Daley Ponderings

We began the day learning about Guy Fawkes Day (Jonathan says now if we ever visit England he wants to visit at the beginning of November so he can participate in the festivities.)  We ended the day by taking Daddy to the ER.  Jon's notes in italics.

It was quarter of five and I had gotten dinner ready a bit early.  I went downstairs to let "the men" know.  Jon was working on adding our new ultraviolet filter (to radiate the coliform bacteria) to the plumbing and Noah and Jonathan were doing projects.  Jonathan's project was making a new shelf for Daddy's tools.  He asked me to hold the shelf up while he hammered.  Then I heard a cry from Jon of severe pain.  He went running out of the well room holding his head.  He was unable to tell what had happened or even say where it hurt (though now he now says if I ever hear that kind of cry it is always eyes...)  I asked if I needed to call the doctor or go to the hospital and he said he didn't know.  He took his hand away for me to look at some point but I couldn't see any blood anywhere.  He was a bit faint, so he lay down on the floor.  I started praying and assuring the boys and Faith (and myself) that God would take care of Daddy.

After a few minutes, Jon was able to tell me what had happened.  He was tightening a screw joint in the pipes, one adjustable wrench in one hand, another wrench in the other hand.  He had nearly finished his complete turn and was pulling really hard when the wrench slipped off and all the force he was putting into it threw the back end of the wrench into his right eye.

I wrapped a bag of frozen corn in a wet towel, which Jon held to his face.  Pretty soon he said we should go to the hospital, so I started getting everyone ready as quickly as I could.  I threw some disposable diapers in the diaper bag, threw the dinner rolls into a plastic bag, and then called Alissa as I was putting on Faith's coat.   I called her to pray but as I was talking to her I realized that I had no idea what I was going to do with the kids in the emergency room. I thought of some friends who live near Cranberry (where the closest hospital is) and Alissa said to call her back if they couldn't take the kids.

We piled into the car and I gave the rolls to the boys for dinner.  I called the Costanzas to ask them to take the kids and after consulting with his wife, Kim called back to say he'd meet us at the ER with his van and we could do a car seat transfer.  The bumps in the road were making Jon nauseous.  Since it was 5pm, there was tons of commuting traffic and in addition to praying for Jon's eye, I was praying for my own peace at red lights and slow traffic.

We finally made it to the hospital and I swung around to the ER entrance where Jon walked in.  I think that was around 5:30.  I parked and Kim was right behind me.  Faith was asleep, so I left her in the car seat and carried it with her to his van.  She woke up a bit with the cold breeze and was upset, but I had to just kiss her and reassure her and leave.  Then I walked in and the triage lady brought me right back.  She said Jon had laid down on the floor and said, "My wife will be here in a minute."  So I gave all the check-in info as they took his vitals. They asked him a bunch of questions including if he had gotten a flu shot this season, when his last tetanus shot was, and if he was feeling suicidal.

I stepped out to call Mom so she could pray and pass the word while they took Jon back and then I joined him.  They began the usual routine about asking what happened, taking vitals, examining the eye.  It really hurt him to have them poking and pulling.  They asked him to move his eye and he could do fine up and to the left, but right was hard and down didn't work at all at first.  That really scared them and they ran off to call the ophthalmologists at a hospital in Pittsburgh.

While we were waiting we got to hear snippets of conversations about the other ER cases.  One older man had slipped down a hill while working on his property.  A younger man injured his thumb at work.  They asked him about the flu shot - no, he hadn't gotten one.  Then he volunteered, "My last tetanus shot was about thirty...[here I'm thinking boy he sounds young to remember his last shot if it was thirty years ago]...four seconds ago."  Jon laughed out loud at that one.

We had the lights off in the room because his eyes were sensitive.  They had given him a new ice pack but it had so much insulation that it wasn't very cold for a while and he said our corn bag was better.  They asked if he wanted anything for the pain and he said maybe a little.  So then the nurse came in to start an IV and Jon said, wait I didn't mean that much, just an Advil or something.  The nurse looked at him like he was from Mars and said, "So you're refusing all medication?"  Well, IV medication, yes.  He didn't think it was that bad to have pain meds so strong that you also have to have anti-nausea meds, too.  She still thought he was weird.  It turns out Advil is bad to take if you're bleeding, but Jon meant some kind of pill - Tylenol is the same in his book.

