12/21 - evening

I didn't want to go to bed without sharing what news we have, although there is not much new to tell you all.  The plan to take away the pentobarbital is underway.  They took the first half away already.  Tomorrow at 8am, they will take away another half, and at 8pm tomorrow, they will stop administering it altogether.  This is both good and scary.  We have no idea of what we will see.  We do know that it takes a good amount of time for it to get out of your system.  We were even told that it can "stick" to your tissues.  However, younger patients with higher metabolisms can get rid of it more quickly.  We think we have at least a few days before Sam comes out of the medically induced coma. 

In the meantime, it is important that his ICP stabilizes and stays below 20.   After he comes off of all of the pentobarb, they will be removing the bolt--the device that monitors his pressure.  All we know is that at some point after the pentobarb is done, they will be taking that out.  There are several reasons they're removing it, but the bottom line is, the pressure is going to do what the pressure is going to do.  They will be monitoring Sam via EEG and BIS monitors.  The EEG monitors brain activity, and the BIS monitors levels of anesthesia in his system.  

Here is the good news:

1.  I felt really good after talking to the trauma doctor today.  The picture is not all positive, but he said according to Saturday's brain scan there is oxygenated blood going there.  He also said the swelling has stopped increasing.  Jenni had told me earlier there were no new bleeds, and she was anticipating more damage than she saw in the scan.

2.  Brain science is less than exact.  We have always claimed that Sam's brain works like no one else's.  The doctor said part of the reason we were not going to be monitoring the ICP via monitor is because we might be just chasing a number.  We are hoping that as Sam comes off the pentobarb, that he is able to stabilize himself, and that there's no excessive pressure that causes new brain damage or worse. 

3.  I almost hesitate to write this one because I am not an optimist.  Never been, probably never will be.  I hate getting my hopes up--or anyone else's for that matter.  Most of the afternoon however, I was incredibly hopeful for the first time in a long time.  And, as a normally non-optimistic person, (I prefer realist, thank you) I want to cling to that hope desperately.  I also don't want to set myself up for the biggest fall I will ever have experienced.  It's so hard to find that balance when you're this exhausted!

Challenging things:

1.  If Sam's pressure goes up too high, it could cause everything from more brain damage to complete shut down.  We will not know the result until after he comes out of the coma.  Without the ICP monitor, we feel like we're flying blind.  We have been obsessively watching that thing for 9 days.  That's incredibly scary.  I'm sure they'll tell us what we're looking for on the EEG, but it's not quite the same.  

2.  As I mentioned in an earlier post, from this point on, it's up to Sam & God to sort this out.  There are no more medical interventions to prevent brain pressure or reduce swelling.  We are excited to potentially see our boy awake again, but there are so many variables that could go awry.  For the last 9 days, the unknown has ruled our lives. This is the biggest unknown yet, and it makes us incredibly uneasy.

To close, we are again coming to you for prayer support.  Our biggest concerns are:

• that Sam's pressure and swelling come down
• that all of the medical staff continue to bring their A game
• that everything goes well when they remove the bolt
• that Sam is finally able to regain consciousness
• for all of us to be hopeful and to have peace each step of the way
• and continued prayers for Lily and for Jay's family, and for the 16 year old boy they brought to the floor this evening.  (I do not have specifics, but 2 young kids at once on the floor is exhausting for everyone.)

My boys