She's Coming Home

Not again

Nat- what's going on?
Nurse 1- started seizing 2 minutes ago, O2 SATs are low, heart rate's high, ripped out both her IVs, bleeding from both sites but we can't get pressure on them because she's moving too much.

Crap, this is a bad one and she's lost all IV access so I can't give her meds to stop it.

Nat- try to keep her on her side, suction her mouth, someone grab a vent circuit with a suction catheter so we don't have to disconnect the vent the to suction her trach. Get the vent set to 100% O2 to try to keep her SATs up. I'm going to prep meds in case it doesn't stop on it's own. Prepare to place another IV if we need it.

I prepped the meds and another few minutes went by.
Nurse 2- she's vomiting.
Nat- Keep her on her side and suction, do not let her aspirate!
The timer shows 5 minutes and there's no sign of the seizure slowing down.
Nat- it's not stopping on it's own, we need to get a line in
Nurse 3- how? She's moving around too much.
Nat- we need more people, we'll just have to hold her down, we can't let this keep going.
I call a code and a bunch more people come running in.
Nat- seizing for over 5 minutes and lost all IV access, we need to get a new line in, help hold her down so I can get the line in
After 2 more minutes i finally get a line in
Nat- pass me the meds
I push meds and we wait. After a minute with no change I go to push more meds.
Nat- vein's blown, get me a new kit and hold her again.
Several minutes later I finally have another IV in and push more meds.
Nurse 2- 10 minutes
I give her more meds
Nat- she's maxed out on medazelam
Finally after 15 minutes she stops seizing.
Nat- ok, good work everyone, I only need 1 person now.
Almost everyone leaves to go back the their stations around the hospital.
Nat- let's get her cleaned up and settled, hopefully the excitements over for the night.
I decided to stay with her. Her SATs were still low and her heart rate was all over the place. 2 hours later she started seizing again and a bunch of nurses came rushing in again.
Nat- get her on her side, get ready with suction and try to protect that IV.
I'm really hoping this seizure will stop on it's own because she's maxed out on the only med that seems to stop her seizures, I can try others but they haven't worked before.
Nurse 1- 5 minutes
Nat- pushing lorazepam
No change, every few minutes I give her more meds but it's not doing anything. She's been seizing for 20 minutes now.
Nat- that's it, page dr Abrams, I'm putting her in a medically induced coma.
When she finally stops seizing I set up an EEG. A while later dr Abrams came in
Dr Abrams- what happened?
Nat- 2 seizures, first one 15 and maxed her out on medazelam. Second one about 2 hours later, after 20 minutes I put her in a medically induced coma, nothing else was stopping it. I set up an EEG once she stopped seizing.
Dr Abrams- alright, take her to CT to check for any rebleeds that might be causing this.

After the scan
Nat- nothing on the CT
Dr Abrams- ok, well let's give her until the afternoon then we'll try bringing her out of the coma and hope she doesn't start seizing again, if she does we'll put her back out. No visitors until she's stable.
Nat- ok, I'll call people in the morning and I'll be back for when you try to wake her up. I go find an on call room and sleep.

Morning
As I'm getting ready to head home I call Antonio.
A- hey Nat, is everything ok, is Gabby ok?
N- she's fine for now. She had 2 bad seizures last night and we had to put her in a medically induced coma to stop them. We're going to try to wake her up in the afternoon but we don't know how that will go.
A- can I come see her?
N- not yet, sorry Antonio but she's too critical right now, I was on shift all night but I think April's with her again today, I'm sure she'll keep you updated.
A- is it because she pushed herself yesterday? I should have been there, I should have made her stop sooner.
N- this is not your fault. It's like she was telling April yesterday, stupid brain injury, seizures are just a part of that. She'll be ok.
A- ok thanks for the update.

That Evening- Gabby POV
My brain is so foggy, I don't know what's going on, everything hurts. Slowly I start to become more aware of my surroundings, I hear people. Eventually I open my eyes and see April and Maggie and Nat. I'm so confused, why are they all here?
Nat- hey, you're awake! How are you feeling?
I just look at her then remember the eye gaze. I try to use it but I can't focus on the small symbols for long enough.
Nat- April can you go find Lisa? Maybe she can make the device easier for Gabby to use.
I close my eyes again. Everything hurts and I'm exhausted. Then I hear Lisa talking to me
Lisa- hey, I switched you to 4 buttons per page so it's easier to make selections. I can switch it back once your stronger again.
I look at her then try use my device again, it's really hard but eventually I manage one word
Gabby- hurt
Nat- I'll get you some pain meds.
She leaves and comes back
Nat- here, this should kick in soon and make you feel better. You had a rough night, do you remember anything?
Gabby- no
Nat- you had a really long seizure in the middle of the night and another one 2 hours later, I had to put you in a medically induced coma to stop them. It's the next evening. You're probably sore from seizing for so long, you were moving around a lot, and because we had to hold you down to get an IV in because the ones you had were pulled out.
That's why I feel so weird. The pain meds are starting to kick in and I'm even more tired. I can't keep my eyes open anymore and fall back asleep.