Emma wakes!

Fantastic news today - Emma is awake and has been breathing on her own for the
afternoon. The surgeon and doctors are very happy with the results.
Emma is having hallucinations from the ketamine as expected and this will continue for at least the next day but she is doing really well and is remaining quite calm.

Today's update

It is now 48 hours since surgery and Emma is continuing to do well. The
surgeon was very pleased with her progress and her condition is
improving. She is peaceful and still sedated. We are very encouraged
by the results of the last 2 days and hope beyond hope that she
continues to improve. Thank you to everyone for your messages of
support and prayers.

Surgery

The serious complication and infection Emma suffered early into the coma has meant that she required surgery last night to her abdomen. She is recovering well and the outlook is very good, although we know the next couple of days could be difficult. She has responded well to the surgery and she is still sedated and on ventilation. We are just taking one step at a time, with lots of prayers & faith.

Day 9

The Doctors’report this morning was quite good, Emma is still improving, her blood work is getting better by the day and her abdominal & lung x-rays are OK too. Yesterday she had her antibiotics changed and this seems to be bringing down her fever. She is still sedated. There is a delay in waking her up for another day or two to make sure the infection remains under control.

We can feel all of your positive energy coming our way and we're sure Emma can too!

more sleep required

Overnight Emma did very well, blood tests and X-rays were all good and continue to improve. Her digestion is getting better each day. They want to kept her sedated for another day or two as they don't want her to wake today in case she might be too uncomfortable. She is mostly still fed through the blood, but yesterday they introduced a small amount through a line into her stomach and she has tolerated it well, in fact they think this is why her abdomen sounds much better today. They are taking the feeding to her stomach conservatively, while still giving her the best nutrition.

We will keep you posted!

Day 6

Today Emma has been taken off all sedation, including ketamine to allow her to begin to come out of the coma. Her lung function and x-ray continue to look really good. One of drugs they have used to sedate her is long lasting so sometime over the next day or 2 she is expected to begin to wake up. They don't want her to wake yet as they'd like a day without ketamine first as she will be much calmer then. Her lab results are getting better each day and her bowel continues to move – albeit slowly. The way her breathing machine works has been altered to allow her to initiate each breath which she is doing well - the machine did it all for her when she was sedated. The Doctors are pleased with her progress and each day she is improving. Everything is on-track, and the Doctors are feeling positive about good pain results, although that won't be known for quite a while yet – so we just wait some more...

Day 5

This is now Day 5 of Emma’s coma (Day 4 of ketamine), and she continues to improve following the infection from 2 days ago. All of the blood results, x-rays and scans are continuing to improve so Dr Cantu is continuing the ketamine and it has now been raised to 6mg/kg/hour (as per the protocol). Her bowel is continuing to move and do what it is supposed to do, although slowly, but it is OK and they know it will just take time. At this stage, it is estimated that Emma will remain on ketamine for 2 more days and then they will decrease the ketamine to slowly let her wake over the following days.
So she is doing great and she continues to be looking restful and her blood pressure, heart rate etc are good.
Today we met Jessica and her Mum Sarah from New York. Jessica has recently had the ketamine coma and she is in one of the hospital recovery rooms and doing really well. It was great to meet with a family that has had a loved one go through the ketamine coma and we know that Emma will love to meet them in the coming week.

Ketamine starts again

We are 4 hours into day 4 of the coma which has started on a very good note. The infection that Emma has been battling with for the last day has responded very well to the antibiotics and other medications. Emma has been paid very close attention by the ICU staff over the last day as they adjusted medications to ensure she was on the right track. The entire team of doctors (3x RSD/ketamine, 1x ICU, 1x gastro, 1x surgeon) were back in her room just 1 hour ago and the mood was very positive. Her liver function has improved to the point where they are happy that reintroducing ketamine will have no negative affect on the infection and that its analgesic properties will be beneficial. Regular blood testing & x-rays are continuing to monitor Emma’s progress and Emma’s temperature is now in the normal range.

