Thursday, July 23, 2009

Today 7 23 09 Thursday was a mixture of feelings observations and emotions-
I am inspired by her fight, and grit, her eyes when open can speak volumes. She tries to mouth words but because of a tracheotomy the air does not move through her vocal cords to help her say words you can hear. She does her best and displays only occasionally a modest level of frustration. Considering all her challenges prior to this and now this event you would easily understand if she would give up and say I'm done. She still shows fight. The fight that is the Nicole I know. I am so grateful to her to bear the pain. Thursday last week when I was in Wichita she mouthed the words to Angi "I want to go home." Angi said that is not possible we could not possibly give her the intensive care that she needs right now. She replied mouthing the words again "You told we I could go home if I wanted" and she meant this time to her Heavenly home. Angi said yes I did and it would be OK but lets call dad. They called and between patients I stepped out to receive the call.
Angi rehearsed what was said. I asked that the phone be placed next to Nicole's ear.
My comments included she has had pain most her life and that if she wanted to go that would be allright but I wanted to tell her I loved her and kiss her and give her a hug good bye and just see her face to face before she went home. Angi said She was nodding her head. She wanted that too. I said Nicole I might be asking too much but could you wait till I could get there. She nodded yes. I wanted to leave and catch the next flight but I had a peace come over me to wait till Sunday when Angi was flying in from Salt Lake City to Kansas City where I was going to a Dr. John Brimhall seminar to see him speak following losing his wife to Cancer and having remarried. I was to stay with my brother and his family and they really needed us for a challenge they are passing through. We drove from KC to SLC with a detour through Wichita to pick up all my equipment to take to my clinic in Lehi, Utah, for the one week a month I practice there after a three week rotation in Wichita.
Angi and I couldn't wait to get back bedside with Nicole. When I saw her I was so glad to see so much of the swelling down and see the contours of her face. She acknowledged me immediately and opened her eyes when I called her by our special name-Nikki Nikki Timbo. I repeated the rest of the name too. She had a difficult time going in and out of a semi awareness. We stayed several hours Monday after scheduled patients. We had driven 16 hours and had 2 hours to prepare for patients and then went to see her. We have spent half days at the hospital
It is now Thursday. I am somewhat encouraged by her progress. She still is given a 50/50 shot.
We were permitted to watch Nicole have debridement(washed and scrubbed and loose skin removed along with scabs that had loosened) and her dressings changed.
I am so impressed with the compassion of those that attend to her. They talk to her and are gentle as possible with her. I wish that all medical attention received by anyone was of this nature.
The totality of her burns were rough to witness. The full impact of 60% of her body having been burned with 80% of it third degree and deeper was visually overwhelming if you focused on just that. Her flesh had the appearance of raw hamburger. She was totally at the mercy of their care. We had to gown up, place face masks, hairnets, and gloves on. She was lifted while in a hammock type bag fully lying down and placed on a table prepared with her new dressings. These new dressings were covered by plastic to allow the multiple water type hoses when used to drain from this slanted table into a drain while her several layers of dressings were cut off and removed. She was then thoroughly washed. The old dressings rolled up like a bed roll under her and she was rolled to allow it to be completely removed. The plastic layer beneath was than cut and she was rolled/rocked onto the fully prepared layers of new wrapping. A silver impregnated layer of aluminum type wrap was put on than tubing palced on that allows water to be pumped over it and the silver to leach out and protect the open wound from bacterial infection. Gaze was wrapped over that and than specially prepared gaze with an A & D type ointment was used to wrap each finger so as not to adhere to the skin. This was so that when these daily washings were performed and the bandaging removed skin would be minimally adhered to it and not tear it off her when removed. A thick layer of this gaze was applied and finally Ace bandaging was wrapped over her arms and legs. Today a gown was placed over that.
Vital organs are functioning. She did not need an artificial vent to assist her breathing today. This is good because artificial respiration leaves a patient open to lung infections. This is a good sign of progress.
One of the three attending MD's came in and assessed her. We spoke. Typically for each 1% of the body burned you stay 1 day in the hospital in intensive care. Its day 20 and she has 40 to go but with third degree burns over 60% of the body we were told it may be more and still she has wound rehab for 60 days. We were told don't be surprised if she is in intensive care so 90 days.
We moved Nicole's bed into our bedroom and rearranged things preparing for her to come home. Christian has been so helpful and he moved from the house he was in into the home to help too.
We read to Nicole all that had been written in her guest book to her by those who have visited her in the hospital. We were choked up many times as we read the precious words of love written to her. We were again deeply touched by the influence this daughter of ours and of Heavenly Fathers has had upon so many.
Tonight as we kissed her goodnight I felt an impression that God was happy with us.
It meant a lot.

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