Saturday, March 20, 2010

February 26, 2010 - More challenges

Continuing to bring our story up to the present—last month we took a brief look at our daughter’s recovery process during the first winter and spring after her burn accident. Expanding on that, it must be mentioned that her marriage fell apart. She and Jim were able to separate amicably, however, and she later married her friend Mark.

When Andrea went back to Salt Lake for one of her checkups at the burn center and Dr. Saffle learned that she was pregnant, he was elated. He said that the hormones of pregnancy would help her skin heal faster. She also realized she was lucky that her torso was not burned in the fire. Her abdomen and back had been donor sites, providing healthy skin for grafting of her arms and legs. The donor sites healed back to normal and thus the stretching ability of the skin over her abdomen was not impaired—whereas grafted areas can never be elastic. Pregnancy can be very difficult if grafting goes all the way around the abdomen, because the grafted skin cannot stretch enough.

She was still on a lot of medication so she discussed this with her doctor to see which medications would still be safe to take. She quit the pain medications that might be harmful to the baby. Still, it was a rough pregnancy. About a month before the baby was due, Andrea was starting to dilate and the baby’s heartbeat was too low and very erratic. Her doctor sent her on a life flight to a specialist in Missoula, Montana, where they were prepared to take the baby by Caesarean if necessary. After a thorough checkup and keeping her there overnight to monitor the baby’s heartbeat, the doctor in Missoula decided to let her come home. The baby’s heartbeat was low, but not low enough to be life-threatening. The doctor thought Andrea’s blood sugar problems (which stemmed from becoming diabetic while in the burn ICU receiving high calorie nourishment via stomach tube to supply enough nutrients and energy to keep her alive and enable her body to heal) might be causing the trouble. She would have to keep close track of her blood sugar levels and was also on insulin for the rest of her pregnancy.

The last few weeks were rough, and the baby came 2 weeks early, but seemed normal and healthy at 8 pounds, 2 ounces. Charlie Casey Hansen arrived safely on August 24, 2001, after causing all of us a lot of worry. Little Emily proudly held her new little brother, and when she talked to us on the phone the next morning she told me excitedly, “Grandma! My baby brother popped out last night!”

But by the time little Charlie was 2 days old he wasn’t eating well and was burping up his milk and a lot of stomach fluid. Andrea got worried and took him back to the hospital where the doctor did x-rays and thought there might be a blocked bowel or an intestinal infection—and started him on antibiotics just to be safe. The nurses were able to start an IV in a vein in his tiny little hand. He continued to get worse so the doctor sent Andrea and baby on a life flight to Primary Children’s Hospital in Salt Lake. Blood cultures showed he had an intestinal bacterium (a deadly bug that had shut down his intestines and that’s why he was burping up all his milk), so he was kept on IV antibiotics for a week. During that time Andrea pumped milk for him. She couldn’t breast feed him because the doctors needed to measure everything he ate.

She stayed at the hospital with Charlie for 8 days and spent a lot of time on her feet, hiking between the baby ICU and the cafeteria, and the two hospitals (going back to the burn center next door to see the people who had made such a difference in her life the year before). Constant walking made a big difference in progress toward regaining mobility in her knees and ankles (the tendons of which had been so damaged in the fire). Her stiff left knee could almost straighten completely.

Three-year-old Emily stayed with us at the ranch while her mama was in Salt Lake, and made herself right at home like she had the summer before. She enjoyed helping me do chores, and petting her “baby horse” that was now a yearling.
After Andrea and Charlie came home, the baby stayed healthy. Andrea came out to the ranch a few times that fall and one day she rode with me to check on our cows in the mountain pasture. Carolyn (our daughter-in-law) took care of Emily and baby Charlie. It was Andrea’s first ride since early June and she was glad to be back on a horse again. We had a good ride, though she bumped her leg on a tree as we were going through dense timber—and scraped some of the delicate grafted skin off the leg. With no feeling in the thin, fragile grafts, it’s easy to nick or scrape that skin. But in spite of these challenges, her grafts were healing and “maturing” and looking better by that fall.

Other problems were more worrisome, at times. She got pneumonia again in mid-October, but it wasn’t quite as serious as the pneumonia she’d had in late May. She didn’t have to go to the hospital this time—she just drove to town daily for the antibiotic injections. On one office visit the doctor took a biopsy of a mole that had suddenly appeared on the grafted skin of her ankle. The grafts on her lower legs came from skin on her back, where she’d once had a malignant mole. Over the past 8 years her grafted legs continued to develop moles that had to be removed.

Little Emily started pre-school that fall. Not quite 4 years old, she was too young for kindergarten, but in October she started going to pre-school 4 hours a day, 3 days a week. She was proud and excited to be going to “school”.

UPDATE – RECENT GRAFT REPAIR – When Andrea went back to the burn center in Salt Lake for contracture release surgery on her right arm and hand in December 2009 and again in January, the goal was to remove/release some the thickened and contracting skin that was pulling all the joints out of line. The second surgery in January involved cutting out a large hunk of scar tissue in her upper arm and replacing it with skin from her upper thigh. The new graft didn’t “take” very well, however, and the doctors were afraid they might have to redo it. Instead of turning pink and healthy within a few days, it stayed gray and lifeless. So they didn’t let her come home, but kept checking on it. Her body did not reject it, however, so they kept hoping it would eventually “take”. Finally, 2 weeks later, there were signs that it was alive and starting to heal.

We kept her kids here at the ranch until she was able to come home on January 28.
It was a busy time, getting them to the school bus (a 2-mile drive down our creek to the highway) in the morning, taking the youngest one in later to pre-school, going back to town to pick her up in early afternoon, meeting the school bus in late afternoon. We had fun, but it was really nice to have mommy back again!
By this writing (February 26, 2010), her surgical sites are continuing to heal, but she will need to wear a pressure glove on her hand and wrist and some kind of pressure garment on her upper arm to try to keep the skin smoother and less lumpy and ridged as it heals—in hopes of preventing thick contractures (like from the first grafts) that caused such pain and disability.