Personal Experience after Many Years as a Nurse

[pblottRN]

I've just recently lost my son (17) after a freak accident where he was playing a pickup game of football during baseball practice (to get in their conditioning/running/exercise instead of just running laps, etc) and he went back to catch a pass, tripped in a rut, and fell, landing on the top/front of his head.

Initially, it appeared that he strictly had a severe spinal cord injury due to a C5 fracture. He was awake and alert, talking and breathing well, but had no movement from nipple line down and only some sensation and a slight Babinski reflex left foot only. We were hoping that it was just a stinger or spinal cord trauma, but quickly saw on CT what a horrible fracture it was. (I am a nurse of many years, fwiw)

I was able to be with him in the ER, thank GOD, and was talking with him when he suddenly became violently ill, vomiting without the diaphragmatic control or strength to do so, laying flat of his back in a high C collar. The neurosurgeon and I log rolled him and I suctioned him while he vomited and this continued to get worse. He was given 4mg of Zofran for the nausea, and became groggy, but within about 10 minutes, he was completely non-responsive and decompensating with his breathing terribly. This was all while we were wheeling him from ER to OR and by the time they got him intubated and vented, he was in traction with a beautifully reduced C spine fracture. Probably one of the most easily reduced and well aligned I've ever seen. He had surgery at that point to remove the shattered vertebrae, disc remnants and replace with cadaver bone and fuse to C4 and C6. The surgery went beautifully with very minimal bleeding and the aligment and hardware all looked great. The surgery was completed around 7:00 pm or a little bit later.

He was brought back to an ICU suite to begin to wake on his own. This is a healthy, strapping 17 year old athlete with absolutely NO health problems that we are talking about. We went in to see him as soon as he came back and of course, was still asleep.

However, as the night wore on, he was not awakening nor reacting to us at all. Neuro checks were "ok"....pupils reactive, responsive. At first we thought he was just extremely sensitive to the anesthesia, as he'd never had surgery or meds at all. The neurosurgeon called me and told me that he'd realized that there was not a CT of the head done, in all the excitement over the neck fracture, and he wanted to send him back to CT. Of course!

Well, later in the night, the neuro and I were at the desk, talking over this case (my beautiful son, but me trying to be clinical) and he tells me that the vertebral arteries looked great on the CT, but that there is some opacity of the basilar. However, there were no signs at all of any infarct or bleed, so he just wanted to "watch it". We looked at the imaging together and the brain looked great, I'll admit. I had a niggling concern about the basilar opacity and why we weren't pushing that, but this is a wonderful doc we're talking about and I figured he knew best.

He calls me sometime later and tells me that my son has developed hydrocephalus and he's taking him back to surgery to place a shunt and ICP monitor. And we wait.

By 6:00 the next morning, I knew something was different. His pupils were very sluggish and he was simply not responding at all to anything. Sternal stim, pin prick, light, girlfriend, nothing.

I went out to the car to rest a bit after visiting and was soon called back by the nurse, telling me that there was a change....BP was bottoming and pulse was racing. We came back in and body temp was rising. I immediately knew we were looking at a brain stem stroke.

Of course, it was worse than just that (if there is such a thing) and we were soon told that he was "locked in". I almost lost it, because after taking care of patients in this condition, I felt that this was the most horrible situation anyone could be in. Soon after, both pupils were blown and he failed apnea testing miserably.

I had already declined a feeding tube the day before, because of the ethical and legal issues involved and knowing my son's wishes. He had also made the decision a year ago to be an organ donor, so I went ahead and told the doctor to begin preparations for that. He was stunned by this whole ordeal.

This has only been 2 weeks ago for me, and I am so very lost without my son. This neurosurgeon has been in practice for 25 years and is a wonderful surgeon, with many awesome successes where none were expected. He told me that he had NEVER treated a case that progressed like this in his 25 years in practice.

I begged them to sedate him while waiting for the organ donation process, because I could not bare the thought of him possibly actually having locked in syndrome (mother's minds, you know) and being afraid or in pain with no way to let us know. They were gracious enough to comply with my request, but I still find myself scrounging for all the clinical information I can find to reassure myself that we made the right calls.

I need to reassure myself that my child was ok and not in pain or fear, and this article is a great one. Please excuse the wordiness as this is still a very fresh pain for me and I guess I'm trying to "talk it through". I've never hated being a nurse as much as I did through this ordeal, knowing what I was seeing and being so very helpless.

[JustBeachyNurse, LPN]

I am so sorry for your tragic loss and this horrible sudden turn of events. It sounds like you did everything humanly possible within your power and capabilities.

Perhaps there is a grief support group in your area for parents who have been through tragic losses? Your church leaders? Or even your facility's traumatic loss support group or critical incident stress debriefing team that can assist you in your quest for information and support.

May peace be with you and your family at this most difficult time. I know there are no words that can help and I cannot imagine being in such a position as a parent and a nurse. Just know that you are in my thoughts and I'm sure the thoughts of many others in this group.

[Esme12, ASN, BSN, RN]

Beachy is right we cannot give medical advice......However, Mom....I think you have been through a horrific experience and being a nurse gives us Moms NO comfort. What a horrible accident...I can't even wrap my brain around what losing a child would be. Words cannot express how sorry I am for your loss.

I think you need to have faith that everything was done for your son. That everything offered to you was the best and you made the best decision you could under any circumstances. I think that your son knows how much you love him. How much you miss him. I think that your life has changed forever and I have no words of advice to help your pain.

I know that as an ICU nurse once brain death has been declared.....there is no brain activity to have/perceive pain. I believe your son was not in pain.. and that you did your very best for your son. He is lucky to have a Mom like you.

My deepest condolences for you and your family at this tragic time.

My heartfelt prayers for you to someday find some peace ((HUGS))

[sbostonRN]

I'm so sorry for your loss. Definitely seek out a support group in your area, you don't need to go through this alone.

[applewhitern, BSN, RN]

I am so sorry for your loss. My son passed away 3 years ago. I also referred to him as "my beautiful son." I am always available if you ever need to talk to someone.

[salvadordolly]

God bless you and your family in this difficult time. You made the best calls any MOM could be forced to make.

[Tait, MSN, RN]

I am so sorry for your loss. I hope you can find peace in the situation when you are ready.

Tait

[xoemmylouox, ASN, RN]

I am so sorry for this tragic loss. You followed through with your sons wishes which, respecting the choices he wanted. You ensured he wasn't in pain. And you made sure he didn't suffer a future of frustration and confusion. You made desicions no parent should ever have to make, and in the end you saved countless other lives. Again I am so sorry, please seek help in whatever way works for you.

[madwife2002, BSN, RN]

I am so sorry for the loss of your son, I read your whole story and my heart aches for you

[rn undisclosed name]

Sorry for your loss. I can not imagine. I would love to have seen the article but it appears it was removed.

Remember to take all the time you need. I do think a support group would be incredibly helpful to your situation.

It is so hard to know if you did the right thing. It sounds as if things progressed so quickly and you were forced to make a decision in a moments notice. But knowing that you respected your son's wishes should provide great comfort to you. Hugs to you!

[drowningdaily]

I am so sorry for your loss. You did an amazing job of advocating for your son. Losing a child is any parent's worst nightmare. I pray for you and your family. May peace be with you,

[JustBeachyNurse, LPN]

I would love to have seen the article but it appears it was removed.

There was no link to an article that was removed. The OP is referring to her post here on allnurses describing the events as an article.