The knee replacement part of the surgery went extremely well, accomplished with just a spinal block along with conscious sedation, similar to what you would experience in a colonoscopy. Mom had been told to expect to be up and walking the day of the surgery. However, the recovery nurse noticed right away that Mom had weakness in both arms. After a couple hours of monitoring her, they asked if we would come to the recovery room and observe her. She was able to speak to us but was unexpectedly groggy. When she still hadn't improved five hours after the surgery, they ordered a battery of tests and finally sent her up to ICU. By evening she had lost her eyesight, but could still recognize our voices and provide short, belabored responses to our questions. We gathered the family together and gave her a blessing which spoke comfort and peace to everyone.
By Tuesday morning she was no longer conscious. As the day wore on it became evident that she needed more specialized care. Our family prevailed upon the hospital to immediately move her to the brand new Intermountain Medical Center in Murray where they have a Neurocritical Intensive Care Unit. Although she probably doesn't remember any of the excitement, it was quite the scene early Wednesday morning when the Life Flight team arrived to transport her to IMC by ambulance. It has been so comforting to have her in this new facility where they know what to do and are giving her superb care.
The neuro specialists here are baffled by how this happened, and told us that the chances of this occurring are literally one in a million. The doctors have been able to determine that the stroke was caused by low blood pressure during the surgery, despite the fact that her blood pressure remained within acceptable levels all throughout the procedure and everything appears to have been quite routine. For some unexplainable reason, the blood pressure levels that work for most everyone else must not have been adequate for her, and blood was not able to flow to all parts of her brain. The MRI's show numerous, widespread mini strokes in the watershed areas of her brain and expected swelling around those areas of damage which developed over the course of the next two days. Although the damaged areas are permanent, as the swelling subsides she will likely regain much of the functions impaired because of swelling. Because of the dispersal of the mini strokes, there is a good prospect for neighboring areas of her brain to take over and help restore much of the lost functionality.
One of the spots of damage is in the area of the brain that controls consciousness, but there is also swelling in that area. They expect that once the swelling subsides she will be able to regain consciousness. We are hoping for the same thing with her vision, since early on she did have her sight, but lost it several hours later, hopefully as a result of swelling and not permanent damage. It appears that the worst is past and she is on the mend. Changes will be slow, but steady, incremental improvements are expected.
On Sunday night when everyone gathered to give my Mom a blessing before the surgery, she was told in the blessing that she would be able to see the hand of the Lord through this experience. Although we never imagined that things could have turned out this way, we have indeed seen the hand of the Lord these past few days, and know that He is aware of us and in charge of what is happening. So many people have appeared at just the right moments to guide our path, and we are grateful for the help we are receiving.
We are holding a fast for her tomorrow, on Sunday, August 2nd, and invite you to join with us in fasting on her behalf. Although we don't know how much she is aware of her surroundings, we think she can hear us and is becoming more responsive. We know she would love to hear from each of you and feel of your love and friendship. Please feel free to post a response below by clicking on the "COMMENTS" link at the end of this entry. We will read the comments to her.
Thanks again for your love and support. We'll keep you posted.
Nice job, Diane! It was fun writing this with you. You're an awesome sister!
ReplyDeleteThis an email I sent to some of my friends on Thursday night. It gives my perspective at that time. Randy
ReplyDelete---------------
I want to tell you how much your thoughts and concerns and prayers have meant to me. However, words cannot begin to express the deep appreciation I feel.
This afternoon was a very good day. We had discussions with several doctors. The surgeon that performed the surgery, the anesthesiologist, the neurologist in charge of the neurologic ICU facility and others. We were briefed on the full extent of the injuries to her brain.
To make a long story short, Mom went in for what was described as relatively routine knee surgery. (As if double knee replacement is rountine.) However, after the surgery she never came out of recovery.
The problem was that during the surgery her blood pressure was reduced to minimize bleeding. (This is normal) Unfortunately, in Mom’s case, the blood pressure was reduced to levels that were too low for blood to flow throughout her entire brain. This lack of blood flow is called a hypoperfusion stroke. Her stoke was not like a typical stroke where one portion of the brain does not get blood. In her case, there were many places throughout the entire brain on both sides that did not get blood that was needed.
Consequently, there were all kinds of problems that became manifested. Her sight went away, she lost the ability to move her arms and hands, she couldn’t talk, she couldn’t communicate and she didn’t feel any pain. There were other issues, but these were the most obvious.
Since this wasn’t a normal stoke, it didn’t have the typical signs of a stoke so the doctors did not feel it was stoke and didn’t treat her problem accordingly.
It took over two days and transporting her to an Intensive Care Unit, that specializes in neurological disorders, before an understanding of what actually took place began to emerge.
Today the surgeon and the anesthesiologist both visited us in the ICU to express their deepest concerns and sympathy and obsolute shock over what had occurred. Neither of them had experienced this type of complication in the past. My daughter, Dani, had previously worked for the surgeon in the past. He had performed thousands of knee surgeries over the years. He is recognized as the best knee surgeon around. He was very saddened and disturbed over the outcome of mom’s surgery.
