After what seemed like forever, Dr. Cornwell arrived with some good news. “Mrs. Newman, your husband has stabilized somewhat, he’s in the ICU, in a private room, of course, with any luck, you can see him fairly soon. He should be coming out from under the effects of the sedatives he was given during the surgery fairly shortly.”
“Thank you,” Nikki replied with a faint smile, thankful that, at least, at last, it was good news she was getting.
“You’re welcome, either Dr. Thorton or myself will come back to update you as soon as we have some more news,” Dr. Cornwell replied with a tired smile before walking back out into the hall.
Back in the ICU, the nurse at the front desk did as she had been told and within minutes all three doctors had converged on Victor’s room.
Dr. Cornwell spoke first. “You did the right thing, Carol.”
“There’s not much we can do but continue to monitor him and wait. Still, I’m glad you had us paged, we may just be able to save him yet.” Dr. Thorton agreed quietly yet regretfully.
“I’m not so sure we can do anything for him. We may have been able to before this, before he slipped into the coma. But, now-” Dr. Hoffman caught himself and told the nurse,
“Thank you, we’ll take it from here.”
With a small, sad nod, she left.
“Frankly, I think we all know what his chances are now. He might have had a chance had it not been for the coma. But now, I just don’t see how he can come out of this. The damage is too severe. I don’t see him making it.” Dr. Hoffman was brutally honest, and yet he was not without feeling, his voice not without regret as he gave his sound medical opinion on what he thought to be one of the worst cases he’d ever seen. ‘It’s a shame. The guy had everything, an amazing reputation, great family, all the money anybody could want, more money than most people ever dream of. Now all that’s up for grabs, his whole future is. I guess it just goes to show you can’t take anything for granted.’
Hesitantly, carefully, Casey entered the waiting room and stopped just a foot or two away from the couch where Nikki sat staring blankly at the letter she’d just read. “Nikki, how are you holding up?”
“Fine.” Nikki lied as she tried unsuccessfully to compose herself and dried her tears. “What’s going on? Have you heard anything?”
“No, not yet. I think it’s still too soon, the doctors are still running tests.”
“How many more tests do they need to run? How long does it take for someone to tell me what’s going on with my husband?”
“Nikki, I know that you hate waiting, but right now it’s the only thing you can do. Getting upset and confronting the doctors won’t help anybody, it won’t make things any easier. It won’t move things along any faster either. It certainly won’t help Victor!”
“So I’m just supposed to wait and do nothing, is that it? Come on Casey, you know I can’t do that!” Nikki bit out completely shocked at what she viewed as a total inability on her sister’s part to understand her reasons for doing what she felt she had to do.
“You don’t have a choice! There’s nothing anybody can do! All we can do now is sit and wait, that’s all we can do. Why can’t you understand that? Why won’t you even try to understand that? Why do you insist on being so stubborn at a time when you need to let the people who love you help you?” Casey railed, quickly reaching her breaking point thanks to her sister’s attitude. ‘She’s got the worst case of tunnel vision I’ve ever seen! Why won’t she listen to me? At this rate, she’s going to end up being a patient here, she certainly won’t be any good to Victor then!’
When Nikki said nothing, Casey softly told her, “I’ll see if I can track down Dr. Cornwell and Dr. Thorton and get some answers.”
“Thanks.” Casey nodded sadly as she walked out of the waiting room and past the front desk.
“Doctors Cornwell, Hoffman and Thorton are on their way to see you and Mrs. Newman.” the nurse told her.
“Thank you, Anna.” Casey said as she turned and started walking back to the waiting room. Then, turning back to the front desk she asked, “Who’s Dr. Hoffman? I’ve never heard of him.”
“I’m sorry, Dr. Reed. I can’t tell you any more. Doctors Cornwell and Thorton will be here in a few minutes to answer your questions.” Anna replied regretfully while trying to offer what help she could.
“Thanks. If you hear anything-”
“I’ll let you know.”
