Chapter 33: Trouble
"We're never so vulnerable than when we trust someone -- but paradoxically, if we cannot trust, neither can we find love or joy." – Walter Anderson
"The stars / That nature hung in Heav'n, and filled their lamps / With everlasting oil, to give due light / To the misled and lonely traveler." – John Milton
Sydney took the time while Vaughn was napping to survey the plethora of charts and instructions that she had been given. Since it was technically the first day Vaughn was at home, she figured that she should really make a schedule. The sheets that she had read to Vaughn were just a jumping off point for patient comfort. There were about a million other sheets that detailed medications, bandages, warning signs and the like. She got out a pen and some paper and began making a checklist of things that she had already completed:
þ Prop pillows/Elevate head
þ Rest
þ Nutritious Foods
þ Avoid loud talking and laughing – she thought they had that covered
þ Avoid twisting, turning, bending, vigorous activity (well…they tried she thought)
She drew a line and made notes to check on the following topics:
· Deep breathing – she'd have to read up on that…plus, she wasn't sure he was ready for deep breathing yet
· Get cough suppressants – just in case he started to cough (which one of the sheets said happened when patients first were taken off of oxygen
· Get ice packs (for rib pain)
· Fever over 101 degrees, shortness of breath increases, painful coughing – CALL DR. TOM!
After looking satisfyingly at her notes, she started on a medication and bandage-changing chart. She figured the sooner she had a system going, the more smoothly things would go.
She got a new piece of paper, got all of the medications out and made a time table, referencing the sheets:
· Administer pain medication as needed for pain. Pain medication is to be administered at recommended intervals only. Only exception: Ibuprofen, which may be administered every 3 hours if necessary.
· Take Ibuprofen or Naproxen, for pain, inflammation of ribs or lungs or shoulder, stiffness or fever. (Take 2 pills every four hours or as needed) Take ibuprofen with food, milk, or an antacid to lessen stomach upset.
· Take prescription Percocet (Oxycodone), or Vicodin (Acetaminophen and hydrocodone) to suppress perception of pain and calm emotional response to pain. For moderate to severe pain. (Take 1-2 pills every 4-6 hours as needed) Take with water.
· Administer direct morphine injection for severe or emergency pain or severe muscle spasms. (Will directly reduce the number of pain signals sent by the nervous system and the brain's reaction to them). Only to be used in emergency or severely acute pain.
Sydney took stock of all the pill bottles in front of her and the syringes of Morphine that Dr. Tom had given her.
She sighed and decided that if today was any indication, then Vaughn would normally wake up at around 8:00 AM. She could give him the pain medication that he required with breakfast, around 8:30 or 9:00 and then work from there, giving him more as needed at the four or six hour intervals.
She got yet another piece of paper, took stock of the huge pile of bandage material, and set up another chart.
First she listed all the injuries that needed bandage changing, then the intervals when they should be changed:
· Ribs – wrap must be removed at least twice a day to allow for deep breathing
· Surgical incisions – bandages must be changed every 6-8 hours the first week, and then taper off following
· Burns and lacerations – bandages must be changed daily the first week, tapered following
· Ankle – wrap should be removed daily to allow skin to breathe – remove at discretion
· Fingers – splints should be monitored, allow 4-6 to heal, must be removed by doctor – do not disturb splints
· Shoulder – shoulder should remain immobilized in sling for 2-3 weeks, avoid strenuous use for 4-6 weeks
Sydney then narrowed that down further:
· Surgical – every 6-8 hours, first week
· Ribs – wrap removed 2x/day
· Burns/lacerations/ankle – daily
Looking over all her notes, Sydney was pleased that she had managed to get all that information down to three pages. She gave herself an approving nod and then went back to the bedroom to check on Vaughn. He was still napping, so she busied herself making a few more notes about daily things they needed to do: baths, shaving, exercise. Once that was completed, she went into the bathroom to try to figure out how they could get Vaughn in the tub comfortably since this wasn't a hospital tub. She was deep in thought when she heard a groan and a curse coming from the bedroom. She raced in to see Vaughn lying rather haphazardly in the middle of the bed.
She raced over to help him back into the elevated position. "What the hell happened?"
Vaughn was gripping his ribs gingerly and said quietly, "I guess I thought since I could weather the oral exam that I could sit…I think I was wrong…" He groaned again in pain and gripped the ribs tighter.
