Sunday, March 16, 2008

Work

Yesterday was tough. First thing in the morning we hit the ground running, all the way to Vancouver with a sick patient. We saw the station for a total of 1 hour, 10 minutes yesterday. It was a very busy day, but that wasn't why it was tough. It was difficult because, first of all, almost everyone we came in contact with yesterday mentioned or wanted to discuss the hit and run incident in Aldergrove last week. For those of you from further away, I'll give you some details: three men in their early twenties were driving to the Abbotsford airport early in the morning. They passed a truck, somehow angering the driver. The driver of the truck sped up and rammed the back of their vehicle, driving it off the road. All three passengers got out of their vehicle and the angry driver sped off. A honda pulled over to make sure the three young men were okay, determined that they were, and left. A few minutes later the angry driver returned, hit one of the young men with his truck, and took off again. The young man who was hit died. The police have issued a vehicle description and an admonishment for this angry driver to turn himself in. I think everyone is shocked and horrified because of the lengths to which this road rager went to with his vehicle. Who, who, WHO, I ask you, thinks power is more important than a human life? Who loses their temper THAT badly? WHO lives with that much anger in them and doesn't seek help? BEFORE killing someone? Anyways, everyone is talking about this tragedy and it's a tough one to deal with.
Also, one of our patients yesterday (actually there were two victims) was beaten in the head with a two-by-four with 4 inch nails sticking out of it. He had a massive brain bleed and his eye was irreparable. He needed both neurosurgery and opthamological surgery. His buddy was not much better off.
Also, a pregnant mom went into a coma and is now on life support, brain dead, and the docs are trying to keep her body alive long enough for her baby to develop to a gestational age where they can deliver it by c-section and hopefully save it. The likelihood that her organs will hold up that long is not good, but they are going to try.
Also, one of our frequent flyers is an eleven year old girl with cerebral palsy and a seizure disorder. She has seizures every single day. Most days her mom can control them with extremely heavy duty drugs, but once or twice a week they are so bad and last so long that she runs out of drug options and has to call us. One of the problems is that this little girl is constantly developing a higher and higher tolerance for the anti seizure medications that work for her, and eventually reaches an unsafe threshold. Seizures are extremely exhausting for the brain and the body. Muscle contractions are so strong and so constricted during a seizure that breathing is often inhibited and all the muscle groups involved become extremely tired and painful as lactic acid builds up. Some seizure muscle contractions can be so strong that they break bones. This little girl uses up so much energy every day seizing that she is very thin. I think the worst aspects of her seizures are that she is conscious the whole time (unusual) and that they last for so long. Usually her mom will call after 45 minutes or an hour. ALS comes with us, they start an IV and give a stronger dose of the drug that works best, and finally it slows and stops. She will usually try to talk to us, and this is what she says, "Pain, owie, pain, owie, owie, help." When we pull into the driveway she recognizes the backup signal and she says, "Beep, beep, beep, help." She knows we have the drugs that help. She's usually tolerant of our needles, but yesterday she was pulling away. Can you blame her for wanting to avoid MORE pain? She makes me cry. Every day she lives like this. Every day. When she's getting a needle I tell her, "You're so brave. You are such a strong girl to put up with so much," but it feels dishonest: what choice does she have? Be brave or keep seizing. Stick your head in the lion's mouth or the cougar's paw. No doctor or neurologist yet has been able to tell her parents what is wrong, what it is called, what it is caused by, or what to do beyond the drugs that work. The seizures are not grand mal seizures because she is awake, and can somewhat control her muscles (bladder, for instance, and, while seizing, can pull her arm away if she is not ready for a needle). But the movements look like grand mal movements. She has brown eyes. She is very sweet. It is very sad.

2 comments:

tamie said...

Oh Mel. Oh Mel.

Tonya said...

My heart breaks for the little girl and her mother. Katie seized nonstop sometimes - but usually the petite mal kind. It was so you didn't even notice them anymore. They did a cat scan last year and said there was constant seizing in her brain. The hardest part is knowing that every time they have a seizure like that, more brain damage is occurring. Which means more seizures ... The good thing for Katie was that valium usually helped if she were having too many (she was on anti-seizure meds too). Sorry for your tough tough day.