Somewhat satisfied, Casey walked back to the waiting room to sit and wait with her sister. “I just talked to one of the nurses and she told me the doctors will be here in a few minutes to talk to us.” Casey told her, trying to offer what little bit of information she could.
“Thanks,” Nikki said, only looking up at her for a moment before turning her attention back to the research, which she now saw as her only hope of helping her husband and his only lifeline.”
“Still at it, huh?”
“Yes, and before you even suggest it, I am not going to put it away.”
“Okay, it’s your call.”
Somewhat satisfied that Casey was willing to let her do what she felt best, Nikki went back to her reading. “Diagnosis of Strokes and TIAs: Diagnosis–it’s sometimes hard for doctors to diagnose TIAs because the symptoms have usually disappeared by the time the individual receives medical assistance. The most important thing about treating a TIA is prompt recognition that a TIA has happened. Tests are then preformed to find out why it happened. With this information, the doctor can work with the individual to plan the best treatment to prevent future TIAs or a stroke. Keep in mind the most significant thing you can do is to tell your doctor if you’ve had symptoms of a TIA or stroke.”
“There are several tests that doctors can perform to determine whether a patient has had a stroke. Tests that may be preformed include blood and urine tests, physical examinations, testing a patient’s reflexes, eye movements, speech and other body functions. Although physical exams help determine the type of stroke, other tests may provide mor information on how to treat it.
One of these tests is called angiography or arteriography. This a means of taking pictures of blood flowing through the arteries in the neck and brain. A dye which shows up on x-rays is injected into an artery and a series of rapid-image x-rays are taken while the dye moves through the arteries. These x-rays will indicate to the doctor how the blood is flowing and the size and location of any blockages. The procedure is also sometimes used to help identify problems or malformations in blood vessels, like aneurisms or arteriovenous malformation.
How to prepare–Let the doctor know about any allergies you have or any medications you’re taking. This test is done in a hospital. You’ll be examined and routine blood tests will be preformed before the test. Don’t eat or drink anything for four to eight hours prior to the test. You might be given a sedative an hour before the test to help you relax.
What to expect–You’ll be asked to lie on an x-ray table and your head will be immobilized. A needle will be inserted into an artery in the upper thigh or groin. Following the needle is a catheter (a long, narrow, flexible tube). There is a sting when the anaesthetic is given and the patient may feel a sense of pressure or discomfort as the catheter is inserted. When the catheter is in position, the contrast dye is injected. As the dye is released, patients may have a headache or feel flushed on the side of the face. After x-rays are taken, the needle and catheter are taken out, then a bandage is put on. Patients should keep their legs straight for approximately twelve hours following the procedure and may have some tenderness and bruising.”
Turning to Casey, Nikki asked, “How will I know which tests they do?”
“Nikki, we don’t even know if Victor had a stroke! We’re working on suppositions here!”
“I know that, Casey! But, it’s better than not knowing anything, it’s better than not doing anything while Victor’s in there fighting for his life!”
“Nikki, I probably know what the answer is going to be, but I have to ask. Shouldn’t we tell the kids about what’s going on?”
“No. Not until we know exactly what’s going on, I’m not going to get them worked up for nothing.”
“Nikki, you’re getting yourself worked up, maybe for nothing. I really think–”
“I’m not going to call them, Casey. That’s final!” Nikki’s tone brooked no argument as she glared at her sister stubbornly before going back to her reading.
“Tests for Stroke/Testing Information: Blood tests–Depending on what the doctor is looking for any of the following may be tested: how smoothly your blood flows through the vessels, the time it takes for your blood to clot, as well as the level of a clotting component named fibrinogen, your blood cholesterol levels, your blood sugar (glucose), and the level of calcium in your blood. What’s involved –No special preparation is necessary. Blood is taken from a vein in one arm. The arm is first cleaned with an antiseptic and then a tourniquet (an elastic band) or a blood pressure cuff is put around the upper arm, which makes veins in the lower arm fill with blood. A needle is inserted into the vein and the blood is collected in a vial or syringe. Once the blood is collected, the needle is taken out and a bandage is put on.”