She was about to tell him that she would get the pain medication when he yelped in pain loudly. His body seemed to go stiff and his right hand balled into a tight fist. He looked up at her in confusion and fear, and Sydney was totally unsure of what to do.
"Oh my God! What's happening? Are you ok?" She had moved so she was leaning over him, trying desperately to figure out what was going on.
Vaughn's face dissolved into that of agony and sweat broke out on his forehead.
Sydney was frantic, and it seemed that Vaughn couldn't tell her what was wrong. He finally chocked out, "Chest is tight…hurts…"
Sydney thought a moment in her utter desperation and remembered something from the sheets. She tried to remain calm. "Ok, Vaughn. I think this is a muscle spasm…um…let's see…I should really get the sheet…"
She was about to go, but realized she couldn't leave him here in this state. She was rapidly getting frantic again, since it seemed that the spasm wasn't ending. She grabbed the phone and dialed Tom's number. He answered after two rings, "Dr. Tom here…"
"Tom, it's Sydney…Bristow. Vaughn's having a muscle spasm I think, I don't know what to do, but he's really in a lot of pain…you've gotta help!"
"Ok, Sydney, first you need to calm down. He needs you to be calm right now too…he's probably more than a little scared here, and alarmed cause he doesn't know what's happening…how long has it been going on?"
"I don't know, a couple minutes I guess…" Sydney was trying to calm Vaughn by gently rubbing his ribs, but it wasn't having any effect."
"Ok, do you have those morphine syringes I gave you handy?"
"I can get one…I'll be right back Vaughn…" she dashed out of the room, grabbed one and was back in a flash.
"Ok, got it."
"Give him the shot, arm's probably the best place…"
"Ok…" Sydney cradled the phone between her ear and shoulder and popped the tip off the syringe with her teeth. She bent down and tried to be as gentle as possible as she jabbed the needle into Vaughn's arm.
"Ok, now what?" she asked.
"You wait…"
"That's it?" She went back to rubbing circles on Vaughn's ribs.
"Yeah…"
Slowly Vaughn seemed to come down and the anxiety left his face. His hand flexed and his breathing returned to a fast-paced, but steady rhythm. He looked very tired, however, and he was still sweaty.
"How is he?" Dr. Tom prodded.
"Uh, he seems to be better…his muscles have relaxed, I think…have they?" she asked.
Vaughn took a minute, "Yeah…but it really hurts now…although the morphine is a wonder drug…" he sighed.
"He's still in a lot of pain, he says it hurts more…and he's really sweaty…"
"Congratulations, you've just made it through your first muscle spasm…" Dr. Tom said proudly.
"That's what I thought it was. Is he going to be ok?" she asked.
"Yeah, he'll be fine…he'll have more of those as he starts to use the muscles more…you should be warned…if he's in a lot of pain, give him some of the Percocet or the Vicodin…if he's really, really in a lot of pain, you can give him both now, but don't do that too often…we don't want him to OD or anything. He'll probably be sore for a while too…what was he doing?"
"Uh, he tried to sit up…"
"Yeah, that'd do it…tell him he's still on bed rest or isn't he following my instructions?"
Sydney smiled at Vaughn, "He says you're supposed to be on bed rest, why are you sitting?"
Vaughn smiled, "I can't really tell him why, Syd…I was still in the bed when I did it!"
"He says he was in the bed when he sat up, or attempted to."
"Tricky bastard…"
"He's swearing at you now…" Sydney said to Vaughn.
Vaughn smiled back, "Tell him I'll be good."
"Tom, he promises to be a good boy."
"Good, otherwise I'll have to come and kick his ass…no more sitting this week…not unattended."
"Ok…I'll let him know…"
"Good job Sydney. Call if you need anything else."
"I will Tom, thanks."
She hung up the phone and looked down at Vaughn's tired form.
"Well, that was certainly fun," he said wincing.
"Yeah, let's not try that too often, ok?" she said in reply as she leaned down to kiss him. "I'll get you the pain pills…"
She got up and returned with the pills. She lifted his head so he could swallow them, and grinned down at him.
"What?" he asked.
"You really think all it takes is one blowjob to make you better?"
"Well, not just any blowjob…" he smiled up at her and she kissed him.
"Vaughn…you rest for awhile…and DON'T and I mean DON'T try to sit up again by yourself. If you want to sit up, let me know, and I'll help you…"
"Ok Syd."
"While you rest, I'm going to run you a bath…"
"Ok Syd…"
She went off leaving him in a state of medication-induced bliss.