They came back in and said that he needed to be transferred to UPMC Presbyterian in Pittsburgh and he said he wondered if we should have just gone down there first.  But it was too late then.  They said he'd be going by ambulance and I asked if I could just drive him down but they said with eyes, time is of the essence.  So then we wait and wait.  One thing they did do while waiting for the ambulance (there were lots of accidents and all the ambulances were busy) was do a CAT scan.  I'm not sure they looked at it there but just stuck it on a disk (they talked about burning a cd, and I thought it was funny to hear those terms in a hospital) to take down to Presby.

The doctor came back in during his scan to tell me what was going on.  She said she always feels bad for running out, but she was in a hurry.  She was very concerned about entrapment, which is when the eye cannot move.  It is usually a very bad thing, meaning muscle damage, or nerve damage, or lots of bleeding and pressure behind the eye.  That is why he needed to transfer, to see the eye specialists. In preparation for transfer, they did put an IV line in just in case he would need something quickly later on. She also said there was the possibility of a fracture of the bone around the eye, which is called the orbital.

We debated about whether I should drive behind the ambulance or ride with Jon.  I'm not so good driving in the dark, and I wanted to be with him, but we decided to have me drive so that we could have a car down there.  It was a good decision.

Finally the ambulance came (at about 7:00), and I went out to the car.  I had given Jon his phone back and turned mine on.  There was a message from Jon's mom and I tried to call her back and drive out of the parking lot at the same time.  I ran over a curb while doing that and then finished my message as fast as I could.  Then I prayed, "Lord have mercy on my driving."  I sure needed it.  He answered that prayer, through dark and rain and mist.

A few minutes down the highway, Jon called me.  His ambulance had broken down and was waiting on the side of the highway for another one to come.  "Time is of the essence, so you must take an ambulance."  Uh-huh.  So in a couple of minutes, I saw the flashing lights and pulled over behind them.  I said why can't I drive him the rest of the way and one guy thought it was a good idea and the other guy said it was out of the question.  "Patient abandonment"  But wait, it was the patient abandoning him.  Surely Jon had the right to leave if he wanted to.  But he was adamant.  The one who was on my side suggested that the driver call the doctor to see if she would okay Heather driving me.  The driver insisted that the doctor wouldn't okay it, so they shouldn't call her. So we waited.  I called Alissa to pass on the news.  I also quoted Psalm 23 to myself.  I repeated the "I will fear no evil" part louder and felt much better after that.

Finally the new ambulance came and Jon walked from one to the other.  They pulled off and I did too.  They did not use their lights or go faster than normal traffic speed.  I could see them all the way to the Camp Horne exit (we had started from just before 279 splits off 79.)  Jon said the doctors had not told them to go faster than normal.  And were surprised when I said that the hospital said Heather couldn't bring due to time constraints, and she verified that yes, the patient can always leave if he wants to.  Both of the EMTs who watched over me in the back of the ambulance were nice, and tried to accomodate me as much as possible.  The first guy said that it was the first time he had ever ridden in the ambulance with the lights off, and then it was the first time that he had an ambulance break down.  The second woman said that she had fractured her orbital and it usually isn't a big deal.  What about the essence of time?  The whole system frustrates me.  On the one hand, I'm thankful for specialists who have studied these things and know what to look for and what to do.  On the other hand, the system is full of unnecessaries, overkills, bureacracies and other problems, yet most of our society thinks it is god.

Just as I got to Oakland there was a great flash of lightning, followed closely by its thunder and some rain.  I found the entrance to Presby ER but realized I couldn't really do anthing there.  I saw Jon's ambulance parked there but it was empty.  I pulled ahead and followed signs to a parking garage.  Then I ran down through the rain back to the ER.  Just as I arrived, I saw Jon through the window in Triage, and my cell phone rang.  It was Jon's mom, who was happy to hear that we were at the new hospital and who thought it had not taken very long to get a new ambulance.  It was 8:00.  However, I could not talk long to her because the security man wanted to talk to me.  It turns out I came in the wrong way and had to go around to go through the metal detector.  I got a visitor sticker as payment for not making the thing beep.

By the time I got to triage, they had taken Jon to a room, but they showed me the way.  He was in an eye exam room, in a chair that was not really so comfortable for resting.  They had given him a new kind of ice pack and this kind got warm quickly.  We went through about 15 of the packs throughout the course of the night.

