Wednesday, September 9, 2009

Oh Good, an Ophthalmology Exam

It's all in one's frame of reference, and RantWoman must say from the outset she herself has an unusual one.

RantWoman is also aware there is some kind of email information exchange. RantWoman has not yet connected with the precise coordinates so she apologizes if this duplicates content available elsewhere.

RantWoman went to see Jana today (Tuesday), don't let the time stamp on the blog entry fool anyone). For someone lying in intensive care 5 days after trying to stop a speeding car with only human flesh, a LOT of things look and sound darn good. RantWoman cautions readers though that these are the comments of a layperson. As the ophthalmology resident indicated there is still a pretty good problem list, so best not get too carried away.

Jana has been free of ventilator and breathing on her own since Monday afternoon. Today she had a LOT of visitors, so many that when RantWoman arrived sometime a little after 5, there were already 4 people there including Warren. Some visitors took the opportunity to say Goodbye and Warren also went for a cup of coffee.

Jana's ICU nurse was worried about overstimulation. Warren reported that Jana had spoken and said clearly that she really appreciated the conversation, even though she did not talk a lot and spoke with a little difficulty. Jana also was able to say "Hi sweetie" when a phone was held to her ear with a call from her daughter. Warren also said at one point, she said "okay, we can go now!" though Warren was not sure where she meant to go except probably out of the hospital. RantWoman sort of imagines that Jana's daytime work at a busy pharmacy involves a lot of people around so that all the voices probably in some way sound perfectly normal to her.

Jana's friends commented about her licking her lips frequently. Someone applies lip balm and also moistens her mouth sometimes with a hospital sponge on a small stick.

RantWoman gathered from bedside conversation that today was when the bolt, the instrument that has been monitoring pressure on her brain was removed. RantWoman is not quite sure what the connection is between removing the bolt and being able to do an ophthalmology exam including dilation, but that was one of today's tasks. The Ophtho resident came shortly after RantWoman arrived and did his initial check. Jana has broken facial bones under her left eye that eventually will have surgery but other problems are ahead of that in line.

Right now Jana can clearly control her right eye--and arm and foot. The left eye does not close completely. There is a stitch near her eye and a little bulge of conjunctival tissue that keeps the left one from closing completely, so someone has been applying some kind of ointment that might look blurry if Jana commented. The resident said they are monitoring her eyes so her corneas do not dry out with the one eye that won't quite, quite close. The Ophtho resident was definitely into eyes in the kind of enthusiastic way that suggests he is in the right line of work.

Then the ophtho resident put in the dilating drops and RantWoman, ophtho frequent flyer that she is suggested turning down the room lights so Jana's eyes could dilate more comfortably. One of Jana's nurse friends asked where to find the light switch and this was easily accomplished. While we were talking, Warren mentioned that the day's earlier exam had shown that both eyes are in good, pretty normal position and tracking the way they are supposed to. (RantWoman did not ask specifically whether the eyes were tracking together but she thinks, precise as the doctor was that he would have said something if not. RantWoman's own eyes do not track together by default; RantWoman supposes that not having eyes track together if they usually do could mean something different than if, post accident, eyes that don't track together still do not track together or track differently than before an accident, but she definitely is not doing experiments about the topic today.)

After time for Jana's eyes to dilate, the resident came back, plugged his special eye exam head gear into one of the cords hanging from ceiling tracks over the bed, and did the usual bright lights and magnifying glass exam. He asked Warren what kind of brain bleed Jana had and Warren said actually he did not know; the resident said he would look it up on the chart. At one point in the eye exam, Jana needed to cough, a kind of deep cough to remind us that all is definitely not perfect.

The important points: there is no blood in back of the retinas and the optic nerves look good and pink, not pale. The doctor said sudden changes in blood pressure can damage the optic nerves; RantWoman was in braille class with someone that happened to and is very glad for what sound like comparatively positive reports today.

After the eye exam, a nurse came in to turn Jana, clean her a bit. The nurse shooed Warren, another friend and RantWoman out to the waiting room for a bit. The other friend left; when Warrren and RantWoman came back, Jana was in a slightly different position. The nurse had found a pillow because the other friend had been holding Jana's hand and noticed that Jana kept trying to hold her arm up a little and having it drop. When we came back, RantWoman noted that Jana's broken leg is in a cast that stops below the knee. The nurse said surgery on the leg will happen Wednesday or Friday she is not sure which. Warren soon said good night and departed to go to a Healing Worship with his son and other Young Friends. RantWoman stayed for another half hour or so. Jana seemed glad to rest.

The hospital brought in an email from a friend of Jana's. RantWoman dug out a magnifier and read it to Jana but could not tell what the reaction was. RantWoman stuck the printed email slip in the notebook full of good wishes and also wrote the friends name and phone number in the guestbook in case the slip gets lost.

Before leaving, Warren kindly fretted about people crossing streets; RantWoman assured him again that her bus leaves from right across the street and pointed out her extensive list of visibility-enhancing measures including reflective armbands, reflector tape on several bags, and her cute little bright orange light on one of the cords around her neck. RantWoman did not mention that she had a couple more errands between the hospital and home, but she definitely thought of him when someone on the bus was lecturing her about how she should be home before dark.

Before leaving the hospital RantWoman asked the nurse whether Jana had a call button. RantWoman thinks she could press it if it were there, but the nurse thinks maybe not. RantWoman also notes bedside conversation with a friend who is a hospice nurse about teaching people to operate the machine that dispenses IV painkillers. The machine, like a welder's propane tank mentioned by the other friend present, has features that make it not exactly super easy to use or to use incorrectly. RantWoman was thinking about this and also thinking that personally, being sometimes into musical or other distractions from pain, RantWoman might wish for the kind of button that starts up a CD or delivers music, not just a painkiller.

Jana's daughter comes Wednesday and RantWoman probably will go back in a couple days and meanwhile try to intersect with other info flows.

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