Late this afternoon, the lead neurologist reviewed the MRIs of her brain with us and showed how widespread the damage was. He then explained the good news is that although there was damage everywhere, it was his opinion that the damage was not as deep or severe as the initial MRIs would lead you to believe.
He felt that there was a lot of hope for a very significant recovery and he thought the brain could “rewire” much of itself and begin to resume or relearn most of the functions that were affected. He further explained that he felt most of her outward symptoms were being caused by the swelling of the brain that was a natural result of the injuries caused by the lack of blood. He also felt that the swelling should begin to subside over the next few days. He said that he had seem some improvement in responsiveness overnight.
During the rest of the day the increased responsiveness improved even more. She seemed to hear us and she seemed to look in our direction when we talked. She started moving her feet. I know these sound like tiny baby steps, but they were actually monumental improvements over the past two days.
There is still a long, long way to go and it will not be easy, but we definitely see God’s hand in it all. All of your thoughts and prayers have made a major difference and we appreciate them more that we will ever be able to express.
Thanks for your love and understanding.
Randy
I have home taught Pauline and Jim for several months. My love and prayers go out to both of them as Pauline recovers. I know the Lord will help her in this life event and she will grow from it. May the Lord bless you, Pauline, for your righteousness and your service to the Lord in the ward and in your family. -Brent Dowdle
ReplyDeleteWe love you Aunt Pauline! You are in our thoughts and prayers, and we will be fasting for you tomorrow. Sending our love and hugs. Brian and Jennifer Powell
ReplyDeleteMy love and prayers are with all of you, especially my sweet sister, Pauline. Even though the miles separate us, my heart and thoughts are with you constantly. It is difficult to be far away when I want to be right there with you. Sending love and good thoughts. May the Lord's tender mercies surround ALL of you. Can't think of a better reason to fast tomorrow. Sending more love, Christie
ReplyDeletePauline,
ReplyDeletemy prayer go out to you and your family during this time. My thoughts have been on you all week. Get well soon. We miss you already and it hasn't even been a week since we saw you last. Can't wait to see your smiling face up in the front of church leading the music again for us. It will not be the same till you get back.
Donna Enslen
Hi Pauline. We were sad to receive news tonight that you're in ICU. You have never been one to idle away time or shun duty! The doctors say you're case is... "one in a million..." Is this the only way to get you to slow your pace...to rest a while? Knowing you, you'd be up and running circles around the rest of us...the day following surgery? Dear Pauline. You truly are a "one in a million" individual to our family. Steady, calm with a remarkable testimony of our Heavenly Father and our Savior. Thanks for your reassuring strength and example through the years. How blessed to sit and learn from you while we served together in Relief Society!
ReplyDeleteOur family has a great love for you and Jim and your amazing family. What a sad day for our community when the Whiteheads moved away! Remember the excitment when you two received your mission call? We loved our visit to see you at Adam-ondi-Ahman and especially to experience that hallowed place through your eyes. We look forward to hearing from you soon.
Love you...Dion and Maryanne Graybill
dearest pauline...our hearts and prayers go out to you at this time. you are a wonderful woman who has been an example to me from an early age. you have a sweet dispostion and a sincere concern for others. i want you to know that we love you and pray and hope for your quick recovery.
ReplyDeletelove,
jared & tia (graybill) glover
We send our love and prayers to you, Pauline. We miss you in the ward but will forever be grateful for your examples of faith and dedication. We are confident that the great faith you have will get you through this time of difficulty and will help your family members as well. May you know that you are loved by us and by countless others!
ReplyDeleteLove,
Bill and Lynne Cannegieter and family
Pauline,
ReplyDeleteBrad and I have thought a lot about you over the last few days since finding out. We want you to know you are in our thoughts and prayers every moment and we know you are an incredible individual. I want you to know how close you are watched and admired. I have loved seeing the spirit that radiates from you. You are an amazing woman! We will continue being with you in spirit, thought, and prayers...You are truly amazing!
Pauline,
ReplyDeleteYou are always one who comes out of her way to say hi. To see how we are doing. You are a light to so many of us. You are in our thoughts and prayers. We love and care for you so much!
Pauline,
ReplyDeleteI want you to know how much I have grown to love you over the past couple of years we have been in the ward together. You have been a wonderful example and friend. My thoughts and prayers have been with you all week and I know so many others love you and are praying for you, as well. May Heavenly Father bless you with peace,comfort, and the knowledge that you are loved by so many!
Hi Pauline,
ReplyDeleteI just wanted you to know that my thoughts and prayers are with you for a speedy recovery!!! Thank you for being my friend, visiting teaching partner, confidant, etc. I have thought of you often and miss you! Please get well soon so that we can do lunch when I am in town in October! May the Lord bless you and keep you safe!
Love you,
Shonnie Whitney