Gregory A. Patrick
12/08/2020
Jaiden Chapter 86
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Greg Patrick
"Good morning, Mr. Brunson; how do you feel today?" "Jaiden, I slept well last night, and I haven't had any pain." "You haven't taken any pain medication through the pump in a day and a half. Let me check your incisions and check your lab results. Janice, how were the lab results last night?" "Jaiden, the white counts were a little above average but are still falling, and his temp was 99." "Mr. Brunson, you still have a bit of infection, so we will change your antibiotic to Doxycycline. It is a good drug that should knock the rest of the infection in a day or so. We'll continue to watch you for a couple of days, and if the infection goes away and your white cell counts normalize, we'll talk about you going home sometime this weekend. I don't want to dismiss you and have the infection crop back up. Richard will check on you tonight and see how your labs go during the day."
"Jaiden; 229. Jaiden; 229."
"This is Jaiden." "Jaiden, an ambulance is bringing in a child injured in a car accident; we need you in the ER." "On my way, order a bottle of buffered lidocaine from the pharmacy in case we need it."
"Janice, a child was injured in a car wreck, and I have to go to the ER to meet the ambulance when it arrives. As soon as I am finished in the ER, I'll come back to the floor to complete rounds."
"Jaiden, the ambulance is pulling in now. The patient is a ten-year-old boy who was not wearing a seat belt and hit the dash of the vehicle."
The paramedic advised Jaiden the child's BP was 110/70, and respiration was normal on the way to the ER.
Jaiden looked at the nurse and said, "a head, neck, and spinal MRI with contrast, and I need a wet read." The ER radiologic tech immediately took the child to x-ray while the receptionist got the patient information from the boy's parents.
"Jaiden got a call from the radiologist, and the boy has a disc compression between C-4 and C-5 and bruising along the thoracic vertebral bodies. Jaiden had the staff orthopedist paged to examine the boy to see if admission was necessary. Dr. Zemanski examined the child and admitted him for observation overnight. There wasn't any sign of a subdural hematoma, so that was good news.
Richard came through the ER as Jaiden was heading back to the surgical floor. Jaiden filled Richard in on the boy he admitted to the hospital. He would be the last patient Jaiden and Richard would see on rounds.
All the patients were doing reasonably well, so Jaiden and Richard headed to the boy's room. When he got the patent's chart, he noticed the child's name was Jackson Marcus. His parents were Jeremy and Helen Marcus. Jaiden knew the names from the synagogue. When he walked into Jackson's room, Jeremy and Helen were sitting with Jackson.
"Jaiden, we didn't know you were helping Jackson." "I am, and I will be for a couple of days with my brother-in-law, Richard. How was Jackson riding in your car without wearing a seatbelt? When he hit the dash, it compressed a disc between the C-4 and C-5 vertebral bodies and bruised the thoracic spine. I hate to tell you this, but soccer is out for the rest of the year until the neck heals itself. One good hit or one bad fall, and the disc can rupture, and if that happens, it means surgery, and that will undoubtedly end all sports activities."
"Jaiden, I didn't realize Jackson had undone his seatbelt. I should have noticed, but I didn't. Now we both have to pay the price for what he did. He has to suffer the pain and give up the one thing he loves the most, and I feel like a schlep." Jaiden looked at Helen, and tears were rolling from her eyes." He wanted to crawl their case, but they were punishing themselves. Jaiden would keep mum with his anger; Jackson's injuries were senseless.
When Peyton arrived at the hospital the next morning, he went directly to Jackson's room. Jeremy and Helen were sleeping soundly in the room, so Peyton was as quiet as he could be as he examined Jackson. Jackson's neck was severely swollen, and his back didn't look any better. Peyton prescribed an anti-inflammatory, and if the swelling wasn't better by evening rounds, an MRI would be ordered to ensure the disc had not ruptured during the night."
