Day #2 in LTAC

Meghan met with one doctor this morning who said he didn't feel she needed to be on IV antibiotics. PT came and ran her through the typical milestones for patients at LTAC. She could do them all: walk 150 feet, walk stairs, etc. The PT said they would just put her on a maintenance therapy plan while she's in LTAC for now. No word yet on what therapy she will need for her arm.

Ms. Lynn and Mom washed Meg's hair and gave her the spa treatment complete with toe nail polish and Meg's own clothes this evening. Mom brought Meg's balloons and stuffed animals that she's gotten since the accident and cards that have come in the mail. 

Day #16.5 in ICU & Day #.5 in LTAC

After hyperbaric treatment, Meg returned to ICU. The stitches in her right arm were removed. She's no longer using her morphine PCA pump and no longer getting IV fluids. Her catheter has been removed as well as the monitoring leads and bp cuff.

The doctor wrote orders to release her from ICU today. We spoke to the intake person from the long term acute care (LTAC) hospital. She told Meg that the average stay at LTAC is 25 days and that she was going to review her file and determine if they could get her into LTAC today or if she would have to go to the orthopedic floor until Monday. While the intake person was reviewing her file, Meg started walking laps in the ICU. Meg's nurse told the intake person that she didn't think Meg needed to go to LTAC and didn't know why she couldn't just go home with home nursing care. The hospital social worker, the intake nurse and mom discussed Meghan's immediate needs (IV antibiotics, hyperbarics, unknown physical therapy needs, etc) and decided that going to LTAC for the short term is the right thing for Meghan's needs right now. Her doctor agreed to re-evaluate Monday to determine if she should stay in LTAC beyond the weekend.

Mom was able to take Meghan out of ICU in a wheel chair to tour the rest of the hospital. Meg ate Chik-fil-a sandwich for lunch in the "main street" level. Then Meg walked from the Women's center (Purple tower for those who know the hospital) all the way back down the "main street" hall to the Green tower elevators, up to the ICU and walked right back into her ICU room.

6:00 pm - The wound nurse changed her leg wound dressing this afternoon in ICU. Meg needed 2 mg of dilaudid and 2 mg of ativan to get the tape off. The wound nurse said everything looks FABULOUS. She will have dressing changes M,W, and F of each week. The doctors finally got on the same page and all the decisions made and paperwork signed to admit her to the LTAC today. Meghan rode in mom's car (!!!) to the LTAC and was admitted into her new room. She's very excited that she has ABC Family channel as well as other cable channels that weren't available at the hospital.

Meg can have visitors 24 hrs a day with no limitations other than when she has therapy. She also has a direct phone number to her room. If you'd like to visit or call her room, please feel free to email for details or text or call Meghan's phone. (laura_lambert@bellsouth.net.)

Day #16 in ICU

12:00 pm - Meghan's been in the chair next to the bed since returning from hyperbaric treatment this morning. We practiced getting up and walking but she's still tethered to equipment so she couldn't go far. They are planning to ask the doctor to order taking her off IV saline and monitoring today which will free her quite a bit.
4:30 pm - We were able to convince her nurse to free her from all the contraptions temporarily. We wrapped a sheet around her and she walked a lap around ICU. She's had no pain today and hasn't needed to use her morphine pump at all today. During her walk, she felt she doesn't need the cane they've loaned her and she didn't want the sling to hold her arm. She didn't need to stop and catch her breath or anything. Mom had a hard time keeping up carrying the V.A.C.! She climbed back into bed after the walk but didn't fall asleep. She likes that she doesn't want to sleep all the time, but she is starting to get bored and VERY sick of being in the hospital.
The wound nurse said they would be changing her leg dressing tomorrow.
9:30 pm - Dr. W says they'll move her out of ICU tomorrow. Not sure at this point if it will be to orthopedic floor or long term care facility.

Day #15 in ICU & Surgery #5

Terrible weather in the area this morning, yet Meghan still was taken to hyperbarics. They told her she has 46 more visits to go.
1:30 pm Dr. F (the plastics guy) has taken her into surgery. Meghan and mom talked to him before the surgery: there's a 50/50 chance that this will be the last debridement (and surgery) until the wound bed is ready for skin grafting. She will still have the V.A.C. on her leg after surgery. They are not doing anything with her arm today.
3:15 pm Dr. F said surgery went well. He did remove a large area of skin and tissue from her leg and they replaced the wound V.A.C. He doesn't see a need for additional surgery for debridement. He will see her every other week at dressing changes and weekly when it gets closer to time for the skin grafts. The time frame is totally dependent on how quickly Meghan's wound regenerates the granulated tissue. Dressing changes will be every 3-5 days and may require heavy doses of pain meds. She will be in ICU at least another 24 hours. There are no limitations on her movement other than the cast on her arm and the knee brace to keep her quad muscle in place. Dr. F said it's likely the skin on her arm will heal on its own, but if not, he can graft a small piece to it when the leg grafting is done.

Day #14 in ICU

While Meghan's been in the hospital, there's been a lot going on at the hospital itself. Here's a shot of the new entrance that was just opened and the Christmas tree on top.


Hyperbaric went well this morning. Dr. W and Dr. F (ortho and plastics) visited her today to check out her leg and arm wounds. They have removed the V.A.C. on her arm! They put just a dressing on it and expect to change it every three days or so while it heals. She's already moving her arm around freely even with the cast on. This was a very big success for her to get rid of being tethered to that V.A.C. on her arm. Unfortunately, they had to give her extra pain meds to deal with removing the tape and it's made her sleepy again.

Mike visited with her tonight. She's in good spirits. 

Surgery #5 scheduled for 1:30ish Wednesday afternoon.

Day #13 in ICU

The plan this week is for Meghan to go to her hyperbaric chamber treatments on Windy Hill every morning around 6:00 am then will be returned to the hospital afterward.

Meghan's had a busy morning. Her HBO treatment was bright and early. She was able to take a nap when she got back to the hospital. Then PT arrived and got her up and walking. She walked out of the room and into the hall before returning to the chair in the room. She's eating ham and mac 'n cheese for lunch in the chair beside the bed. It's so good to see her out of that bed!

Had a good conversation with the plastic surgeon today. He said that the tissue on her leg has to "declare itself" and that may take another week to two. Once they are certain which tissue is not going to survive, they will finish debriding the wound and then she'll continue with wound V.A.C. therapy to prepare the wound for skin grafting.

Another surgery has been scheduled for Wed afternoon or Thursday morning to debride her leg wound and replace the V.A.C. dressings.

Day #12 in ICU

Caitlin's visiting with her today in ICU. She slept as much as she could even though the nurses turned her at 3am. The Benedryl she took last night seemed to help her sleep more restfully.

Her blood counts dropped during the night so they're giving her two units of blood today. Hopefully this will help her feel less tired and sleepy, too. Dr. W and Dr. K came by on their rounds. They expect to move her to the long term care facility (LTAC) by Tuesday if a bed is available. If a bed is not available, they plan to move her to the orthopedic floor in the next day or two until the LTAC is available.