Dad was moved from ICU to the NCCU, or Neuro Critical Care Unit. He would have normally gone here from the get-go, but he would have been the only patient in NCCU at the time (praise God!) So they had closed the NCCU and shifted Dad and the NCCU staff down to ICU to help there, which was also slow (another praise.) But there were two neuro surgery patients coming into the NCCU later in the week, and the ICU was getting busy, so they moved Dad from the 4th floor to the 7th floor. I was personally very pleased. St. Mary's has a 5-bed NCCU, with highly-trained staff and a recognized center of excellence for neurological care. It as also much more bright and just had a more pleasant feel to it (as much as any hospital can). We found out that it used to be the pediatrics ward, so that explained the colorful hearts on the wallpaper borders and all the bright colors. Dad has a large set of windows, which is also more uplifting.
The CT scan early that day showed that the swelling was increasing. I'm speaking from memory and a lack of medical knowledge, but I believe I recall that we went from a 3mm offset shift to a 7mm offset shift (where no shift at all is preferred). The blood clot and swelling were pushing farther into the brain, closing off some of the open areas on the interior of the brain and creating a dangerous situation.
Dad was also not quite as responsive as he had been. He was mumbling more, and seemed groggier than ever. Dr. Semenoff stopped by to tell us that after consulting with the radiologist, they recommended that we go ahead with surgery to remove the blood clot, which would release the pressure and give the brain some room. The surgery itself carried some risk with it, but it was overshadowed by the risk of continuing to "wait and see" and risking additional swelling which could cause much more of an urgent and critical situation in getting him into an operating room. We agreed that the proactive stance was best. It was nearing lunchtime, so Dr. Semenoff said he was going to grab a quick bite to eat while Dad was being prepped for surgery. If all went well, he'd be back in his room around 3 p.m. Amazing.
And sure enough, Dr. Semenoff dropped by to see us in the surgery waiting room to tell us that Dad came through the surgery fine and would be heading back to his room. He was going to keep him on the respirator and sedated for at least the evening to keep his blood pressure in check, to avoid him becoming agitated, and give him a chance to heal. If the swelling started to subside, we could look at getting him off the respirator. That was great news.
We were totally amazed at his surgical area. They basically shaved off only a portion of his hair toward his left ear, and where I expected to see a mass of bandages, there was just about a 4-inch long strip of what looked like packing tape layered over the site. That's all??? Wow ... medicine has certainly come a long way. The had performed what's called a craniotomy ... creating a bone flap from the skull to remove the blood clot. Thank God for blessing some folks with the gift of surgery skills!
The remainder of Sunday was pretty uneventful. Dad was sedated fairly well. Veda (Chip's wife) came by to visit and ensure that I was taking a break to eat lunch. As we were leaving Sunday evening, Dad had a "coughing fit" which isn't really coughing with a ventilator tube in your throat. But that's what Dad was trying to do. It looked horrible ... as if he was choking. The nurse came in very quickly, as the respirator stopped (since Dad's body was basically fighting it's mechanism while trying to cough). She was very calm and worked with the respirator, and attempted to calm Dad down. She upped his sedative to help bring him back down some, and suctioned out his mouth a little. It was very frightening to see, but she assured us that it was a normal thing. In my mind, it had to be a good sign that Dad's body was trying to do what it would normally do if encountering a foreign object in the airways.
Once he was settled back down, we left him in the care of the NCCU staff for the night. Skeeter, Bucky and Betsy came over to Mom and Dad's house with chicken, mac & cheese, and some of the best green beans I've ever had. Despite everything, we enjoyed some time with our family around the dinner table and kept our spirits up with funny stories.