"Jackson, your neck is extremely swollen this morning, more so than last night; how does it feel to you this morning?" "Peyton, last night, it felt like a nasty bee sting at one point. It hurt so bad." "Jackson, did you call a nurse when that happened?" "No, sir." "Jackson, that could be a sign the disc in your neck ruptured. I was going to wait until this evening to get another x-ray, but since you said it stung last night, I am going to go ahead and order a CRT with contrast; that's a special x-ray, and they will give you another shot like they did last night before the MRI. Janice, can you send the order to radiology and get the CRT as quickly as possible with a wet read?"
Janice went to the nurse's station and called-in the order for the CRT. She went back to Jackson's room and told Peyton radiology was on the way.
"Jeremy, Helen, I need you two to wake up for a minute. Jackson's condition deteriorated over-night, and radiology is on the way to take Jackson down for a CRT. I am concerned that the disc in his neck ruptured, and we need to make sure. If it did rupture, a surgeon will have to be called in to repair the disc. They can put in a moveable device so his neck movement will be almost normal, but that will be the surgeon's call. The radiologist will read the CRT immediately and call me; as soon as I know something, I will let you know."
Peyton continued his rounds. An hour into his rounds, the radiologist called, and Peyton's worst fears were realized. The disc in Jackson's neck had indeed ruptured overnight. Peyton had Janice page the staff orthopedic surgeon who met Peyton in Jackson's room.
When the surgeon explained to Jeremy and Helen what had happened and the surgery that would be required, Jeremy collapsed. Helen did her best to help Jeremy, but Peyton had to revive Jeremy with ammonia.
The surgeon ordered a surgical suite to be set up, and Jackson would be in surgery within the hour. Peyton called Jaiden and filled him in on what was happening.
Three and a half hours later, Jackson's surgery was over, and he was in recovery. Peyton went to the recovery room to talk with the surgeon and was told the damage to Jackson's neck was worse than expected, and two discs had to be repaired, so the vertebrae had to be fused. Jackson's sports days are over, and Peyton has to tell Jackson when he awakens.
Peyton went to Jackson's room and told Helen and Jeremy the bad news. Both parents started sobbing. Peyton sat with them until they calmed down. They would have to be extremely calm when Jackson was told the bad news. That was not something Peyton was looking forward to doing. Peyton told Janice to page him when Jackson returned to his room.
About an hour and a half later, Peyton heard, "Peyton; 229. Peyton; 229.
"This is Peyton." "Jackson is back in his room." "Thank you; I am on my way."
Peyton lowered Jackson's bed so he could sit in a chair and talk with Jackson. He pulled up a chair, sat down, held Jackson's hand, and said, "Buddy, we need to talk."
"Jackson, the damage to your neck was worse than expected. When the surgeon got in your neck to repair the disc, another disc had ruptured, so he had to fuse two of your vertebrae. I am so sorry, but you won't be able to play sports anymore; it will be too dangerous for you to do that."
Jackson closed his eyes as a tear flowed from the corner of his eye. Seeing that was incredibly hard on Peyton.
"Jackson, this machine is a pain medicine pump. This is the control to the pump. You can mash the button every 30 minutes to give yourself some pain medication if you need it. You can't take too much, so don't worry about that. If you need the pain medication, mash the button, OK." "Yes, sir."
"Helen, Jeremy, the pain medication is morphine. Sometimes it can make it difficult for the patient to urinate. If you notice that happening, call the nurse immediately. We can insert a catheter if necessary, until Jackson no longer needs pain medication. Here is my cell number, call me if you need to. We're friends, so I don't mind if you call." "Thank you, Peyton, we appreciate this." "it may do you some good to call Rabbi Kravitz. He's good at helping people with their stress."
Peyton had completed his rounds, so he headed to the ER hoping all the way that the evening would be uneventful, and it was.
Richard came in at eight and did chart reviews with Peyton. When he saw Jackson's name, he asked Peyton, "what's this about?"
