Halian had several more seizures since I left on Friday. They had set him up for brain mapping this morning and although kids usually make me nervous, this case was especially close to my heart. No matter how good some of the other surgeons are, I knew I had to do this for my nephew. I was not about to allow someone else to mess this up. This was my responsibility.
Halian was asleep when I arrived, due to the medications they gave him to ward off the seizures. Unfortunately lethargy or drowsiness was a very common side effect of most anticonvulsant medications. The procedure being completed today was the first of two steps. Once the electrodes were placed, they would take away the medications to control the seizures and monitor where they originate and what areas are involved in the seizure activity. The external EEG picked up the seizures, but was not definitive on where the seizures originate. This surgery to map the brain, will help determine if the area causing the seizures can be removed or if medications are the safest treatment. Later in the week, we would hopefully go back in and remove the electrodes from the surface of the brain. We may or may not need to use current at that time, to determine if we are able to remove the affected area.
All the required testing had been completed over the weekend, one of the few bonuses to being hospitalized. Outpatient it could have taken months to run all the required tests needed before surgery. My hope is that an area was injured in the accident that can be removed and stop the seizures. This approach has about a 70% success rate. My fear is that the seizures will originate in a part of the brain that cannot be removed and that the injury was serious enough to cause Hal to have lifelong epilepsy.
As I was exiting Hal's hospital room, my mother came walking up the hallway. I met her with a huge hug and a kiss on the cheek. "Good morning Mom."
"Good morning Wambleeska. I'm so glad you are here to help Halian. I wouldn't trust his brain in anyone else's hands," she said with a smile and shiny eyes. "Have I told you lately Dr. Teton, how proud I am of you?"
I actually felt my cheeks flush. I don't blush, what the heck? "Thanks Mom. I love you too. I couldn't have done it without the support of all of you."
"Oh son, you never have taken compliments well. Just say 'thank you', and move on. You deserve our praise. Own your accomplishments."
"Yes Mom. Thank you," I said to appease her.
She patted my cheek with a, "that's my boy."
I took a deep breath, "Hal is still asleep, but I need to go do rounds and then scrub for surgery. Hal's surgery is first. Anything you need before I go?"
"No honey," she said with a sigh, "I'm just nervous. That's all."
I gave her another hug. "I'll find you in the waiting room after we take him to recovery okay?" I asked.
"Thank you son. May God guide your hands," Mom squeezed both my hands gently after blessing me. She turned and sauntered into Hal's room.
I hadn't noticed before, but Mom looked tired. She looked older, like the last two weeks had aged her ten years. I had to get this stuff figured out not just for Hal and Wanda, but for the rest of the family as well. We have always been there for one another, and this would be no different.
The surgery for Hal went well but took about four hours total. As Hal was taken into recovery, I walked out into the surgical waiting room. I saw Mom as expected, but I was shocked to see Wanda, Alec, and Mona. "Wanda," I said as I approached the table they all sat around, "what are you doing here? You should be home resting."
Wanda looked up at me from the wheelchair where her injured leg was elevated on the raised footrest with pillows to make it more comfortable. "You expect me to stay home when my son is having brain surgery? Think again Wam."
Alec looked at me sheepishly from his chair and explained, "I tried to convince her to stay home Wam, but she wouldn't take 'no' for an answer. I figured it's safer for me to bring her than for her to take the city bus, which is what she threatened."
I shook my head but had a smile on my face. "Stubborn as ever I see Wanda. Some things never change huh?" I teased.
Mom nodded in return and Wanda simply glared at me. I can't say I blame her though. If it was my son, it'd be difficult to keep me away as well. I won't even let anyone else operate on Hal, so I'm just as protective as they are. Family has always come first in my book.
Mona spoke up, "well, how did the surgery go?"
I pulled up a chair between Mom and Mona while I filled them in. "The procedure went well, but this is just the first step. We couldn't get a definitive origin of the seizures, so we are hoping this will give us that information. Once Hal regains consciousness, they will stop all his anticonvulsant medications to allow the seizures to return. Unfortunately if we suppress the seizures, we are unsure exactly what we are dealing with. Once we get good internal EEG readings, we will have a better idea of what kind of seizures we are dealing with and the best way to treat them."
Alec asked, "do you have suspicions about the type and location of the seizures?"
"Alec, I understand you want answers. That's why we did the surgery quicker than we maybe would have normally. I really do not want to speculate. I would prefer to have adequate information and make an educated decision. Hal has been taken to recovery, and the nurse will come get you when you can see him. Any other questions?"
