Tuesday May 26th 2009: ?? Diabetes Insipidus ??
No, this is not what you are thinking...Will does NOT have diabetes...what he may have is something called diabetes insipidus or "DI." Today was a challenging day, not a bad day by any means, but there were a few bumps in the road. He had speech therapy this morning which will definitely be his least favorite therapy because it's all memory and brain work outs to help with his brain injury. For instance, a few exercises he did today was to name as many states, foods, and animals all within one minute for each category. He also had to provide "yes or no" answers to questions like, "Does a tree have more leaves than a bush?" "Is your chin above your neck?" He also had to provide detailed answers to questions like, "What would you do if you were out to dinner and you had left your wallet at home?" "What would you do if your car ran out of gas?"
Anyways...back to the "DI" thing. He has been having high amounts of urine every time he gets catheterized. He is putting out way more than he is taking in. When you have a brain injury sometimes you develop "DI." Part of your brain (the pituitary gland) produces a hormone known as anti-diuretic hormone (ADH). With DI, ADH does not get produced and your body starts to put out large amounts of unconcentrated urine. This can be dangerous. Will also has low sodium levels yesterday and today which can also be dangerous. The nurses and docs are on top of everything though. He is on a 24 hour fluid restriction (he can only have 1.5 liters to drink for the next 24 hours). He is also taking salt tablets and having his labs and urine monitored frequently. He also had to have a Foley catheter re-inserted. We will know more in the morning if he truly has "DI."
Other than these events, he also had PT this afternoon. Or I should say I had PT. He didn't have to work out too much today, but Blair did start doing some education with him and myself. She talked to him about 2 common and possibly life threatening conditions that can occur with spinal cord injuries. The first being autonomic dysreflexia and the second being orthostatic hypotension. (Given that it's almost my bedtime I am not going to go into detail here and I will do a separate post in the near future about these conditions.) After Blair did some education, she took us outside and taught me how to get his chair up over curbs and also how to get him up and down stairs. Doing the stairs is a 2 man job and is something you cannot do by yourself. I will soon get checked off to get a "push pass" which means Will is allowed "off-campus" as far as he can push himself as long as I go with him. The next step is for him to get a "day pass" so we can go out in my car for an outing. Next week he will start working on how to transfer himself in and out of my car. His transfer are slowly coming along. He is slightly impaired due to all his rib fractures. It's just very painful for him to do any movement (and as you can imagine, moving is the name of the game down here!) We did have one very scary moment this morning. He was sitting up on the edge of the bed during his OT session and he lost his balance and just fell completely backward on the bed. His head came VERY close to hitting the bed rail and I thought we were about to face a 2nd brain injury! Both he and I had to collect ourselves before the session continued. SCARY!