Sunday afternoon--96 hours

Today has been a rough day. Peak brain swelling was expected to occur at 72-96 hours after the injury. We have finally meet that hurdle and hope to see things start improving. The last post mentioned that her CT scan this morning was somewhat reassuring--the ventricles were actually bigger (they should be compressed if the brain was swelling ). At 7:15am, Shannon was taken off the pentabarbital (coma drug) and the vecuronium (paralytic) drips. The plan was to let the medication wear off so her neurologic function could be assessed. The paralytic effects wear off within 1 to 2 hours. The issue is the pentabarbital can take anywhere from hours to several days to wear off--everyone is different. Her ICPs continued to be elevated in the high 20's all morning and there was no change in her neurologic exam--no movements, no spontaneous breathing, no change in her brainstem reflexes (gag, cough, pupils). The neurosurgeons came in around noon and suggested that the paralytic be restarted to try to bring the ICPs down and give the pentabarbital time to wear off completely. Since the paralytic has been restarted the ICPs have dropped to around 20. The consequence of this plan is we won't be able to assess her neurologic functions while on the paralytic. They are going to hook her back up to the continuous EEG which will help us see when the pentabarbital effects begin to wear off. At that point the paralytic can be turned off and after an hour or two, we should be able to see what she will do neurologically. The wait continues...

The concern continues to be her pupils which should not be effected by the pentabarbital or paralytic. There are effected by fentanyl which she is on. Fentanyl should make her pupils pinpoint (1-2mm). Her pupils are 4mm and nonreactive. We continue to be hopeful that her swelling will start to subside and we will start to see some improvements.

On a lighter note...the nurse last night suggested that we buy Shannon some high top shoes to help prevent her ankles from becoming "frozen" pointing down. She wears them for several hours at a time. Her nieces in NC thought it was pretty funny that Shannon was "sleeping" in bed wearing shoes. I'll let you decided if we'll see Shannon wearing these shoes walking down the halls of Lone Peak as a big senior next year....



We continue to be hopeful and prayerful. We feel the strength of the Lord and the strength of your prayers and support. He is in control and we trust in Him.