Everyone shook their heads but Mom put her hand on mine and squeezed, "thank you Wam."
I shook Alec's hand and kissed Wanda, Mona, and Mom on the cheek before going to see my next surgical patient before a took a quick break before the next surgery. Never a dull moment in surgery.
I sat and consumed a cup of coffee, a bottle of water, and a sandwich before I started the next procedure. I sent a quick text to Lee as I ate.
Dr. Wam Teton: Good afternoon Lee. I hope you are well today. Hal's surgery went as well as could be expected. Hoping we have answers in the next couple days. How is Kedron? How are you? (Hug emoji)
Kynlee: I'm glad Hal's surgery went okay. I hope you find the answers you seek. Kedron is really struggling Wam. I'm so worried. I called last night and he had a complete breakdown while on the phone with me. Nurse Timothy was great, but Kedron said again that he isn't sure he can live like this. I don't know what to do with that Wam. (Crying emoji)
I sighed and ran a hand through my hair. I knew this would be difficult for Kedron, being a young virile male, but I was not expecting him to be so depressed so soon. We hadn't discussed it, but I was unaware Kedron had any mental health issues prior to this latest trauma. I guess now was the time to ask.
Dr. Wam Teton: Has Kedron ever had mental health issues prior to this accident?
Kynlee: No. Kedron has always been very even keel, almost unemotional since our parent's death. That's why this current breakdown of his is so worrisome.
Dr. Wam Teton: It's a possibility he is now feeling the feelings he should have felt the last 18 months. If he kept all his emotions in check and now that cover has been blown off, it's likely all the emotions he tried not to feel before, are now coming out. I can put in a referral for a counselor or social worker to talk with him.
Kynlee: If you think it will help, please do. Thank you Wam.
Dr. Wam Teton: Anything for you Lee. (Smile emoji) I have to scrub for my next surgery. Talk tonight?
Kynlee: Yes, I'll text you later. Have a good afternoon Wam. (Kiss emoji)
I couldn't help but smile as I cleaned up my area, washed my hands, and headed back to the surgical department. Before I scrubbed, I ducked into a kiosk and quickly put in a referral for assessment and counseling for Kedron stat. That should hopefully alert them of it's importance.
The Chiari decrompression surgery took about two hours once the patient was anesthetized. The surgery had no surprises, and Wam was ready for a nice long run to clear his mind.
After changing my clothes, I started on my favorite treadmill to warm up. I had just started running full speed when my phone rang with a call from the hospital in Rochester. I pressed the green 'accept' button, put it on speaker phone and said, "Dr. Teton, how can I help you?"
To my surprise, the call was from Dr. Adams. She did not sound pleased, "Wam, what are you doing placing a stat order for assessment and counseling fir my patient without consulting me?"
Although she cannot see me, I sneered at the phone before responding. "Are you telling me you were not privy to the issues Kedron Knutson had over the weekend?"
"Of course I read the charting, but why the 'stat order'?" She asked with a snotty lilt to her voice.
"Kelly, he said he wasn't sure he could live like this. He also has stuffed his feelings since his parents died. Now that the emotions are coming out, he has no idea how to deal with them. The kid needs help!"
Dr. Adams gives an unhappy laugh at my statement. "You know right that he has no insurance and you're adding to the expenses he will have from this hospital stay? Isn't that rather cruel Dr. Teton?"
I was becoming angry. Finances were a common issue in the hospital setting, but I was a staunch believer in doing what is best for the patient and worrying about finances later. It was time to set this doctor straight!
"Dr. Adams, you know as well as I do that his disability payments and insurance will be approved. The only reason it was returned was because you missed your signature in two spots as his primary physician. Was that intentional Doctor?"
It almost sounded like she growled at me for what I said. I couldn't help but smile that she was getting angry now just like I did. "So Dr. Adams, instead of calling me and complaining, how about you fix your errors so his disability is approved this time?"
It sounded like she was spitting and sputtering on the other end of the phone. I couldn't help but take advantage of this situation, even though it was a rather juvenile thing to do. I've been trying so hard to get Kelly to leave me alone, hopefully this would do it.
"You're welcome. If there are other things you need a consult on or need me to remedy, feel free to give me a call. Have a good week Dr. Adams. Tata," and I pushed the red 'end call' button.
I turned up the speed on the treadmill and ran until I couldn't run anymore. I then limped into the locker room showers, put my street clothes back on, and headed home.
Sammy greeted me at the door with a "meow," and rubbed on my legs. I scratched her head and meandered to the kitchen to feed us both.