Day 34 - Modifications: Phase II

It is now almost five weeks of 12 down. The next appointment is at seven weeks, three days. We should be looking at the CT scan at the visit after that and, hopefully, the halo coming off. With any luck, she'll be out of it by Feb 26. Keep your fingers crossed.

After trying to find something that will fit over the halo-vest to look a little more dressy, I decided it was time to be a little more aggressive with the removal of nonfunctional fluff.

Here's the lamb's wool I removed from the vest. This is about the amount of fur I get off my dog when I shear her for the summer.



It really took a lot off her shoulders. She doesn't look so much like a linebacker. We haven't tried the clothes on yet but they can't fit any worse than they did before the modifications.

Here's the old picture for comparison with the modifications completed. She's not in a picture-taking mood so the look says it all. I'm not sure but I think the front bar (her left) on the right side of the picture has slipped down! So much for stabilization. A halo is only 75% effective and a hard collar is about 50% effective. I'm going to take another one in the same place, in the same position to make sure the bars are not shifting.

Jan's niece came down from Frankfort for the weekend and some good friends came to visit with pizza! She is pretty worn out tonight and went to bed pretty quickly at 10:00 PM.

Day 33 - Two Days In A Row

Two days in a row we encountered other people that have had a brush with halos. Thursday, while shopping at Kroger, a woman kept staring at Jan on the way in.

She finally approached her and said, "I'm sorry to stare and I don't mean to bother you but my mother-in-law is in a halo and I wanted to ask if you found a good way to dress?"

We told her about the v-neck shirts and the slit down the back. She was grateful and we all lamented the lack of a support group for halo users and caregivers. No person could possibly wear a halo without a support person.

On Friday, we were in Kohl's with a mission to find something Jan could wear to Tessa's WKU Presidential Luncheon. A man we've traded vehicles with since 1997 was in the store. We spoke to him and he said he knew what she was going through. Sure enough, 12 years later, I finally noticed his pin scars.

At least we are seeing that others do survive this, despite the medical profession's best efforts to make it nearly impossible to remain sane and healthy.

We finally, after two days of trying, got an appointment back at Bilkmore for Jan 29th. We still have to do x-rays at Bilkmore but they assure us that it will not take long. The appointment is at noon and they say we only need to be there 30 minutes early to get the x-rays. If this goes poorly and turns into another seven-hour day I'm going to demand they allow us to get the images in Bowling Green because seven hours out of the house in a halo is sheer torture!

Despite the myth of the halo's immobilization, it does not prevent movement of the cervical (neck) vertebrae. Jan's neck pops all the time. Getting into the car on Friday caused something to cause her great pain. She says it feels like her neck shifted and is pinched. I'd call the nurse but it will take them the weekend plus two days to just tell her to take more pain medications. The vest is also causing pain in her lower back around the lower lumbar area.

The pins are looking better after Jan called back and we finally got them to look at the picture I uploaded. They said it was normal. I would know how? It wasn't like they gave us any instruction or guidance. Oddly enough, the rear pins that I was afraid would become infected because of the unshaven patches and the ground in hair look like the day they were put in.

The front pins looked the same from day one to day 22, one day after tightening, when they broke through the skin and opened up a slit in her forehead. They've both broken through now and when they finally called us back, wait for it, two days later, they said use a triple antibiotic like Neosporin. After cleaning them three times a day, alternating between hydrogen peroxide and Neosporin, they look as good as can be expected of a recent, to-the-bone gash. The scalp cuts she had were not this deep, just longer.

I swear these people have done her, and to a lesser degree me, a great disservice. They have done absolutely the bare minimum, maybe less, to get her through this and not a thing more. When it takes six days to get a nurse to call you back, that's beyond ludicrous. Maybe I should be grateful that we normally have a 48-hour turnaround on calls? Are my expectations too high?

I'm going to have tattooed on my chest the following:

If I'm not dying, I want a second opinion!
DO NOT TAKE ME TO BILKMORE No residents allowed to touch me!

That was not a joke! Maybe I'll have a custom medic alert bracelet made instead. I hate needles. Perhaps we will soon have an implantable RFID chip available that is tied to our medical records, a living will and specific orders. Should I start such a service and retire on the proceeds?

Day 31 - Seventh Day on Antibiotics

For a refresher, here's the pin site as I found it last Wednesday.



This is the same site one week later. I'm not sure I see any improvement. Just as much redness and more scabbing.

Day 30 - Popular (Second) Opinion

Jan is in bed (the recliner) so I can finally get the results posted. We saw the doctor in Hermitage this afternoon for a second opinion. He was very nice and made a lot of sense. He actually talked to us in an intelligent way and didn't treat us as if we were stupid. He says the break is bad but is better than it could be.

This image identifies the different types of C2 odontoid fractures. Type I generally is only treated with a collar. Type II, where the whole tip is broken, fail to heal in 50% of cases.

Jan's break is a type III. A type III fracture is when the pin and the front of the vertebrae is broken off as a single piece. It is through the body of the vertebrae, which usually heal quite well. Her's is all the way down to the bottom. He says there is less than a 25% chance she'll need surgery. Much better than a type II.

The x-ray is a frame from Jan's ER CT scan. It is a slice viewed from the front. It goes farther through the body than the typical type III in the illustration. The doctor thinks that should lead to good union (healing) of the two parts.

Jan really liked him and wished we'd have gone to his hospital to begin with. I think it has something to do with him saying young people heal well.