“It’s good to know some of these tests aren’t too painful.” Nikki told her sister somewhat relieved.
“Believe it or not, we’re not out to hurt anybody. Doctors don’t like seeing patients in pain.” Casey tried to lightly get her point across, treading lightly so she wouldn’t start an argument.
“I know. It’s just hard to remember you have the same goals as your patients’ families sometimes.”
“Are we still talking about doctors in general or Victor’s doctors, more specifically Dr. Hoffman?” Casey asked, not bothering to be cautious.
“Casey, leave it alone!” Nikki warned, her voice dropping to a cold whisper.
Shaking her head and letting out a small sigh, Casey reluctantly relented.
Satisfied that Casey had again relented, Nikki went back to her research. “Although it’s not always possible at the time of an initial examination, a simple urine test can help a doctor diagnose conditions related to stroke such as blood clots, kidney disease, other metabolic diseases or diabetes.”
“I didn’t know they could diagnose so many things from just a simple test.”
“You’d be surprised what we can do with the right technology,” Casey agreed, still upset that she couldn’t get Nikki to stop reading all the medical research, to tell her children what was going on, or to give the doctors a chance. ‘Nikki’s the most stubborn woman I know! Doesn’t she know she’s digging herself into a hole she may not be able to get out of? What does she think will happen if she tells Nicholas and Victoria. They’d never blame her, she has to know that! They need to know! She has to stop giving the doctors a hard time too! They’re not trying to hurt her, they’re just being honest with her! The last thing she needs is for anybody to give her false hope!’ Casey thought to herself as she watched Nikki intently, shaking her head almost imperceptibly.
Choosing to ignore Casey’s obvious anger at her continued determination to handle things her way, Nikki read on. “Carotid Ultrasound (Doppler)–This test uses sound waves to examine blood flow in the carotid arteries-the arteries in the neck which carry blood to the brain. The sound waves are delivered via a transducer (a unit which directs sound waves), which is placed over the carotid artery. Sound waves are converted into a picture on a monitor. This type of ultrasound can aid doctors in finding any narrowing or blockages in carotid arteries.
What’s involved–No special preparation’s necessary. The patient will be asked to lie on his/her back on an examination table with is/her head supported, then a gel is put on the neck to help transmit sound waves. The transducer is moved back and forth over one side of the neck to get different views of the carotid artery. Then the other side fo the neck is checked. Once the doctors have clear pictures of the carotid artery, they’re recorded on film or video for later analysis. The test takes approximately fifteen to thirty minutes.”
Placing the binder down on the table in front of her, Nikki rose to pace the waiting room once again. Looking at her watch, she felt her frustration quickly reaching its peak. “I know some of these tests can take awhile, but what’s going on? Why hasn’t anybody come to see me yet?” She asked, frustrated and desperate for answers.
“I don’t know. I wish I did. They should’ve been here by now.”
“I’m sorry. I need to be patient. I know.”
“Nikki, you’re doing the best you can. Don’t worry about it.” Casey reassured her.
“Don’t worry about it? Don’t worry about it? If only it were that easy. If only it were that easy, Casey. I’d give anything to be able to just think about something else, even for a few minutes, but I can’t. I can’t, not while my husband is in there fighting for his life and the doctors are practically telling me to get ready to sign his death certificate!” Nikki exclaimed harshly, needing on some level for someone, anyone to feel even a little of the pain and fear she was feeling at that moment.
Remembering the soup, sandwich and milk Casey had brought her when she first came back from the cafeteria, Nikki sat back down to eat, although she didn’t have much of an appetite.
“I’m glad you’re eating. You need to keep your strength up.” Casey very wisely, very understandingly ignored her sister’s latest outburst.
“I know. I am trying.”
“I know you are.” Casey wrapped an arm around her sister, making Nikki smile in spite of the uncertainty she was facing.
“What? What is it? What’s wrong?” Casey asked alarmed.
“Give me your hand,” Nikki told her with a little smile.
As she did as Nikki asked, Casey felt two swift kicks and smiled, “That settles it, you’ve been driving them crazy too. They wanted to eat.” She said, only half joking.
