The Letter: Part 7

Because the Soldier was not coherent. Instead of trying to write what happened this is an email The Miss's sent out to their friends (sorry it's so long).

"I unfortunately have some bad news. The Soldier is okay now but was sick for a period of time. Many of you know about The Soldiers chronic illness of ulcerative colitis. Well, he has had some complications. He has had several major flare-ups and in order to get it under control he was placed on the steroidal medication prednisone, again. He was also placed on a maintenance therapy medication called Remicade which is pretty much the last resort prior to surgery. There are some serious side effects of this medication. One being a decreased immune system. So because of this medication, combined with the prednisone The Soldier was pretty susceptible to getting sick. So he did.

My birthday was on Sunday. That following Monday The Soldier got a fever and was very sick for a couple of days. Tuesday he had an apt to get a dose of his Remicade and the doctor there didn't think much of it. Thursday he was still running fevers between 102 up to 104. He went to his Internal Medicine Doctor (Dr. H) and they took some labs, did a chest x-ray but everything came back pretty close to normal. So they said he probably had something viral and antibiotics don't treat viruses so they just sent him home. I was pretty upset. They didn't even give him an IV. I knew he was sick and something more was going on.

Friday he woke up with a pounding headache. I wanted to take him to the ER but if you know The Soldier you know he wouldn't let me. Especially because he just went to the doctors the day before. So I went to work. Friday night when I got home he was still very sick with a temp of 103 and a headache he could not get rid of. We tried everything, Excedrin, Percocet. Being the nurse I am, I had IV stuff at home and hooked him up to a liter of LR. I was a little nervous to do so though because of the pressure in his head. I hoped I wasn't going to make things worse.

The Soldier was laying on the couch and when the IV was over he wanted to go to the bedroom. He sat up but was very nauseated. I got him a bucket. He started vomiting and then dry heaving. He was trying to talk himself into getting up to go to the bedroom. I don't remember what question I asked him next, but what he answered scared me to death. All that came out was gibberish. He was stuttering and he wasn't able to put a sentence structure together. I told him we needed to go to the hospital now. At this point it was 11:30 on Friday. He was pissed he didn't want to go to the hospital. Even though what he was saying didn't make sense I could tell that much. I told him he had to trust me on this one and went to get his shoes. At this point, if he was going to fight me I was going to call 911 and I told him that, so he didn't.

He let me put on his shoes, I grabbed his wallet on the way out the door for his insurance info and we headed to his truck which was parked behind my car. Even with all this happening The Soldier was able to ask me, "Are you driving?" I said "yes, and we're taking your truck cause it's behind my car." He sighed in disgust. I had to chuckle a little. The Soldier hates the way I drive. I got him into the car. As he was climbing in he hit his head on the roof. I felt horrible, his head hurt bad enough already. We drove to St Marks Hospital which is where all his records and doctors were located.

When we got there I asked him if he wanted me to get him a wheel chair, of course he said no. We walked very slowly towards the doors. I was afraid he was going to fall over on me right then and there. As we walked through the ER door, I said look there is a wheel chair, lets go get it. He said okay. That was the last conscious decision The Soldier made or said to me for the next 36 hours or so.

I told the receptionist the seriousness of The Soldier's condition and the triage nurse was there as well so we were seen right away. While we were waiting for the doctor and after explaining what had happened several times to the triage nurse and then the ER nurse, I called The Soldiers parents just to let them know we were at the hospital, but I didn't elaborate on what was really going on. At this point it was about 12:30. Believe it or not The Soldier was seen by the MD sometime between 20 and 30 minutes after we got there. The doctor walked in turned on the light (it was turned off because it made The Soldiers headache worse) and said, "Hi Soldier." The Soldier moaned in response. I just mentioned to the doctor, he wouldn't be able to respond to his questions. He sat down and asked The Soldier what was going on. The Soldier looked at him and attempted to answer but again came the stuttering and the gibberish. It sounded like The Soldier was trying to say something about a football. The doctor looked up briskly at me (as if to say what the hell is going on) I explained everything that had happened, all his signs and symptoms. The doctor said, "okay we are going to get a CT and a spinal tap," then walked out. As he walked out I heard him ask for The Soldiers nurse. He said "We have a very sick man on our hands, we need a CT and a spinal now!"

