Dustin LaFortune

Archive for April, 2010

Today I spoke with the Charge Nurse and here’s the update:

• The plastic surgeon examined Dustin’s ‘cauliflower’ ears because the swelling has not gone down and likely will not because there is new damage and new wounds/cuts over old and improperly healed damage so the cartilage is ruined.  Dustin will require surgery and this will be done ‘eventually’ BUT it will NOT be done before he’s released from hospital.  (mouth, lips and face too)
• Dustin had two hours of physio today. (in the chair thing)
• Dustin’s white count is going down. He is responding to the antibiotics and the pneumonia is clearing up.
• Dustin is off morphine.  He gets T3 (IV) every 3 hours to keep him comfortable.  The nurses ask him about pain regularly and if he indicates that something hurts, or if they interpret sounds or gestures/grimaces as expressions of pain, he gets more T3.
• Dustin is off the blood pressure medication.  He is getting antibiotics, multivitamins and something for his stomach to help him tolerate the tube feeding.
• Today, Dustin was alert and spent much of the day awake. The nurse said that Dustin was mostly lucid, but confused sometimes.  He did respond appropriately, most of the time, to simple requests and commands (like try to lift your leg).  He also answered some questions correctly (what’s your name, how many fingers) and expressed preferences (TV channels or music).  Most frequent words/phrases used today: hello, yes, no, I don’t know.  Dustin is still repeating words/sounds whether people are in the room or not.
• There appears to be no change in Dustin’s weight.  Sometime next week, after more physio, if Dustin can support his weight and stand (with help of course), they will try to put him on a special scale.

Here is today’s update from Dustin’s nurse:

• Dustin is the same as he was yesterday.
• Dustin spent a total of two hours in the chair, watching TV or listening to music while the therapists did the physio exercises.
• Dustin is ‘talking’ (making sounds).  He ‘talks’ even when nurses are NOT in the room.  Today he kept ‘calling out’ and repeating phrases that sounded like:

“…No, wake me up.”

“…Come here…”

When there were nurses or therapists in the room, Dustin was asked specific questions which he was able to answer.  For example: Dustin indicated ‘5′ by lifting his left hand as if to show 5 fingers when the nurse asked how many fingers she was holding up.

Right now (4:35 BC time), Dustin is awake, alert and watching TV.

There were no tests or examinations today.

I just got off the phone with the nurse.

Dustin is making attempts to talk.  He tried to tell the nurses something about what happened but they couldn’t understand.  When they ask specific questions, he withdrew and looked away.  This started with Dustin “calling out” (nurse’s words) so they went into the room.  At first Dustin seemed confused.  Then he said “memba aw memba”.  Sometimes he answered their questions with “no memba”.

The staff discussed whether they should contact _________ but decided against it because Dustin was still phasing in and out.  They also thought the “calling out” might be Dustin reliving and remembering and asking for help.

Later, during physio, Dustin was able to indicate to staff that he wanted to go “in the chair” (it’s a lift) and that his bum hurt and his mouth hurt.  He also keeps asking for a drink of ‘water’.  The Speech Pathologist was called in to determine if it was okay.  It’s not.  Dustin still cannot swallow.  They tried ice chips the consistency of a slurpee and tiny drops of water but Dustin gagged & choked.

So far today, Dustin was given T3s and no morphine.  He’s asleep now.

I just got off the phone with the hospital.  Here is the latest (in point form, copied from the notes I took while on the telephone)

• Overall, Dustin is the same as he was yesterday.  He is only partly oriented because of the drugs.
• Dustin pulled out his feeding tube this morning. He was asleep and agitated at the time so the nurses and doctor deemed that he was not consciously deciding to pull out the tube.  It will be replaced as soon as he gets back from the X-Ray dept.  If he keeps pulling it out it will be replaced every time because Dustin is not competent or informed enough to make decisions about his health.  His mouth injuries are too severe so Dustin cannot take nourishment through his mouth and he cannot swallow properly.  It is important to get as many calories and vitamins into his system as possible because his body requires more than a normal healthy body in order to heal.
• Dustin is currently in the Radiology dept. having more X-rays of his head, neck and chest.
• When he gets back from X-ray, the SPEECH THERAPY dept is going to do an assessment.
• The results of all the tests to date, will be available tomorrow (Tuesday April 27/10).  There is a ‘team’ meeting this afternoon.  All the data will be collected and entered on Dustin’s chart.
• Dustin is still on the ‘critical’ list.  He will not be released from hospital for a long, long time.

Responses to questions from family members re: April 27th:

From what the nurse told me, Dustin was not alert or awake enough to know that he was pulling out the feeding tube the first time.

But he does have to understand that he needs it so he doesn’t try again.  The nurse said he did it again when they were getting him ready to go for x-rays so they just left it out but told him that it would be put back.

I think Dustin might be hallucinating and/or remembering.  But that is just ‘conjecture’.  He might just be uncomfortable too.  I hated the feeding tube, having a dry mouth, a sore throat, a sore nose and that ‘gagging’ feeling.

By the time the week end comes and Dustin has visitors again, he may be more lucid and better able to understand why it is important to have the tube

• Dustin is lucid and responsive when he is awake.  He responds appropriately to simple requests and commands like ’squeeze my hand’.
• Dustin recognizes and tracks people and objects.
• Dustin makes clear attempts to communicate with sounds, gestures and words.

Court is making arrangements to have a TV installed in his room this afternoon. He also wants to have occupational therapy (closed for the weekend) supply Dustin with a pictogram communication board.

(I am trying to put together a board from Gabriel’s symbols, which I will email to Court so maybe Dustin will be able to ‘talk’ to visitors and hospital staff by tomorrow)