“I know, I need to take better care of myself.”
“Yeah, you do.” Casey decided to let the subject drop. ‘The more I push this, or anything for that matter, the more she’ll just dig her heels in and ignore any advice, no matter who’s giving it to her.’She thought wisely.
Satisfied that, at least her twins were okay and she had her sister’s support, Nikki read on. “CT/CAT Scan–The test makes use of a computer system to provide a detailed image of brain tissue. This is often one of the first tests scheduled for someone who’s had a stroke, if it’s available. The CT scanner is a large device which takes a series of x-rays of the head. The pictures appear as a series of thin slices showing details of the brain’s anatomy. In some instances, a contrast dye might be injected to better define tissues and blood vessels on the scans and enhance the pictures. These pictures can show the doctor whether the stroke was caused by a blood clot (an ischemic stroke) or uncontrolled bleeding (a haemorrhagic stroke. They also help rule out other processes in the brain which may mimic stroke effects. ‘Clot busting’ (thromoblytic) drugs may not be given unless a CT scan has confirmed the stroke isn’t caused by uncontrolled bleeding.
How to prepare–Tell the doctor about any allergies or any medications you might be on. You may be given a sedative to relax. If a contrast dye is used or if a sedative is needed, you’ll need to fast for four hours prior to the test and drink lots of liquids on the day before the test. If no dye is being used, you will not need to fast. Remove all your jewellery before the test.
What to expect–You’ll be asked to lie on your back on a flat bed. Your head will be immobilized, then you’ll be moved into the CT scanner. The scanner takes images at different intervals and levels over you head, so you’ll feel the table moving during the test. Pictures are shown on a monitor and recorded on x-ray film. You need to stay perfectly still because any movement will distort the picture. A contrast dye may be administered through an intravenous (IV) needle or catheter, then the scan is repeated. When the dye is injected, you may experience mild nausea, flushing, warmth, or a salty taste in your mouth. This test usually lasts approximately ten to twenty minutes. However, with the contrast dye, it could take up to forty minutes.”
Meanwhile, at the ranch, Vicki was pacing, her imagination and temper starting to get the best of her.“Where’s Mom? She should’ve been back by now! Why hasn’t she called? What’s going on?” She murmured to herself as she paced the livingroom.
Finally fed up with waiting, Vicki picked up the phone and called Nick. “Have you seen Mom? Have you heard from her?”
“Hello to you too, Vick.”
“I’m serious! I’ve left at least a dozen messages on her cell phone and she still hasn’t gotten back to me! Nick, she should’ve been home by now!”
“Just calm down, okay? What happened? Where’s Mom?”
“That’s what I’m trying to find out. She hasn’t been by there? You’re sure you haven’t heard from her?” Vicki asked frantically.
“No, if I had I’d tell you. Vick, what’s going on?”
“Mom flew out of here hours ago looking for Dad. I tried to tell her to stay put but you know how she is. She should’ve been home hours ago. What’s going on? Where could she be?”
“Sis, calm down. You know what she and Dad have been dealing with. They probably just needed some time alone just the two of them. They probably just lost track of time, that’s all.”
“I wish that were true, but somehow I’m not so sure! When she left she was furious with him and worried that he hadn’t come home! I can’t say I blame her. But, the last thing she needs in her condition is to go crisscrossing the city looking for Dad.”
“Have you tried Aunt Casey? Uncle Douglas? Katherine? What about Hope?”
“No, I thought I’d call you first, I was hoping she’d pass by there.”
“Sorry sis, I’m sure she’s fine. If I hear anything, I’ll call.”
“Thanks. Wish me luck.” Vicki replied as she thought to herself, ‘I just hope I’m not too late. I hope it’s just my imagination running away with me.’
“I really don’t think you’ll need it, but good luck. Sis, I’m sure Mom’s just fine.”
“She’s not the one I’m worried about.” Vicki told him before hanging up and dialling her aunt’s number. After the fourth ring, she finally remembered, “Damn! She’s at work. Even if Mom was there, she wouldn’t have known!”