As scared as I had been up to that point, and I knew something was very wrong, I had kept my wits about me. When I heard the doctor confirm my fears, then I started to break down. I called my mom and dad. They said they would come to the hospital to meet and support me. I felt a little better. I also called The Soldier's parents back to let them know exactly what was going on. They were on there way too. The Soldier's parents showed up first. The CT had already been done and they got there just in time for the spinal. You could tell The Soldier's head was hurting him pretty bad and the position he needed to sit in for the spinal was not a comfortable one. His mom and I held his head and back in place with the nurse, while the doctor did the spinal tap.

Then followed the waiting game. My parents made it there but they couldn't put that many people in the ER room so they waited in the waiting room. I came out to visit every 15 minutes or so, then would go back to sit with The Soldier and his parents. It was about 1:45 or 2:15 before the doctor came in to tell us he was being transferred to 4th South, a step down/telemetry ward. He said The Soldier had meningitis. I think I was in shock at that point because it didn't even seem to phase me. I was actually glad I knew what it was. Now we could work on treating it. The normal white blood cell range in cerebral spinal fluid was between 3-5. The Soldier's was 4600. I went out to tell my parents. They were very concerned about me and The Soldier. Shortly after that they went home so they could come back in the morning.

The Soldier's parents and I stayed with The Soldier as he was transferred to 4th South. The Soldier was now on contact precautions. We had to wear a mask while we were in his room just in case this form of meningitis was contagious. At this point The Soldier was in a world of his own. He just moaned in pain, at times he would say a few swear words then tell himself, "okay, okay, okay, okay" as if he was trying to tell himself he would be okay. He was unresponsive to questioning by the nurses and couldn't obey simple commands.

As the nurse and the aid were trying to get him settled, The Soldier started to receive very high dose of antibiotics and antiviral medications. He was getting a little of everything until his blood culture and cerebral spinal fluid culture let us know exactly what bug we were fighting. I let them know that he had had about 3 liters of fluid and would probably have to pee soon so it would behove them to place a catheter. The nurse was really irritating me. She didn't want to do anything for him. She just wanted to wait until the morning when the doctor came in to write the orders. I think she got a clue when The Soldier tried to jump out of bed to go to the bathroom and we tried to take him there but he couldn't walk. He would lean forward as if he was going to take a step but he didn't have the coordination to put one foot in front of the other. The nurse, CNA and I had to hold him in bed. Once he calmed down the nurse called the doctor.

She got an order for a catheter and a posey restraint to keep him from trying to jump out of bed again. His parents were in obvious distress. I was going to stay the night and once they saw he was a little calmer they went home so they too could come back in the morning. I asked the nurse if they could give him something for pain and she said they couldn't because they were trying to watch his level of consciousness and pain medications usually alter that. When the nurse came back with the catheter and the restraint and I was watching her and the aid put it on him. I broke down. Watching them put that restraint on The Soldier was heartbreaking. I knew it was for his own good but it still killed me. To even think about it now brings tears to my eyes.

It was about 5 o'clock in the morning at that point and The Soldier and I tried to settle down for a few hours of sleep. They brought in a lounge chair for me but it was very bad sleep. Every few minutes it seemed like The Soldier began to moan in pain. I would tell him it was okay then it seem as if he would settle down. The nurse thought it might have been the sound of my voice that helped him.

