Day Seven - Wednesday December 21, 2011 p.m.

Bridgett continues to move around a lot, especially moving her legs a bunch.  She keeps wiggling around and throwing her legs off of the bed.  Finally tonight one of the respiratory therapists devised a makeshift barrier to keep her in bed.  So far, so good. We decided that she is tired of laying in bed.  For those of you who don't know Bridgett very well, she loves to work out, is studying to be a personal trainer, and has been training for a triathalon.  She ran her first half marathon in October.  Bridgett's fever was higher today as well as her heart rate.  They are not sure if she has an infection.  They took a bunch of cultures and we will see.  She has already been on antibiotics since she aspirated vomit.  By late this evening her fever calmed down.  Otherwise, her numbers have been good. The doctor discussed today establishing a tracheostomy for Bridgett.  There are problems with long term ventilator tubes in her throat.  Pressure sores can develop in the throat and the vocal chords can be damaged.  Two weeks is the max they want her on the ventilator.  Right now she is breathing on her own during the day.  The tubes serve mainly to protect the airway--to help keep fluids out of the lungs so she doesn't get pneumonia.  I think I have mentioned that she has broken teeth in her mouth.  Actually today they found a piece of a tooth in her mouth that they think has been there since the wreck.  With the ventilator tubes in her mouth it is almost impossible to assess the damage to her teeth.  Of course, at this point nothing can be done.  However, there exists the possibility that there are exposed nerves.  So, we have decided to go ahead and do the tracheostomy right away.  Tomorrow the ENT (Ear, Nose Throat Dr.) will do surgery for the broken zygomatic arch and fix her broken nose.  At the same time he will do the tracheostomy.  Also at this time, he will move the feeding tube to her nose.  Then when he is done, she will not have any more tubes in her mouth and we can have a dentist come and evaluate the situation.  Today we had a consult with the ENT. He explained that because of the location of the fracture, there are a lot of facial nerves in the way as well as the muscle that attaches to the jaw. It is a difficult and long surgery.  He proposed a different way to fix the zygomatic arch that will be faster and less invasive.  He said that it is what he would do with his daughter if he was choosing.  It sounds kind of funny but he will make a small incision over the zygomatic arch, then go in from outside the bone and try to pop it back in place, much like you would do bodywork on a car.  It will hopefully work, and if not the longer procedure will be used.  So, everyone pray that the shorter surgery will work and go smoothly!!  We are not sure of the time of the surgery yet.  The earliest would be at 7:30 a.m. but it may be later in the afternoon.  For those of you who know my parents, my dad fell out of bed yesterday morning.  His situation is critical and the hospice people said to expect that he will not make it more that a week and perhaps not longer that 24 hours.  I was able to break away during Bridgett's MRI yesterday to visit quickly with him.  Today I went up again while they were doing the picc line.  I was only able to talk to him for a few minutes and then he fell asleep.  During the day he was not very talkative and was lucid only part of the time.  We are praying that dad's pain will be short and that his suffering will not be prolonged.