Taking a couple of deep breaths to try and steady her quickly fraying nerves, Vicki called Douglas. “Hi Uncle Douglas.”
“Victoria, this is a pleasant surprise. What can I do for you?” Douglas asked as a smile bloomed on his face.
“Has my Dad been by there, or my mom?” Vicki asked hopefully.
“No, I’m sorry, I haven’t seen or heard from either of them in quite awhile. Is there some sort of problem?” Douglas replied apologetically, starting to get a little suspicious.
“I really hope not. Call me if you hear anything, okay?”
“Thanks Uncle Douglas.” Vicki answered cryptically before hanging up and calling Katherine.
“Katherine, I’m glad you’re home. Is my mom there?” Vicki asked hopefully.
“No, I’m sorry, I haven’t seen or heard from her in quite awhile.”
“What about my dad?” Vicki asked, hoping against her better judgement that he’d at least spoken to Katherine.
“No, sorry. I haven’t seen or heard from him either.”
“Damn it, where are they?”
“Victoria, what’s wrong? What’s going on?” Kay asked, starting to get very worried.
“That’s what I’m trying to find out,” Vicki answered cryptically.
“If there’s anything I can do–”
“There is. call me if you hear from either one of them, okay. It’s really important.”
“Of course I will.”
“What in the world could be going on over there?” Kay asked herself as she tried to ignore the sinking feeling in her stomach.
“Here goes nothing, ” Vicki said to herself as she dialled Hope’s number
“Hello?” Hope answered after the third ring.
“Victoria, what a surprise. What can I do for you?” Hope asked cheerfully.
“Have you heard from either of my parents by any chance?”
“No, sorry. I haven’t seen or heard from them in a long time. why? What’s going on?” Hope asked, beginning to get alarmed.
“That’s what I’m trying to figure out!” Vicki snapped angrily. Then, a little calmer, she said, “I’m sorry. I’m probably worrying for nothing. Just call me if you hear anything, okay?”
“Sure. You do the same.”
“I will. Thanks Hope.”
As she hung up, Hope wondered aloud, “Could it be?” Shaking her head as if to try and shake off the ominous fear creeping into her inch by inch, she quickly tried to convince herself.
“No, Victor’s fine. He’s just fine. Victoria would’ve told me if he weren’t. He’s fine.”
Meanwhile, at Memorial Nikki was still deep into her research. “Echocrdiogram–An electrocardiogram uses soundwaves (ultrasound) to make a picture of the heart. The recorded waves show the shape, texture and movement of valves, along with the size of the heart chambers and how they’re functioning. This test also helps the doctor look at the heart wall motion. The test may be done to find out whether a stroke was caused by a heart condition and may also aid in determining if there’s a risk of blood clots forming in the heart.
What’s involved– For a normal echocardiogram no special preparation is necessary. A gel is placed on the chest to help transmit soundwaves and a transducer (a unit which directs sound waves) is moved over the chest. This test doesn’t involve any pain or discomfort and is done in a similar fashion as ultrasounds done for pregnant women. It takes about one hour and is painless.”
She was about to go on when she heard the sound of a gurney being wheeled down the hall and rushed to see what was going on.
“Oh my God!” she whispered faintly, as her face drained of all colour at the sight of one of the patients who just got out of surgery. The sight of the tubes and machines in and around the man brought back all the fear that she had been able to keep at bay off and on since she’d begun reading the research Casey had given her.
“Nikki, come on. Come and sit down.” Casey gently lead her back to the couch.“Honey, you need to rest. Why don’t you go home. I’ll call as soon as I hear anything.”
“No.” Nikki’s tone brooked no argument.
“Then at least lie down and try and get some sleep.”
“Casey, I can’t! Every time I close my eyes, all I can see is Victor lying in the ambulance, the paramedics doing everything they could to keep Victor alive when his heart stopped! That’s all I see!” Nikki’s voice was smothered by tears as she hugged herself protectively.
Pulling her sister into her arms, Casey wrapped her in what she hoped was a comforting embrace.