About 7:00 a.m. I woke up because it was change of shift and the new nurse was there. Shortly after that The Soldier's parents came back. We just sat with him as we waited for the doctor. The nurse The Soldier had that day was from the hospital float pool. She seemed to be a little bit lost to me and when she told me she normally floated to the mother baby ward, then I knew why she was lost. She was over reactive too. She led the doctor to believe The Soldier needed to be transferred to the ICU, she was worried about his airway. I didn't think that was a problem because his blood oxygen saturation was fine. He didn't even appear to be struggling to breath. I'm not sure where that came from. Well anyway when the doctor came to assess The Soldier, before he went into see him. He talked to The Soldier's parents and me outside. He said that The Soldier might need to be transferred to the ICU and may need to be intubated to protect his airway because of his poor level of consciousness. Then he went in to assess The Soldier. This freaked me out. The Soldier's dad just pulled me into his arms and just held me while I cried. When the doctor came back out he said we wouldn't need to transfer him that he wasn't worried about his airway. All I thought was phew, stupid nurse. (I'm sure people have thought that about me at some point too. Lets just say this has given me a whole new perspective on patients family members).

The doctor did say that The Soldier was still very sick but we would watch him closely. At this point it was well, I'm not sure what time it was on Saturday. The Soldier's parents, and my mom were there with me. My mom took me home so I could take a nap, eat, and shower. I had been awake for over 24 hours at that point. As we drove home I called The Soldier's boss from work whom he is close to. I also called my best friend (The Best Friend) to let them know what had happened. I was able to keep myself somewhat together as I told them what was happening. My mom and I got back to The Ghetto and I laid down on the couch. I didn't think I would fall asleep because I was so worried, but my mom said I was asleep in seconds. She let me sleep for about an hour and a half because she knew I wanted to get back. When she woke me up I knew I was at my house and on my couch and I looked over at her confused and asked "What are you doing here?" Then it hit me like a ton of bricks. I had woken up to my worst night mare.

For the next hour and a half as I tried to put myself together I cried and tried to keep myself from hyperventilating. My mom reminded me that The Soldier was a fighter, that he never quits. I knew she was right, and it helped. After I got cleaned up and had a little something to eat, we drove back to the hospital. We found The Soldier's parents, The Soldier's sister, my dad and brother and The Best Friend. Good thing The Soldier had a large room. My dad and brother (The Missionary) gave The Soldier a blessing. It was actually The Soldier's aunts idea who asked his mom if my dad would do it. It was a good blessing, and very appropriate. I think it helped us as much as it probably helped him.

I think that was at about 5pm on Saturday. I hadn't really eaten since lunch on Friday so my parents took me to dinner at Marie Calenders across the street. I didn't eat very much but I ate. We got back to the hospital at about 6:30 or 7:00. A little while after that, everyone left but The Best Friend. She stayed with me and it was a good thing. Between 8:30 and 9:30 The Soldier was showing signs that he was getting worse not better. He wasn't calming down to the sound of my voice anymore and was just tossing and turning. He seemed much more distant. The nurse that was on that night was awesome and I was so thankful for her. She had great bed side manner and she was smart (I want to be like her when I grow up).

The Soldier's temperature was climbing again. He was at 103.7 and was beginning to show signs and I was concerned he was going to have some brain damage (sometimes knowing to much is not good, what I know as a nurse and seeing it is what was frightening me the most at that point). I couldn't bear to watch The Soldier any more. I had to leave the room, but at the same time I couldn't leave the hospital. I just paced the hallway and the foyer. Mean while, The best Friend had called my mom and she came back to the hospital to sit with me.

There was an order for a Tylenol rectal suppository (The Soldier was not coherent so he couldn't swallow) and again, the day shift nurse who said she was going to give it to help control his temp had not given it (at least that is what the computer had shown). The night shift nurse gave him the Tylenol. Then the nurse and my mom put me to bed in the room next door that was empty. That was so nice of her. At that point it had been some 40 hours or so with little to no sleep and little to no food. I had no coping skills left and I was a mess. Sleep was what I needed. The nurse was taking care of me as much as she was The Soldier.

My mom sat with me as I slept while The Best Friend sat with The Soldier. Several hours later they switched. The Best Friend told me she didn't want to switch until she had some better news for me, and she did. The Soldier's temp had broke and the signs I was seeing of brain damage, were no longer present. He was sleeping better. "Phew" I thought and went back to sleep. My mom sat with The Soldier the rest of the night and helped the nurse a few times.

