We have now entered our 62nd hour since Christopher's accident. That is how the Dr.'s and nurses think about things at this point. There are many critical stages when it comes to brain injuries, and the time between hours 48 and 96 is one of them.
Christopher had a good day yesterday and remained relatively stable. He is still under non-stop care as his nurses work tirelessly to keep all of his numbers in the desired range. The main ones that they watch are his blood pressure (BP), his intracranial pressure (IP), his cranial perfusion pressure (CPP), and his heart rate (HR). Around 1:00 am this morning the doctor came in and spent a bit of time talking with me about Christopher's condition. I will try to sum it up as best I can. They are pleased with his progress during the first 48 hours and feel that it went as well as expected. Two things they are pleased about is that there were no bleeds and they didn't have to go back into surgery to open his skull to relieve swelling. The fact that everyone worked around the clock to keep his numbers where they wanted them to be and to keep Christopher stable was to be expected. When his blood pressure would drop and his intracranial pressure would rise, they increased his BP medicine, gave him an intravenous bolus and usually increased his sedative. The CPP number (the key indicator of his brain swelling) would typically return to the desired place quickly.
Now they want Christopher's body to begin to take over the regulation of all of these functions. That is what a normal, healthy body does. We are praying for that to happen between now and Sunday night, but know that the human body typically doesn't listen to our requests when it comes to timing. It is only when he is regulating these functions on his own for a minimum of 12 hours that they will even consider 'waking him up.' That process is also one that cannot be dictated by doctors, nurses and anxious parents. At this point, their hope is that this (waking him up) will happen sometime within the next 5 days... the sooner the better.
The fact that Christopher has not already taken over the regulation of his BP, IP, CPP on his own is a clear indication of the severity of his brain injury. It does not, however indicate the depth of possible injury done by the accident. As long as his CPP stays in the range of 60 or higher (preferably 70+), we can feel relatively confident that there is not more damage being done. It is when that number dips much lower and stays lower for an extended period of time that damage is done. To say that Paul and I are obsessed with NUMBERS at this point is an understatement. When we are apart and speak on the phone, we rarely start out with pleasantries... Conversations begin with, "what are his numbers?" A typical text message? "Okay, I haven't had numbers for 60 minutes and am going through withdrawal." My text message to him last night at 10:49 pm was, "136/71, 20, 68." No need for words...
We can expect to remain in the ICU for at least the next week and likely longer. Christopher's Dr.'s and nurses are strongly urging us (mostly me because I have only slept 6 hours in the past 66) to be especially vigilant about our health right now (meaning, sleep more than you're sleeping!) The road that lies ahead of us is going to be long and arduous. For those of you who know me well, I am the eternal optimist, but these days, reality is staring me in the face and I cannot deny its' presence.
We continue to be overwhelmed by the love, support and concern of our family and friends. Early yesterday morning I spent some time reading and answering e-mails and when I was finished, I realized that I had been blessed by the kind, compassionate and encouraging words of over 150 people. Please know that not a single e-mail, text message or phone call is taken for granted. We are treasuring them and they are what keep us going. We have rarely found ourselves alone at the hospital during the past 66 hours (with the exception of small windows of time in the wee hours of the morning when I have literally pushed you out the door). You have cared for Emily, driven us to/from the hospital even under duress, supplied us with fluffy blankets and pillows for the ICU, listened to and taken down answering machine messages, helped to interpret medical terms for us, fed, watered and walked Bella and Chief, fed, fed and fed Paul, Emily, myself and whoever happens to be around (including the nurses who now LOVE anyone tied to the name "Christopher Ackerman"), sent us endless text messages, cards and e-mails that move us to tears and remind us how very loved Christopher is, and most of all, you are praying fervently for Christopher.
This drawing is a scan of a picture that our little neighbor boy, Bryan (age 8) drew for Christopher and delivered to the house. Bryan frequently knocks at the door asking Christopher to play with him. They cut down tree branches (from the trees upon which they have climbed, of course), whittle them into swords and then pretend...I believe that this drawing will be going with me to the ICU later today... It will certainly be a pleasant addition to the many machines that currently surround Christopher's bed.
It is now after 2:00 pm. No, it didn't take me 6 hours to compose this e-mail. I simply got sidetracked in the middle of it, but I am at home and ready to attempt to catch a few hours of sleep. Thank you again for everything.
With much love, Laura (and Paul & Nick & Emily)
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