More of the same questions and poking and then the doctor (resident) came in with a student as well.  She asked Jon if he'd move over one room since "things work better there" and did a vision test on him.  It was slightly worse than the one he had done in Cranberry, but still didn't seem to concern her.  She did a color blindness test as well and explaned to the student that color is one of the first things to go.  Jon passed it just fine.

Then came the shine lights in your eyes part.  Jon doesn't like eye drops or lights, anything bothering his eyes, even when he is well, so this was torture for him.  Halfway through the exam he said he was starting to feel nauseous.  He thought he could handle it if the exam was almost over, but not if it was going to be much longer.  The doctor sent the student to get his nurse to bring medicine. She asked me when was the last time he ate.  Feeling like a bad wife (don't you feed him?), I said, "Breakfast, 9:00"  But we were just about to eat dinner when we had to rush to the hospital! And I often skip lunch due to not being hungry, or doing other things.

Jon felt faint, heard ringing in his ears, and felt like throwing up.  They brought the trash can in front of him.  Then the doctor left the room also.  He started sweating and shaking and then he slumped forward.  I held him up and looked around quickly.  I saw the nurse call button across the room and knew I couldn't reach it without letting him go.  So I called out, "People, please come back!"  They heard me and rushed back in.  Finally a guy with medicine came and put anti-nausea meds in Jon's IV.   Jon was semi-responsive by then, but doesn't remember it.  The nurse put two syringes of stuff in the line and after each one, Jon said, "I'm going to throw up" but did not move.  The nurse kept asking him if he wanted to move to a bed, but Jon did not answer.  I never heard any of these questions.  I said, yes a bed would be good.  So he came back with a wheelchair which Jon wobbily got into and they wheeled him over to a regular ER room.

That room was brighter and noisier.  Jon was flat on a bed and feeling physically better, but more disturbed by things around him.  In the next room was a woman who had OD'ed and she was making horrible moaning groaning sounds.  Jon said out loud what I was thinking, "And why do people think it's a good thing to take drugs?"

The doctor wanted to do a pressure test as soon as she could because she was still concerned that the eye itself might be torn.  She had this electronic marker type thing that bounced itself on Jon's eyes.  Jon tried to ask "what are you doing to me?!?" (And how long will it take, but she wasn't interested in explaining what she was doing)  But that came back with good results, the pressure was fine.  When she came back she said this would be the worst test.  But Jon discovered that if he held his eyelid open himself, it didn't hurt so much.  I think that is what made this one tolerable.  She looked all around inside his eye and finally pronounced his globe healthy with no tears.  That was such a relief.

There was a whole lot of waiting in this room. The doctor would come in and do or say something, then go out for a long time.  I'd go ask for another ice pack.  Eventually, I just got three unbroken ones to have when Jon needed them.  (They were chemically activated where you break an inner pouch and shake to freeze the mixture.)  Eventually the OD lady was taken somewhere else.  There was a potential swine flu lady on the other side.  Jon was getting annoyed with all the apparatus - the oxygen/pulse reader on his finger, the blood pressure cuff, especially the IV.  At one point I noticed that the sink was dripping at the same rate as Jon's pulse.

The doctor came in finally to tell us her conclusion, which was that there was nothing wrong that would not be healed with time and rest.  The things that were wrong were: fractured orbital (under the eye), hematoma (blood collection) also under the eye, and some bleeding behind the eye.  No entrapment, no damage to the globe (the eye itself.) She was waiting, however, for the approval of her senior resident, who was going to review the CAT scan images from home.  The Cranberry technicians had thought there was a muscle tear, but Jon's doctor had not seen any physical evidence of this in her examinations of Jon.  So she left again.  Finally she came back with her senior's approval and said that Jon could go home!  She gave him some drops to help with the sensitivity to light because she did not want him to patch the eye, but to use it.

It always takes a long time to get discharged even once they've given the word.  After quite a while, Jon sent me out to ask what we were waiting for.   It turns out they were waiting for Jon to be feeling better in terms of the nausea.  Even once I told them he was ready, it still took a while.  A nurse came in to give us his prescriptions for pain and anti-nausea meds and to take out the IV.  I grabbed one more ice pack and we got to check out!  A nice bonus was that they stamped my parking ticket with a fee waiver so it was free. It was 11:00.

