Quintin: respirator

What Happened to Quintin?

On April 26, 2010 Quintin experienced what may have been a cerebellar stroke. While crossing the street with his best friend, Quintin fell backward and hit the back of his head on a curb. He was unconscious for several moments, then was able to walk, with assistance, the short distance back into the building. After showing signs of a serious concussion he was taken in an ambulance to Legacy Emanuel hospital.

He was in the ICU at Emanuel until his 29^th birthday, June 5, when he was stable enough to transfer to the hospital’s Trauma Care Unit (TRACU). After nearly a month in TRACU he moved to Vibra Specialty Hospital in Portland.

At the end of October Quintin moved to an adult foster care home in Vancouver, WA. He has excellent around the clock nursing care from a team of people who believe in his potential to make positive progress toward recovery.

At times he seems alert and “awake,” other times not. He still has a tracheostomy tube in his throat and is sometimes on a ventilator to assist with his breathing. He is able to breathe independently; when he's on the vent it's usually there as a precautionary back up when he has a fever or needs his energy for something else that's going on. The trach does not allow air to pass over his vocal cords, but speech therapists can periodically check to see if he’s made progress towards being able to speak.

When he fell his occipital bone was broken, causing a brain bleed. The bleeding obscured the injured area, so we may never know the cause of the fall. It took several months for the internal swelling around the injury to subside. Now that the swelling is gone, CT scans have shown that there are damaged areas in the cerebellum, pons, and brain stem. Typically, brain tissue does not grow back, but it IS possible for connections in the brain to reform, and that’s what we are patiently waiting for now.

Here are a few updates for today.

First, it's Quintin's birthday. Happy birthday Q!

Second, Quintin has been breathing on his own for the past 24 hours.

As you know, the nursing staff has been monitoring his ventilator breathing closely. They have been slowly lowering its settings, allowing him to do more and more of the work. Their goal has been to wean him towards independent breathing. Yesterday morning around 11 am, while still under close ICU supervision, they took him off the vent and let him breathe on his own. The air they are supplying him with is pre-warmed and pre-moistened and he is still breathing through his tracheotomy, so he is not quite breathing normal room air -- but wow, this is a huge step in the right direction!

If he continues to breathe well like this, we are expecting him to be moved from the ICU to the TRACU (Trauma Recovery and Acute Care Unit; pronounced "track-you") in the near future.

We'll keep you updated.

-Adrian

He's still in a coma, though making little signs of recovery from time to time. The drains that had been placed in his head to relieve pressure on his brain are out, which is a great step, and the CT scans show that his intracranial pressure has been stable and normal since then. He's still on a respirator, which is why he's still in the ICU. Because he doesn't have a reliable cough reflex he has to have regular broncoscopies (sp?) to clean his lungs out. He's had an on-and-off fever as his body fights minor infections - they know he's dealing with staph but that's something they can monitor and treat with antibiotics. The worry with infection is the possibility of pneumonia - as long as he's on the respirator there's a higher chance of infection, but they need to see steady coughing and breathing to get him off the respirator. A bit of a catch-22. He's shown a few cough responses, so we're hoping he's progressing that way. The infection risk is the main reason why we can't invite people in to see him. He moves his legs and feet quite a bit; arms, shoulders and head sometimes too. He opens his eyes sometimes and seems to track faces occasionally, but I really don't know how much of that is reflex and how much is him actually looking at us.

The doctors have said that now we all have to have patience because it's a very slow healing process. Weeks and months, they say.

Quintin

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Happy Birthday Q!

May 12: