Ryan’s had it rough over the past several days. It all began overnight last Thursday. Even as of this morning, I am unable to tell you what’s going on.
Ryan’s heart rate is elevated. His baseline is in the mid-50’s at night at mid-60’s during the day. Today is a little improved, but it has been running 30 – 40 beats per minutes above his normal pace… no matter the time-of-day.He’s also having difficulty digesting his nutrition and water. It’s taking many hours too long to clear the contents of his stomach. Last night was a challenge to just get his medications down, let alone water and nutrition. It was one o’clock when his stomach was emptied enough to give his ten o’clock medications. I can, at any time, measure how much volume he has sitting in his belly — called “gastric residuals” — by pulling it back up through his g-tube. In actuality, this is performed at least a dozen times throughout the day so that he doesn’t get too much (and him throw-up). The good news is (on the other side) his bowels and urine are normal.
His body temperature is running between one and two degrees higher, but don’t jump to the conclusion that he has a fever. He might, but I seriously doubt it. It’s my belief that this is his central body temperature responding to some (unknown) discomfort and not a fever due to an infection. This is quite common in brain injured people; where their core temperature fluctuates. The most prominent example of this is when Ryan came out of surgery and his temperature quickly rose to 109.8 degrees (yes, that’s one-hundred nine). It was off-the charts — literally — as a result of the enormous pain he was experiencing. What it wasn’t was a fever in the way that most people think of it. It all comes from his damaged brain and the regulatory system in particular. Not illness, disease, or infection.
Did that make sense?
I’m 99% sure he is not battling an infection. However, since there is that 1% of doubt we will have his blood drawn today and sent off to the lab.
It’s so frustrating not knowing what’s going on with him. Still, I do know what it’s not because I have been assessing him for days. I visually checked every square centimeter of his body that was physically possible. With the stethoscope I listened to his lungs, heart, stomach, and major
veins arteries. I made sure there was no torsion with his testicles. I scoped his nostrils, ears, eyes, and throat. I tapped on every tooth in his mouth. I moved every bone, joint, and muscle in his body. I gently, but firmly, pushed on him from head-to-toe. With the exception of his chronic hemorrhoids I could find nothing wrong.
Then I asked his doctor to do the same. He came to our home yesterday. I wanted assurance that I didn’t overlook anything.
It’s so often the case with Ryan that determining issues is accomplished deductively. It’s a meticulously painstaking process of elimination. All because of Austin Vantrease and Jonathan May (both of Newark, Delaware), they have brutally beaten Ryan’s ability to simply say what’s bothering him.
What they did to him on that night in November 2009 just never ends.
UPDATE: Feb. 25, 2014
There is no change in Ryan’s condition today. We are waiting on the pending blood work results; which might be today but likely tomorrow.
Some additional information that I’d like to share:
- I gave him a dose of medication for urinary tract relief even though there was no indication of a UTI. This had no effect on him which further validates it’s not a urinary infection.
- Sue swabbed his stools for the presence of blood. There wasn’t any present (i.e., it was negative for blood).
- Ryan’s bowel movement smells slightly different. The best way I can describe this odor is like when I eat jalapeno peppers or (they just don’t agree with me) or drink too much alcohol; then the resulting trip to the bathroom.
- Like others, I worry that he might have developed gastreoparesis, resulting from the vagus nerve not functioning properly. I worry about a thousand other things that could cause slowed digestion too. I know he had issues with this nerve shortly after the attack because I was the one who demanded it be checked; problems with sudden and dramatic changes in his heart rate. I’m not seeing any obvious issues with it at this time (uvula is centered and his gag reflex is responding normally), but these simple observations could be misleading since it is just one nerve is a network of cranial nerves.
So, that’s where we are at this point in time. I worried sick about this.