Update from the ICU

Emma has been in the coma for 52 hours so far and unfortunately it has not been going as smoothly as we’d like. The first 24 hours went very well. It is quite usual for the ketamine coma to be a light coma at first and so she would grow restless every hour or so and would be given a slight boost of extra ketamine to deepen the sleep. The second day was when a few problems arose. The problem in Emma’s case was that instead of the bowel clearing in the first couple of days as expected it has remained blocked and distended her abdomen. This has caused a slight infection and lowered effectiveness of liver and kidneys. Because of this Emma has been put on antibiotics and taken off ketamine but is still in a coma using other medication. The aim is to clear the infection and wait for the bowels to clear before reintroducing ketamine. This situation has only happened to one other ketamine coma patient and so there has been a team of doctors in the ICU examining Emma so we feel that she is being very well cared for. X-rays and blood samples are frequent to monitor her status. The problem with the bowel has meant that Emma has been fasting for the last 24 hours and they have just now begun feeding her direct into the blood stream. Her temperature is not too high at present (37.4degC) and the antibiotics should soon do their work.
Emma is calm and peaceful and the doctors have told us her condition is stable and so we wait for the blood results to improve before expecting any change.

Thanks to all of the people involved with the concert for Emma last night in Hamilton. We hope that it went well. We see that there was quite a storm in NZ last night so we hope that everyone still got out and had some fun!

Sleeping Beauty

We had a very calm start to the day and arrived at the Hospital without a problem. Emma was relaxed and in very good spirits. She was thirsty as she was not to have anything after midnight. The admission was easy and then Emma was shown to a room in the ICU and the doctors and nurses started preparing her for the coma. Emma gave Dr Cantu a collection of NZ music on MP3 that she had been making over the last few days. Very soon we said our good-bye's and they put her to sleep. To Emma the time in the coma will seem like 5 minutes. Nikki and I waited outside the room while all of the lines were put in and she was intubated (tubes for breathing and feeding). The ICU staff were all very calm and welcoming - the hospital is very quiet today because of the national bicentennial holiday. They are moving Emma to a bigger room and we will be able to go back in and see her after they are finished getting everything set and have done a few tests (X-rays etc.) Dr Cantu has told us that everything went perfectly which is great news!

24 hours to go

After our long wait we are now only 24 hours away from Emma’s "big sleep". The coma will start soon after Emma’s admission, around 9am Thursday 16th (that’s 2am Friday 17th NZ time).

Thank you very much to everyone for all of your support and kind wishes – Emma has been very excited to hear from you all (and we have too)!

The coma is usually started on a Sunday because the hospital is at its quietest but Dr Cantu has to be out of town until tonight so the coma will start tomorrow morning. This coincides with Mexican Independence Day so it will also be a quiet day at the hospital. Independence Day is a bicentennial this year so a really huge event. There are lots of “Viva la Mexico” decorations and items for sale.

The weather in Monterrey has been 30+ degrees every day since we arrived. Some days have had a breeze to clear the smog and the mountains are very beautiful rising 2 miles above the city.

The view from the 12th floor of the hotel

Visit to San Jose Hospital, Monterrey

We met with the Hospital’s International patient co-ordinator and she speaks English very well, so it made our visit easy. We took a peek at the ICU and a recovery room similar to the one Emma will be in when she is discharged from the ICU. The ICU is just like any one we have seen, with lots of people hooked up to heaps of machines. The recovery room is really nice and quite spacious and has its own bathroom and sofa so when Emma is up to moving around, she will appreciate her own bathroom and space.
Emma is scheduled to be admitted this coming Thursday morning 9am and all the paperwork is complete and ready for her arrival.
We had another visit from Dr Cantu at our hotel, he is very easy to understand and open about things. We discussed in more detail the procedure and what we should expect throughout the treatment. We know that Emma will have catheters in her arm veins for the ICU team to test her blood daily to ensure her kidneys & liver are working properly and she is has the right amount of oxygen in her blood. Other tests the team perform daily are x-rays to ensure Emma’s lungs are healthy. There are other tests also to observe changes in her RSD symptoms like temperature on different parts of her body (as she currently has quite a mixture of temperatures throughout), inflammation and colour of skin. Emma will of course have other tubes like the two through her mouth for breathing and feeding. The drugs used to anesthetise Emma will be through the IV line and will be slowly increased during the five days and this is to ensure she remains under general anaesthesia. After the 5 days, the quantity of ketamine is decreased slowly until Emma wakes up. They have found that it is much better for the patient to slowly come out of the ketamine coma, so it is likely that it may take Emma a couple of days and these days could be some of the toughest for us.
Dr Cantu has stressed to us, that it is important that Emma takes things very slowly after the treatment and that her rehabilitation needs to be slow and continuous; small steps each day.
Emma has been resting up heaps and eating really well. We are pleased with our hotel here and it has a free shuttle to the hospital which we will use lots in the following weeks. Our hotel is located across the road from a supermarket which has been really handy to get good food. Our hotel also has its own walkway across the highway (accessed only by hotel door key) to a good mall which has been fun to take a look around.

