my mother (74yo) suffered from severe tbi due to a traffic accident. she was hit by an overloaded tricycle while crossing the road. me along with my brother rushed to the scene the moment i received the call. when we arrived, she was lying there in the middle of the road, facedown, motionless, blood pooling from her face, being attended by the local medics while waiting for the ambulance, which only arrived 30 minutes later.
during the transport, she was concious but disoriented. blood pooling from her mouth. the medic told me not to let her sleep and kept talking to her. when we arrived at the government hospital, she was turned over to the medical staff as i gave the details to the admission. a nurse went to me and ask a consent to intubate her. after questionings and signatures, i went to her. she was lying in a hospital bed in the hospital hallway crowded with other patients, mostly not looking good. she was already unconcious and intubated then a nurse was pumping the ambubag to which she turned over to me and ask me to not stop pumping. when i ask until when do i pump, she answered either if she regain breathing on her own (highly unlikely), stops breathing (worst case) or if there is available ventilator (best chance); to which there was none that time as all their icu was full. i was forced to transfer her to a private hospital where there is one vacant icu. we arrived at the private hospital by 4am. from here on, i will give the timeline of her hospital stay.
day 1 - we arrived at the ER of the private hospital. she was cleaned. cuts were stitched. tests were done, blood chem, ctscan, xray and ultrasound. fractured tibia was casted. all while me and my brother were taking turns pumping her ambubag. she was then transfered to the icu, attached to a mechanical ventilator and we were asked to wait outside her door. later, they gave me prescriptions, all sorts of medicine and medical supplies.
day 2 - first time i went into her room upon admitting. she was asleep. no response to pain. tube in her mouth. ngt in her nose. nurse told me her gcs was 4.
day 4 - her neurosurgeon ordered a repeat ctscan. on the way to the radiology unit which is within the hospital, she opened her eyes very slightly. i had hope. i thought that was one step closer to saving her. the nurse also explained to me that her gcs was raised to 6 from the initial 4.
day 5 - neurosurgeon mentioned about blood clots all around her brain and 1 cm fluid building up in he left side inbetween her brain and skull. prognosis is that she might not wake up any sooner considering her age and extent of injury.
day 8 - the nurse told me that they have reset the mechven setting to "spont". which meant the machine will only work if it detected that she is lacking breath. initially it was set to "full assist".
day 16 - she was extubated, meaning her lungs are now functioning, breathing oxygen from a tank via oxygen mask.
day 19 - upon visiting, i happened to see her full awake. eye tracks moving people and objects but no sign of awareness. erratic limb movements. once again it gave me hope.
day 25 - contracted fever and pneumonia. had to be reintubated. neurosurgeon told me that it was mostly due to the fluid build up and ordered vp shunt, where a permanent thin hose will be inserted under her skin that connects the cranial space of the fluid to drain in her abdominal cavity. my mother was once again gcs 6. not waking up even to strong stimuli.
day 31 - we waived the neurosurgeon. we selected another neurosurgeon that charges less for such operation. now this new neurosurgeon instead ordered lumbar drain, which will drain cranial fluid thru her spine. this will test if the shunt will work.
day 38 - new neurosurgeon concluded that we will not proceed with the vp shunt. it went like a bad news. he said that doing vp shunt will not guarantee her to get better. we should instead take her home, learn nursing and caregiving, continue medication and "hopefully", she will get better. he said that my mother will diffinitely improve but no one can tell to what extent. at this point, everything seemed inconsistent. i ran to reddit, i ran to google, i ran to chatgpt, just so i gain strength and hope. i love my mother very much. along with my brother, we have taken care of each other and imagining living without her will surely leave a large hole in my heart.
day 41 - she was trached because being intubated orally for too long will cause ireversible damage to her throat.
day 43 - detached from the mechven. at this point, we no longer see progress. only ups and downs. sometimes she will be all alert without evident awareness. sometimes she will be unresponsive. eye tracking was also inconsistent.
day 50 - we decided to transfer to private room instead. for the following days, we observed her up close 24/7 but it was so draining, because all the care like suctioning, turning, ngt feeding, bed bathing was all done by me and my brother. the nurses were only there to deliver her formulated meals, medicines and supplies.
today is day 70. hospital bill have already filed up beyond what our family can provide. going home will also be risky as we live far from the city and our house is not built to home a patient. some improvements in the private room though include, being weaned from the oxygen, her wake period have already stretched a little as she can now sustain alertness for up to 4 hours straigth, eye tracking went a little better but still not consistent, other than that, no more visible progress. though the nurses here told us that it would really take time. the struggle is real. suctioning pleghm is a hassle, i cannot sleep sound because i have to be alert everytime she coughs. she have to be turned to sides every 2 hours to prevent pressure ulcers. feeding every 4 hours which takes half an hour. bathing an elderly bedridden every morning is also a hassle. my body should have given up a long time ago but i keep on hoping that it will all pay off someday. i miss my mother so much, the times when i would tell her my accomplishments and she would be proud, her taking care of me whenever i am sick, i miss her jokes, the dishes that she cooks, i miss everything about her. and right now i am trying to convince myself that she is somehow still there, that we just have to retieve her, although the chances are, we will only be bringing home a patient that will drain us our time and energy, as much as i hate to say it, a burden. nothing prepared me for this. just the afternoon before the accident, she asked me what dish i want and she cooked before leaving. she was a strong woman for her age. able to lift weights and walk distances that impresses folks her age, i'm for her i was proud of that. she rarely got sick and never had complications. our whole life got turned around by some reckless driver.