"Richard, Jackson had unbuckled his seatbelt, and Jeremy didn't notice. Jeremy was rear-ended, and Jackson was thrown into the dash of the car. Hitting the dash caused a disc to bulge, and last night it ruptured. He was taken into surgery, and there was a second rupture that didn't show on the MRI or CRT. Two discs had to be fused, and his sports days are over. He is horribly upset about that. He is on a morphine pump that is set for every thirty minutes and no more."
"Peyton, that sucks. The Marcus' are good people, very active in the synagogue." "Yes, they are, Richard. When Jackson started crying when I told him he couldn't play sports anymore, it took everything I had in me not to lose it too." Be sure to watch the swelling in his neck; it has been severe since surgery, and we don't want his throat to swell and make breathing difficult for him." "I'll keep a close eye on him and call the surgeon if I need to." "I'll fill Jaiden in when I get home."
"We have done chart reviews, so I'm headed home. Call us if it gets busy and you need help." "I will. Try to get some sleep. The boys were in a good mood when I left home, but they should be asleep now. It was fun playing with them before I came to work."
"Hello, Sweetheart, I'm home." "How did the day go?" When Jaiden asked that question, tears fell from Peyton's eyes. "Jaiden, it was horrible. Jackson said his neck hurt last night like a nasty bee sting, so I had a CRT done with contrast to make sure the disc didn't rupture. It did. I called in an orthopedic surgeon, and he reviewed the CRT scan, and Jackson was in surgery within an hour. When the surgeon got into Jackson's neck, two discs had ruptured, and one didn't show up on the CRT. Two vertebrae had to be fused, and I had to tell Jackson he couldn't play sports anymore. He closed his eyes and started crying, and it took everything I had in me not to lose it."
Jaiden sat on the couch in the den and pulled Peyton onto his lap. He held Peyton's head to his chest and gently rubbed his husband's head, and ran his fingers through Peyton's hair. He kissed his sweetheart on the head and quietly held him. Jackson reminded Peyton of Seth's hospital stay, and Peyton had a hard time with that.
Jaiden picked Peyton up and carried him to their bedroom. He laid Peyton on their bed and removed his shoes. Then he removed Peyton's socks, unbuckled his belt, unsnapped his pants, lowered his zipper, and pulled off Peyton's pants and briefs with one tug. Then he unbuttoned and removed Peyton's shirt and his tee-shirt.
Jaiden then pulled the covers back and placed Peyton under them. He removed his clothes, got into bed, pulled Peyton to him, and then cuddled his husband. They slept the next morning until they heard their sons stirring about.
Jaiden and Peyton got up, dressed, and went to their son's room to help them potty and then eat. After the boys ate, they pottied one more time and then went back to sleep. Peyton and Jaiden did the same thing.
Two hours later, the boys woke up ready to play. After they pottied, their Dads had the best time playing with their sons. The boy's personalities are really coming out, and as feared, they seem to be just like Jenny and pulling their pranks on their Dads.
Peyton called Jenny's at nine Oregon time and told Jebet he was mad at her. She asked why, and Peyton said the boys were just like her and were learning to pull pranks on their Dads. Jenny started laughing so hard she started coughing. "Peyton, that is hilarious! I can't wait to see them doing that to you and Jaiden. That is so funny. Have you told Mom and Dad?" "Not yet, but I will call them shortly. It has been a rough two days, and I am trying to wind down. A 10-year-old boy in our synagogue was severely injured in a car accident and wound up having surgery to fuse two vertebrae. I had to tell him he couldn't play sports anymore, and when he started crying, it took all I had not to lose it. They are friends of ours, and Jaiden was on duty when they came into the ER by ambulance. When I went on duty to do rounds, he said his neck hurt the night before, and it felt like a nasty bee sting. I ordered a CRT with contrast, and an hour later, he was in surgery. It was like reliving Seth's hospital stay. I have to develop a thick hide if I am going to practice pediatric oncology and surgery."
"Peyton, I am so sorry you have had cases like that. You are a good man, and you know that. I don't think you would be as good as you are if you weren't so compassionate. Don't lose that quality." "I won't, Jenny, and neither will Jaiden."