He was shocked they didn't shave the rear pin sites, as indicated in the instructions for the vest. It keeps the chances of infection way down. He also didn't like the particular model of vest as they are more cumbersome than the ones he uses. Imagine that, $6,300 for the Yugo of halo-vests! You can buy a good used Honda for that kind of money.

In addition, he was surprised they didn't keep her 24 hours because you are supposed to check the screws in 24 hours. He said he would have kept her for a day for observation and then she and I would have been instructed on how to care for the pins. I guess that is the problem with teaching hospitals. If there is anything requiring surgery, she won't be having that at Bilkmore!

In the end, he says they did the proper things to protect her neck but they could have been a lot better about her treatment in general. He would have done much the same thing. He also said that it might have been treatable with just a collar but he would not have done it.

We probably could have gotten him to take the case as they asked us at check-in if we wanted that. The problem was his office hours are one day a week in Bowling Green and the next slot was in March! We could have continued to drive to Nashville to see him but he recommended we stay with Bilkmore. Jan was fine with that and I suppose I am, too. At least we have some valuable information and Bilkmore is the only place responsible should there be issues.

Now we come to Jan's next appointment at Bilkmore on Jan 23rd. The NP has ordered a CT scan to "make us feel better" about the treatment. The second opinion doctor says that the only reason to order a test is if you are going to do something or change treatment. He says there is no way they are going to take her out of the halo at six weeks so why do it. I agreed and Jan is considering canceling the appointment in favor of me going to the luncheon on the 23rd with my father and Tessa. She wants to push it to the next week with just an x-ray.

Instead, we are going to see if we can just get x-rays in Bowling Green to avoid the hassle at Bilkmore with the shuttle and the extended duration between imaging and NP appointment. For a 10:00 AM imaging appointment, we need to leave by 8:45 AM. The visit with the NP is at 12:30 PM and you just know she'll be running late. At the last appointment she was 30 minutes late and the visit lasted an hour and a half. Even if we make this one shorter, it will still be at least 2:00 PM before we are done and another hour to get home makes it an all day affair.

Day 30 - Counseling and Second Opinion

Day 30, 54 to go!

Yesterday we went to see someone for counseling. I think we both have a lot of trauma related issues, me so more than Jan. We went to Sam's before my chiro appointment to get out and pick up a few things. It tires her out but she needs the exercise and to build some stamina. Another person came up to her in Sam's and said she went through a halo treatment, knew what she was going through and it gets better. The poor woman looked like she was near tears as if it brought back bad memories. It kind of tore Jan up, too!

The counselor said we are experiencing all the normal thoughts and emotional symptoms after such an experience. He recommended we see someone else that deals more with this sort of thing since he was more of a marriage counselor. We may need marriage counseling eventually but not at the moment. One of the people he recommended is a WKU person so Jan is going to contact them.

We've gotten all of our records and images together for the doctor to examine her and give a second opinion. I'm hopeful but not overly so. Realistic expectations need to be the norm.

A friend from Jan's church brought over the evening meal on Monday. It was wonderful barbeque meatballs, fixings and even an apple pie with ice cream. It is so comforting to know that everyone is praying and thinking about Jan when she really needs it. The next door neighbor is bringing supper on Wednesday. Who knows, I might actually gain back the 15lbs I lost in the first three weeks! I haven't weighed under 155 since my first year of college in 1980! All my belts are in the last hole and still loose!

I think after a full month we are starting to settle into a routine. I expect to not update but every couple of days from now on. I'll make exceptions for news that is out of the ordinary, such as the second opinion later today. You can still email Jan directly. She usually does an hour or so a day in front of the computer. It breaks up the day and gives her a reason to get off the couch.

Now, if we could just get that antibiotic finished and keep the pins clean, we'll have smooth sailing for the next seven weeks, five days.

Day 28 - Four Weeks Today

Despite it being a grim four week anniversary of the accident, things should be looking up. We are one third of the way through.

Yesterday was good in that Jan had her night guard modified by Charlotte and my mother fixed supper for us while we were in town.

Charlotte was absolutely great about staying late and working us all in. I thank her greatly for taking the extra time to get Jan squared away with her guard and being careful with the halo. She even found a couple of small bean bag hot/cold packs we could fit in Jan's collar area to relieve her tight neck muscles.

Mom made a great pot roast and fixings, including a peach cobbler! I think everyone left pretty stuffed. She also fixed the hem on some of Jan's new slip-on pants that were too long. When in a halo, slip-on clothing is a must.

We are still finding it tough to get in all four of the antibiotic pills. She wants to take a Nexium in the morning but if she has to wait to wake up, it is late in the day before the first dose of antibiotic. If I wake her to get the Nexium down so she'll take the antibiotic in half an hour, I'm the bad guy for waking her.

On the way home yesterday, we drove by the Kentucky Building and Jan showed Tessa where her and her grandfather need to go for the luncheon on the 23rd. That is CT scan day at Bilkmore. With any luck it will show some healing and give us an indication of what to expect.

If I sit quietly for too long I am still reliving the crash in minute detail, desperately thinking about what I might have done differently. It all seemed to go in slow motion as I heard the faintest of pops when the tempered glass blew out of the door, the crinkle of the windshield and then the rear window as it disappeared into a million pieces. People say these things happen so fast but the detail and clarity with which I remember it is all too real. As an intelligent person, I know I should let it go. Easier said than done, especially after only four weeks.