Lots to report today.
First of all, as I posted earlier today, the big news of the day is that Dad was released from the Intensive Care Unit and transferred to the Trauma Unit of the hospital. This was big news as it signifies that Dad's status is no longer considered critical. This is really excellent news. He was in ICU for exactly two weeks; two weeks that have both felt like an eternity and have somehow also flown by.
The unit that Dad is in now is not actually a "regular" hospital unit as I reported earlier. It is still a more highly monitored area of the hospital for more serious cases, just not at the level of the ICU. In fact, he still has a nurse's assistant assigned to monitor him around the clock. They felt that he still needed this constant monitoring for his own safety. He still tries to pull out the various tubes and wires on his body. As of today there is one less tube for him to pull out, however. Dad had his chest tube removed this morning. One more step in the healing process.
Dad is still considered serious. He still has a long way to go. The physical therapist conveyed how important it is that he gets lots of rest, and that when he rests that he is allowed to sleep deeply. They are trying to get him to sleep deeply and then wake up more fully, and not just doze all day. Because of his still serious injuries, his need for deep sleep and lots of rest, his heavy therapy schedule, and his still foggy mental status, we have been asked to keep his visitors to a minimum and to limit them to immediate family members.
Dad has really been struggling to rest well today. Because of this, they once again gave him some pain medication and also had to administer blood pressure medication.
Besides the noteworthy move out of ICU, there were other significant notes from today. Dad was cleared as stable enough for his facial reconstructive surgery and that has tentatively been scheduled for Wednesday. Because his is an inpatient surgery, it is possible that his surgery could be pushed to later in the week if emergency surgeries come up in the meantime. As far as the surgery itself goes, the plastic surgeon told us that the surgery will not need to be as complicated as they had previously expected. For one thing, they will no longer have to wire his jaw shut during surgery. Also, the only bone needing repair work on the left side of his face is his nose, which has a bump sticking out. They will need to plate that bone to straighten it, and will remove the plate after a week. The repair work on his right side will be more extensive. The bones in his right eye socket will need to be filled in to push his eye outward (it is currently sunken in due to the fractures). His eyelid will also have to be pulled up with stitches. His eye will require a patch for a few days after surgery.
Speaking of Dad's right eye, we had previously been told that Dad may have lost all sight in that eye from the accident. Tests of the eye before today did not produce any muscular response of the eye or any response to light and the Dr. had indicated that it did not look promising for Dad to have any vision in that eye. Today, however, Dad's right eye did show a little response to light as well as a bit of muscular response. This is a really good sign that some healing is taking place. The Dr. said that Dad may still regain some vision in his right eye. It most likely will not return to normal and will not be as good as his left eye, but at least there is still some hope that he is not completely blind in that eye.
The pupil in Dad's left eye is damaged and remains dilated at all times. We have been told that this is something that may with time correct on its own. If it does not, then way down the road there are some procedures that can be done to reduce sensitivity to light and protect his eye. These various eye problems have been troubling to us, so we are hoping for the best on all counts.
The neuro surgery team also consulted with my mom and sister today. They have officially declared that it appears that Dad will not be needing their service, and they are releasing him from the constant monitoring of his brain injury. They will do a follow up with him in a month and perform another CT scan at that time. She explained that Dad's brain injury had been labeled "moderate" on a scale of light, moderate, or severe. They are hopeful for a full recovery for Dad, but cannot make any promises. It will take months of recovery time for his brain to finish healing and he will experience difficulties during that time. The areas that will most likely be affected during that time are short term memory, judgment, and decision making. They will not have a complete picture of the areas that Dad will need help in until he is talking and a full neurological exam can be given. Brain injuries are slow to heal and can be unpredictable, so we really just have to wait and see what his outcome will be.
So the goals with Dad for the next little while are to strengthen his muscles and motor skills after having been immobile for 2 weeks, to work on his speech and communication, to get his facial reconstruction surgery out of the way and, most importantly, to continue resting and healing. As a family we understand that this is going to be a long, sometimes slow, process for Dad (and for all of us), but we are encouraged by the positive developments of the last couple of days. Thank you again to all of you for your care and support (and prayers!). This experience has helped us all to realize what an awesome net of people we all have to fall on and rely on during tough times. We are so blessed.
