Vocabulary Word of the Day: Subdural Empyema

Day 2 in the PICU.

Nora is still resting, getting a lot of IV antibiotics and frequent pain medications. When she wakes it is clear that she is still uncomfortable, so she gets dosed with more pain meds that put her back to sleep. She isn't eating much - or doing much of anything - right now.

She had another CT scan this morning. The neurosurgeon was pleased with how it looked. It appeared that the drain he put in the subdural cavity (area between the brain and skull) removed a lot of the fluid that was building here. Now it is just a question of why there was fluid there. It could be that the infection caused a buildup of fluid in that area, or it could be that by reducing the pressure in the right ventricle, the ventricle has become smaller and the brain is pulling away from the skull, leaving a space that will be filled with fluid. Option 1 is quite serious because it means she has an infection of the CSF which must be carefully treated otherwise there can be really terrible outcomes. Option 2 is also serious since it means she would probably need a shunt surgically installed now to drain the fluid from the subdural area. We will probably not get a real clear answer anyway, so I think that both options will be addressed. The brain is a very sensitive system where pressure changes in any one area affect the whole thing (remember PV=nRT?). So, it is quite complicated. I am thinking I should have paid closer attention in Fluid Dynamics!

We are working on getting a schedule set up assuming we are going to be in this thing for the next while. I really want to have someone here 24 hours with Nora so when she wakes she sees a familiar face. Andy and I probably can't sustain 12 hour shifts for 3 or more weeks straight, so our parents will pick up some shifts to make it easier. Andy will do nights. He doesn't mind it. I stayed here last night and it wasn't too bad, but I have an awful ache in my neck from this recliner I slept in. They have rooms with beds available, but I would prefer to stay in her room so I can be there when she gets woken by the nurse every couple hours.

Anyway, I will be on days and probably be updating the blog once in a while since it can get a little boring. Boring is good though. It means nothing catastrophic is happening. Stay tuned.