I woke at about 6:30, and it was Sunday now. I had gotten about 6 hours of sleep and felt a whole lot better. I went out to find the nurse because I wanted to thank her before she went off shift. When I found her she said he was doing a lot better, and when I went to see him he was. He wasn't responding yet but I could tell we had turned a corner through the night. I was disappointed to see that the same nurse The Soldier had on Saturday was back on Sunday. But it was okay because I was there and I could tell he was getting better.

He started asking where he was. Oh to hear the sound of his voice. I had never heard something so wonderful. As the morning progressed to about 7:30. The nurse and I gave him a bed bath and I grinned from ear to ear when he yelled at me, "Sweetie!" in a pissed off voice as I was washing his butt. (The Soldier is a clean person, I knew he would feel better if he was clean. He showers twice a day at home). I didn't care he was mad, he knew I was there and that was all that was important. I knew everything was going to be okay when I brushed his teeth and he spit on command.

I went out to the foyer to eat a bagel my mom had bought and The Soldier's parents were back. We visited for a few minutes and I happily gave them the update on his condition. Slowly through out the morning he was talking more. My mom had gone home at this point but The Soldier's sister, grandpa, and cousin had shown up prior to the doctor coming. When the doctor came and asked The Soldier questions he was able to respond and he would squeeze the doctor's hand. The doctor asked if The Soldier knew where he was, The Soldier thought for a second then said "no". Then the doctor asked, "are you at the mall, or the hospital?" The Soldier replied, "the hospital". The doctor asked him what year it was. The Soldier thought for a minute and said. "two..........., two...........thous....and.........two thousand.....and................six" the doctor said "good. What month is it?" The Soldier replied, "ya, ya it's two thousand and six" The Soldier was still sick, but we all had to chuckle a little. It was so good to hear him talk.

Then the doctor asked him to "take his right index finger, touch his nose, then touch his left knee." This was too much for The Soldier, he said "What?" The doctor repeated himself then The Soldier bunched up his fist and said "I touch my right nose, then what?" We all laughed out loud at that point as much as his loss of memory was not funny, it was still a little funny. The doctor said it was okay. He then took us out of the room to give us an update. He said The Soldier was still very sick but his progress from yesterday was remarkable. He actually said to us that he wasn't sure if The Soldier was going to make it through the night (now I like to be right but I didn't want to be right about that, I knew The Soldier was doing bad on Saturday but, AHHH!) He also said The Soldier had turned the corner and he was going to be okay. We weren't sure about his memory, we would have to wait and see about that.

He also told us that the infectious disease doctor had identified what kind of meningitis he had. He had Bacterial Meningitis from a very rare bacteria called Listeria, that he had a rare condition also called Listeriosis. To this day we have not identified exactly where he got it from, but with some research I learned you can get it from almost anything. Unpasteurized dairy, deli meats, hot dogs, fruits and vegetables that have been fertilized with manure type fertilizers, and I think I read even water. Approximately only 1500 people in the United States get it each year and 500 of them die. Last year only 1200 people got it. It normally only affects pregnant women, the elderly, and people with compromised immune systems. The Soldier and I probably ate the same thing, but because of the medications he was on for his ulcerative colitis which compromised his immune system, he got sick and I didn't.

The Solider slowly progressed throughout Sunday and was talking even more. Still repeating himself a lot, but he was talking. They took him off contact precautions, discontinued all the antibiotics but high doses of ampicillian. The Soldier had the same bad headache he had on Friday, and they started giving him pain medications.

The Soldier's mom stayed with him Sunday night because I had to work Monday. That was a long day at work. I knew The Soldier was going to be okay and we were going to need the money so I went. Over the next couple of days his memory began to come back and he began to get his strength back. He still had the killer headache though.

He came home on the following Wednesday with a long term IV or a PICC line and continuos IV antibiotics with a home health agency managing it. Today it has been 2 weeks since he has been home. He still has the headache and the antibiotics but he is alive and has some of his memory back. If it wasn't for the headache he would be feeling pretty good. So for right now he rests on the couch. The doctor doesn't' want him to return to work at the earliest 6 weeks and maybe up to 12. The Soldier's boss has been great to us too! They love him like family and it has really made it easier to focus on getting The Soldier better."