Monday, April 30, 2012
Graduation Day
Dad has just graduated from the ICU to the trauma floor! One more step on his road to recovery. They will not give us any expected time frame for the remainder of his hospitalization, but he still has a long way to go on the road to recovery. After the trauma floor, he will be moved to rehab. One step at a time . . .
Sunday, April 29, 2012
Today was a big day for Dad. This morning they brought him the sacrament. He can not chew or swallow yet, so it was just touched to his lips. I am sure he was very happy to have that. The physical therapist tested his core strength in the morning and had him sitting up with his legs dangling off the bed. From there they had him stand up and shuffle step to the right, giving him support on both sides the entire time. He did great and they indicated that his muscle strength was good.
The afternoon brought more big moments. Dad was really awake with his left eye open all afternoon. Mike got permission to bring his kids in. Mike asked Dad if he wanted to see the kids and he nodded yes. He smiled at them, patted their heads, and tried to give them hugs. He seemed really happy to see them. It was a sweet moment to see him and the love he has for his grandchildren.
Dad is breathing completely on his own. He was able to cough and clear his own throat, and the respiratory therapist said his breathing is looking great. The speech therapist also came in and tried to get him to talk. They hooked up something to his tracheostomy to help them hear his voice. It was a struggle for him and he would take quite a bit of time to answer each question. When they asked him who Mom was he said "Kathleen Kendall." Mike was the one at the hospital at that time and Dad said "Mike" when they asked who he was. He also responded "Dale" when they asked him who his oldest son was. He did have a long pause in responding and struggled with some of the questions. He didn't know how many kids he has, and it took him a long time to come up with Jeff's name. He also said his oldest daughter was Jennifer (really is Mary). He said "St George" when asked where he was. He indicated he is from Nephi, but he could not say where he now lived (that could be that West Valley is too hard to say?). He definitely has some confusion. They have indicated that when we ask him questions we should give him a long time to respond. It was taking him at least six seconds to respond. They also said if he closes his eye it may mean that he is processing the question.
The afternoon brought more big moments. Dad was really awake with his left eye open all afternoon. Mike got permission to bring his kids in. Mike asked Dad if he wanted to see the kids and he nodded yes. He smiled at them, patted their heads, and tried to give them hugs. He seemed really happy to see them. It was a sweet moment to see him and the love he has for his grandchildren.
Dad is breathing completely on his own. He was able to cough and clear his own throat, and the respiratory therapist said his breathing is looking great. The speech therapist also came in and tried to get him to talk. They hooked up something to his tracheostomy to help them hear his voice. It was a struggle for him and he would take quite a bit of time to answer each question. When they asked him who Mom was he said "Kathleen Kendall." Mike was the one at the hospital at that time and Dad said "Mike" when they asked who he was. He also responded "Dale" when they asked him who his oldest son was. He did have a long pause in responding and struggled with some of the questions. He didn't know how many kids he has, and it took him a long time to come up with Jeff's name. He also said his oldest daughter was Jennifer (really is Mary). He said "St George" when asked where he was. He indicated he is from Nephi, but he could not say where he now lived (that could be that West Valley is too hard to say?). He definitely has some confusion. They have indicated that when we ask him questions we should give him a long time to respond. It was taking him at least six seconds to respond. They also said if he closes his eye it may mean that he is processing the question.
After the speech therapist, Dad was completely exhausted. The physical therapist came back in and had him move off the bed to sitting up in a chair for about a half hour. This was another great step and is supposed to help his lungs and other organs get working better. They are going to be doing this kind of rehab multiple times a day from now on. When he got back in bed he was immediately asleep. The little bit of talking and moving completely drained him of all his energy. He was pretty exhausted for the rest of the night and was not social after that. Besides a smile or small hand squeeze, he wanted to be left alone and just rest. He didn't even want his hand held this evening. Rehab is going to be hard and exhausting for him.
Dad has now been cleared for the facial surgery. Nothing is scheduled at this point, but it should happen the first of the week. The Dr. also indicated that the CSF leak appears to be completely healed, so that is great news.