I led Jon by the arm up to the garage, and then circled around Oakland for a while trying to find the 24-hour pharmacy.  Jon stayed in the car to rest while I went in to fill the prescriptions.  While I waited, I found some raisins, granola bars, water and ice.  Jon still had not eaten anything since breakfast. Quarter to midnight, we headed back up north.  It was very dark and there was misty fog in places.  It's a good thing I know what the turn to the Costanza's road looks like because I would have missed it if I was dependent on street signs.  12:30 we arrived at the Costanzas.  Everyone was sprawled over floor and couches like a sleepover party.  Faith was in Amy's arms.  Kim helped me get stuff, car seats and kids into the car.  Faith woke when Amy stood up, but she got to come right into my arms.  She had done a great job considering it was the longest she's ever been away from me. The boys had had a blast playing with the Costanza kids and watching Disney's Jungle Book.

We thanked them over and over again and then headed home (Amy said, "Don't mention it, just get better... and call a plumber).  We arrived about 1:00am and Jon went up to bed while I carried the kids up one by one to put them to bed.  Faith was very hungry and nursed a very long time.  But I stayed awake from adrenaline and stress.  I could feel my body tense and I did not get to sleep until around 2:30am.  Jon did well in the night. (I don't think I've dreamed at all since before the accident; and I've slept pretty soundly for the most part - I was awake at 5 this morning, but that has been typical for the last couple months)  I got him ice and food and more pain medicine in the morning.

I am thankful to God for answering the prayers for Jon's eye, for Faith's acceptance of being away from Mommy, for my safe driving under stressful and dark and rainy situations.  I am thankful to all of you who prayed for us and helped us.  I am thankful for my family, for this remembrance of life's fragility, to remind me to think on eternity and not get bothered by little stuff.  I am thankful to have been able to be with Jon to help him in his pain.  (If you ever have to go to the ER, try to make sure someone can come with you.)

Please continue to pray for the healing of his bone and the absorption of the blood.  His eye looks really gross from the blood, though the doctor said that's the least worrisome part, medically.

This post has now taken three days to write.  Jon's taking the pain medication less frequently now.  (I did take some again today after being up and my eye open during church and afterwards - I had stopped taking it on Saturday, and had been feeling great) He wears sunglasses most of the time, but can keep his eye open with them on. He does use ice still quite a bit.  He's doing a pretty good job of taking it easy.  He rests several times a day (which is hard for him - he likes to be getting things done!) My vision has gone up and down from time to time, generally worse at night, ranging from 20/25 (in Cranberry,which is normal for my right eye) to 20/50 on Friday night, when I called the ophthalmologist since they had said to call if my vision got worse.  I think mostly everyone considers 20/40, etc. to be excellent vision anyway, so they don't really think about where my eye sight usually is - the triage nurse thought he had heard wrong when the nurse reported 20/13 in my left eye.  I printed out an eye chart, and I (and the kids) check my vision from time to time.  I read somewhere that 20/10 is the theoretical best vision for humans, which surprised me, since I wouldn't have thought my vision was that good, and I know it has gotten worse as I've gotten older.  I hadn't seen my eye at all until Friday morning, and when I saw it, the lower side of the white was completely dark red and poking out, probably 1/16" of an inch.  I called to ask Heather (who was out getting a prescription for a steroid that the attending physician recommended after seeing the CAT scan images on Friday morning - all previous diagnoses had been made by the residents) if that was what it had been looking like, and she said, "yes", so I didn't worry about it, though just now she said that she hadn't noticed that it was poking out, so I wonder if it was worse on Friday morning.  It has since flattened out almost to normal shape, but the white is almost completely red. I haven't taken most of the prescriptions, that I haven't had any nausea and I am not convinced the dialating drops are any good, as my eyes were the worst just after taking the drops and waiting in the CVS parking lot on Thursday night, and probably the sunglasses do at least part of the job of dialating my eyes anyway, and they are much more comfortable than eye drops (Mom says, "oh good, as long as you can rationalize it...)

Another interesting thing is that I reported a "8 or 9" on the pain scale to the Cranberry ER nurses, and "2 or 3" to the UPMC ophthalmologist, and both Mom and Erica had the same reaction - "Jon's '2 or 3' is probably way higher than other people's and even if he was hurt, he wouldn't tell anyone anyway", which I think I was being honest about it, but I guess I can't compare other people's pain to mine.  I have been debating about whether the initial pain was worse than the headache from the meningitis, and I think that it was worse in the short term, but the meningitis was a continual pain, so worse overall.

Notes for next time we need to go to the emergency room - don't bother saving the 10 minutes by driving to Cranberry, just drive straight to Pittsburgh.