Tampa - Downtown Riverwalk

San Jose Hospital, Monterrey - from Cerro del Obispado (Bishop Hill)

Hola Amigos

Well we've arrived in Monterrey! We arrived yesterday afternoon and stayed one night at the holiday inn. It's been quite amusing at times trying to talk to people that know little or no english, but we're having fun and I've decided we're all going to try to learn a new sentence each day.
Sentence for today is:
Por favor nos trae la cuenta
It means please bring the bill, dad tried it out on the waitress for our brunch this morning and she seemed to understand him fine!
We are now at the hotel that we are going to be staying at, it's near the hospital and there will be a free shuttle that can take us to the hospital, which is great!
We met with Dr. Cantu last night, he made a visit to our hotel. It was really good talking to him. He told us there is going to be five senior doctors that will be over-seeing my medical care and at least one will be there at all times. He also said that all the doctors live within 10 minutes of the hospital and that we can contact him 24 hours a day, 7 days a week, which is good!
We are going to go to the hospital tomorrow to check it out.
Nothing much is happening, I haven't seen any lizards here... I'll have to find out if they're here as well.
It seems a lot cooler here, although it is the same sort of temperatures, it doesn't have as high humidity so it's much more comfortable.
Much Love,
Emma

Adios!

High School Fundraising Concert

A big thank you to Scott, Tony and many other helpers from Hamilton Boys' High School Leo Club and the Hamilton C.B.D Lions Club for volunteering to put on this great fundraising concert for Emma!

Here are the details:

The Hamilton Boys' High Leo Club in conjunction with the C.B.D Lions Club are holding a charity concert for High School Students from the Waikato Region.
This whole event is dedicated to fund-raising for Emma and is being organised by Hamilton Boys' High student volunteers.

• Date: Saturday September 18
  
• Time: 7:30 to 11pm
  
• Venue: The Meteor, Hamilton
  
  
• More info is available on the concert facebook page
  

Confirmed Artists:

• The Good Fun
  
• Tied on Teeth
  
• DinosaurGoesRawr
  

*Tickets are $10 and a School ID will be required* ( unless another agreement has been arranged)

Heading to Monterrey

In the past week it was a relief to be able to book more than one night in advance but we have still had quite a few hiccups with arrangements for the hospital in Monterrey. Dr Kirkpatrick has been very helpful and he and Dr Cantu have worked for us to sort out the problems. We are all set to fly out to Monterrey tomorrow morning (Sunday) via Houston. We will meet with Dr Cantu on the 9th and the coma should now start on the 15th. So still a long time to wait but we will meet with hospital staff on Monday so it will all seem a lot more real by then.

We rented a car this week and that made things a lot easier - we could drive to the shops, supermarket etc. Emma continues to struggle with the travel and spends most of her time in the hotel room trying to get comfortable. We have managed a couple of sight-seeing activities - two nights in St Petersburg on the other side of Tampa Bay - highlight was the St Pete's Pier and the lowlight was the grotty hotel. On Thursday we spent the afternoon at the Tampa zoo. Emma was extremely excited by all of the animals but the turtles, manatee's and giraffes were the highlights. Hurricane Earl looked huge next to Florida on the weather-map for most of the week but was never forecast to hit Florida. The storm made Florida much drier than usual and we continued to get hot sunny days. The lower humidity made our afternoon at the zoo much more comfortable but it was still over 34 degrees C. There were three other major storms forming in the Atlantic behind Earl and one which was likely to head in to the gulf of Mexico but these are all weakening now and don't look like they will disrupt our travel plans tomorrow.

We are thinking of our Cantabrian friends and relatives as they deal with the major earthquake there last night. The damage looks significant but it's great that the casualties are so minimal.