After my long three days off, I am back on track.
I was pleasantly surprised that the young Micronesian girl has been brought back to a regular room. The girls was the one who undergone MVR, AVR left thromboeectomy and IOTEE.
She is no longer on mechanical ventilator. She is now on oxygen per nasal cannula and she has a nasogastric tube for feeding. Her Glascow coma scale (GCS) is 10. She opens her eyes spontaneously, no verbal response and only withdraws to pain.
Since she cannot move on her own, frequent turning is required. Also she needs frequent suctioning of oral and nasal secretions.
Her mom, in broken English continuously expresses her gratitude to the ward nurses as she feels our care for her daughter.
The bedside rehabilitation is ongoing and at the moment, her legs seem to be powerless.
As I browsed through her chart, I saw that she has had subdural hematoma and they also performed emergency by pass on her.
According to Medline Plus Subdural hematomas are usually the result of a serious head injury. When one occurs in this way, it is called an “acute” subdural hematoma. Acute subdural hematomas are among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury.
I remembered the neurosurgeon telling the mother before that the fluid accumulated in the brain was negligible and does not require surgery.
What puzzles me is that the girl was ambulatory before the operation and now, her GCS is only 10. I also wanted to know why there was a need for emergency by pass.
Nancy Drew investigates

Instead of having her checked in a hotel, the insurance company serving the daughter who has undergone MVR, AVR, thrombieectomy and IOTEE, has decided to have the mother(a Micronesian) admitted to the hospital. She is actually occupying the room in our ward her daughter has vacated when transported to OR.
Since there was a complication, the girl was placed on heart pump and mechanical ventilation. The neuro-surgeon wanted to talk to the mother of the patient and we informed him that the mother barely understands English hence a need for an interpreter. Despite our attempt to convince him to get an interpreter, the doctor went on with his plan of talking to the mother. He just informed us that he’ll try to act and we obliged.
He let him inside the mother’s room and he introduced himself. At first the mother looked okay but when the doctor acted out as if he chopped his skull and stood still and closed her eyes, the mother began to panic. That was our queue to stop the doctor and call the interpreter in the other hospital.
The co-staff nurse and I were actually fighting hard not to laugh at the moment. Seeing a hardcore surgeon doing the “charades” is ridiculous.
We reserved our laughter until we punched out of the hospital.
Kindly check my story on The great barrier for the details about the girl’s story.

Another Micronesian couple will be discharged in time for their flight back home tomorrow. Like typical locals there, their bodies are big built. Just imagine Lilo in Lilo and Stitch. The lady was fixing the clothes she got for her granddaughter. I told her that I thought it was hers then she laughed. As I handed her medication she reached for Del Monte Fit ‘n Right. I told her that I noticed that almost all Micronesians I met in the hospital love that juice. She said maybe because like her, they all wanted to lose weight. As part of my health teaching, I told her that with her present condition, it is best to modify her lifestyle and diet. She should also incorporate exercise in her activities of daily living instead of opting for the best fat burning pills