A few minutes after talking to Jenny, Peyton's Mom called. She said, "Peyton, talk to me. Jenny said you had several rough days this weekend." "Mom, a 10-year-old boy in our synagogue was in a wreck with his Dad and had to have surgery to fuse two vertebrae. I had to tell him he couldn't play sports anymore, and he took that very hard. It was like dealing with Seth's case all over again, and that was tough on me. It took all I had not to lose it."
"Jaiden was doing rounds when he got a call that the ambulance was bringing the boy to the ER. I got the brunt of the case getting bad very quickly. Jaiden was so sweet to me when I got home. If it hadn't been for him, I would have gone to pieces when I got home. I am going to have to develop a thick skin when Jaiden and I start our practice in pediatric oncology and surgery." "You will, Peyton. When the cases become more common to you, you'll toughen up. Just don't lose your compassion for the children." "Mom, that will never happen; that is a promise."
"Are you and Jaiden off today?" "Yes, mam, but it is turning out to be a tough day at home too." "Why?" "Jaiden's and my worst fears are coming true." "What do you mean, Peyton?" "All five boys are turning out to have Jenny's sense of humor, and at seven months old, they are already starting to pull their pranks on Jaiden and me."
Peyton's Mom started laughing hard, and his Dad wanted to know what was so funny. She handed Jim the phone and said she was talking to Peyton.
"Hey, son, this is Dad. What's got your Mom laughing so hard?" "Dad, it is a problem with the boys." "What sort of problem, Peyton?" "Dad, they have Jenny's sense of humor, and at seven months old, they have started playing pranks on Jaiden and me." Now Peyton's Dad was laughing. "Son, I warned you about that possibility. Get ready; it is going to be a fun, lifetime ride if they have her sense of humor." "If they have it, IF THEY HAVE IT? Dad, they already have it, and it is obvious. They know precisely what they are doing!"
"Peyton, that is too funny. As they get older and you get used to their personalities, it will be a lot of fun for you; trust me on that."
After Peyton and his Dad hung up, Papa and Granny called and said Peyton's Dad told them the boys were turning out to be pranksters like Jenny. "Papa, Granny, they are, and they know exactly what they are doing when they pull one of their pranks on Jaiden and me. You can see the wheels turning in their heads. It is hilarious!" "Peyton, if they are taking after Jenny, it has to be hilarious. They will be a lot of fun for Jaiden and you when you spend time with them. Life will never be boring." "Believe me, Papa, we are at that point now. The boys are hilarious as they are plotting something together. It is evident when they are ganging up on is." "Peyton, all you Granny and I can say is: get ready, son, you are about to embark on a 20-year rollercoaster ride!" "Thanks a lot, Papa. By the way, did Jaiden and I tell you that we are planning on the boys staying with you and Granny during the summer?" "Peyton, keep thinking that; your Granny and I will start spending summers in the UK. Well, when you do, look up Jaiden's first cousin. He should be easy to find since his name is Jaiden Reynold's and his husband's name is Payton, just one letter different from my name."
"Peyton, are you kidding me?" "No, sir, I'm not. Jaiden got an email from him one day, and he verified everything with his Mom. They still live in the same town where Jaiden's grandfather lived. It turns out his grandfather had a penchant for women. Jaiden has a big family in the UK, and they seem to have the same names as their relatives on this side of the big pond. Jaiden in the UK is my Jaiden's first cousin once removed. He has a gorgeous cousin named Donna over there we want to visit when He, I, and our brothers take our ten children over there. They communicate regularly by email. She is a genuinely upbeat, sweet lady. We can't wait to meet his cousins, especially his cousins Ian, Alan, Kath, and, of course, Donna." "Peyton, I hope you, Jaiden, Charley, and Dale can take all ten children with you when you go, and I hope it is sooner than later." "Papa, we are going as soon as we complete our residencies and internships. Ginny, Gampy, Granny, and the Reverend are going with us along with Jaiden's Mom, Mom, Dad, Seth, and Richard. We're going to make it a family affair