a couple hours. This made me realize how I had no control of
anything around me. The doctor and staff were great, just overworked and I had no
experience at this, but I am learning fast.
About 1 pm Debbie was settled into her new room #5203. This was a step down from the
intensive care unit with 5 beds and 3 nurses monitoring and charting every 10 minutes on
all 5 patients. At least the feeling of death was not as strong in this unit. This is a place
between trauma and a regular hospital room. All of these patients were stable and getting
better. The girls (my 2 daughter) could stay for hours and take turns reading to Debbie.
WRITE MORE
The staff knew by now I was going to take Debbie home and I could stay with her more. I
only had to leave the room when there was a problem with another patient. This happened
often. This is still intensive care. This is hands on learning. The hospital Physical
Therapists came and instructed me on Range of Motion (ROM) everyday, 2 times a day.
Debbie had to be stretched on every joint; arms, legs, neck, fingers, feet, toes, ECT. While
Debbie is asleep it is my job not to let her have shortening or contractures of muscles and
tendons. So I will have to keep Debbie moving until she can move on her own.
The Physical Therapists told me how important Debbie’s ankles and face were not to get
contractures. I asked everyday before I finally got boots for Debbie to wear. I got the
feeling a lot of things aren’t important if the electricity in your brain is off. That did not stop
me, Range Of Motion was the only thing I could do to help Debbie. The staff says if Debbie
can mentally walk again then they can do tendon releases for contractures. I hope we did
not have to go that far. This is the week I learned about tracts. Before when she had the
air tube in her mouth no suction was needed. But with a trac Debbie needed her airway
suctioned (cleaned out) often to keep from choking to death. One nurse said a quart of
saliva a day every 20-30 minutes is produced. Debbie is wearing an oxygen collar around
her neck that provides oxygen to her trac but when the saliva gets to thick she chokes
because air can not get to her lungs. To suction you take a ¼’’ diameter plastic tube about
2’ long, remove collar and insert this straw like tube in the trac in her neck, down the airway
of throat into Y of lungs. Debbie coughs, chokes and gags. When you reach the bottom
you turn on the suction and pull debris up and out of lungs and trac. If you get all of the
debris then Debbie lays there peaceful, if not then you have to go back in again. Maybe its
better she sleeps during this time of healing. Debbie’s breathing has been the most
important minute by minute issue to watch. The next thing the nurses teach us is about bed
and pressure sores. Debbie is lying on a special air mattress but still needs to be turned
every two hours from one side, to her back, to the other side to prevent bed sores. I could
not move Debbie in trauma unit but in this unit I can work and touch Debbie everywhere.
That is how I found a 3’’ bald circle on the back of Debbie’s hair from laying 15 days in one
spot, while in the trauma unit. Debbie’s skin looks great, no pressure sores at this time.
Also we are learning how to feed Debbie through the feeding tube in her stomach.
4/21/03 - Debbie’s vital signs are still stable. Her temperature is below 100 and she is
till in a coma. The doctors said since I am taking Debbie home, maybe Charlotte Institute of
Rehabilitation could come and evaluate her this week
4/22/03 – two doctors from Charlotte Institute of Rehabilitation came to Debbie’s room and
did an evaluation. They said that Debbie would be a good candidate for rehab and that
they could teach us how to take care of Debbie at home. The rehab doctor noticed swelling
in Debbie’s right arm shoulder and ordered an ultra sound. It turned out to be a blood clot
and the doctor started treating it that day through medications in an IV. The clot never
gave Debbie a problem and finally the swelling went down. I felt better when we put the
green filter in the artery to the heart to catch a clot if there had been movement.
4/23/03 - Te doctors removed the nose feeding tube. Now they are using the g-tube in
her stomach. She breathed 24 hours through the trac without a ventilator.
4/25/03 - Debbie got her boots.
4/26/03 - Debbie was stable enough and ready to be moved to a private room on the 11th
floor. Amber and I took turns staying with Debbie 24 hours a day. When I got back from
sleeping this evening, Amber was pale as a ghost. Keeping Debbie’s air way open so
she could breathe is a full time job. This was Ambers first day to be responsible for suction
by herself. There was a nurse per several patients, but most patients have no family to
help and when Debbie starts choking she has to wait her turn. So Amber learned that day
how to perform suction so Debbie could breath. To this day Krystal and Amber can not
stand to hear a suction device. With time and praying, this will only be a dream, not a
continuing nightmare.
4/27/03 - 1st night in private room and I stayed with Debbie all night long. Debbie is
still asleep in a coma. She shakes and needs suction often. She is still on respirator and
has IV’s.
4/28/03 – staff came in this morning and said Debbie was being moved to Charlotte Institute
of Rehabilitation today. She only got one full day in her private hospital room. Debbie was
still asleep. I went with Debbie and staff to Charlotte Institute of Rehabilitation. We went
through a tunnel under ground that connects Charlotte Institute of Rehabilitation to the
hospital. Debbie was laying on a wheeled stretcher a sleep (coma). As I walked through
this tunnel I could finally feel the weight or load come off my shoulders, that I’d felt since day
one. I did not feel or sense any death in the air. All I could sense is hope and life. It was a
feeling I can not explain.