Another concern we have had is that he cannot open his right eye, and he doesn't move the right side of his face. The Dr. indicated that most likely the movement would come back. If the nerve is smashed and damaged it will repair itself at a very slow rate of one millimeter a day. However, if the nerve is completely severed, it would not repair itself. The Dr. did say he would be very surprised if it was severed.
So today was wonderful to hear his voice and see his movement. He is making great progress and we feel he won't be in ICU much longer. However, it also was reiterated to us all that he has a long way to go. It is all very hard on him and he is not up to visitors yet. We will keep you posted.
Saturday, April 28, 2012
Today was a pretty quiet day with Dad. He still had great stats - with blood pressure and temperature both normal. He was relaxed and had lots of rest, which is what he needs the most.
This morning our family all attended Jeff's daughter Bella's baptism, which was a very special event. Bella was baptized by Dale's son Jace, which made it an extra memorable occasion. Dad's dear friend Kent Bawden agreed to sit with Dad all morning and into the early afternoon so that we could all attend the baptism. We would like to thank him for this loving service that he gave. We are sure that Dad appreciated having his companionship as well.
Today the ventilator was turned completely off and Dad was breathing great on his own, with just an oxygen mask covering his tracheotomy. He still had to be suctioned out periodically, but was not struggling to breathe at all. They do plan on putting the ventilator on through the night for added help and protection, however.
The doctors also removed the spinal fluid drain from Dad's spine today. It has been a couple of days since Dad has had any spinal fluid leaking from his nose and the drain was no longer draining properly anyway, so they opted to remove it. The hope is, of course, that the leaks in Dad's membrane have sealed, but there is no way of knowing that for certain at this point. If he begins leaking spinal fluid from his nose again, then they will replace the drain in his spine.
The doctors had decreased Dad's sodium level to help reduce the swelling in Dad's brain. Now that the brain injury appears to not be growing, they have increased his sodium once again to allow his brain to normalize in size. They said that if the brain itself has expanded a bit, it may be filling in the leaks in the membrane and allowing them to heal. It would certainly be wonderful if the cerebral spinal fluid leakage is no longer an issue.
With the spinal drain out, Dad was cleared today for physical therapy. We are expecting him to begin that tomorrow. They hope to get him up out of bed and trying to walk a little in the next day or two. When I told this to Dad and asked him if he was ready to get out of bed, he shook his head "no" at me. He is probably still feeling so very weak and sore.
A few of us noticed that Dad seemed a little down today. He just looked sad. I can't even imagine how difficult it must be for him to be going through what he is. Not able to talk or get out of bed, in pain, and maybe even unsure of what is going on. Not to mention being stuck in the boring hospital. So I tried to think of something that might lift his spirits a bit. I asked him if he would like to listen to some music and he nodded his head. I had his ipad there, so I downloaded Pandora and played religious and classical music to him for an hour. It was amazing to me to see how much this calmed him. He moved his head toward the music and closed his eye and just listened. His blood pressure quickly dropped by 15 points. When I turned the music off after an hour his blood pressure went back up. It was still in the normal range, but I was just amazed by how quickly the music caused those physical changes.
Ashley also provided a service to him when she offered him a foot rub with lotion. We could tell that he liked that as well. In fact, after she finished she asked if he would like another foot rub and he again nodded. Hopefully we can find other little things that will help him to be more comfortable and at peace through this healing process.
It is hard to see a man who has given so much to so many of us suffer so greatly. But we are so grateful that he is improving. The Dr. today reiterated to me that he is still in critical condition and will remain classified as such as long as he is in the ICU. However, he also told me that he was doing much, much better than he was earlier this week when he was so sick. In fact, he told me that during that setback things were very "dicey" for Dad. We are grateful for all of the prayers that are being given, heard, and answered in Dad's behalf. Thank you to all of you.
This morning our family all attended Jeff's daughter Bella's baptism, which was a very special event. Bella was baptized by Dale's son Jace, which made it an extra memorable occasion. Dad's dear friend Kent Bawden agreed to sit with Dad all morning and into the early afternoon so that we could all attend the baptism. We would like to thank him for this loving service that he gave. We are sure that Dad appreciated having his companionship as well.
Today the ventilator was turned completely off and Dad was breathing great on his own, with just an oxygen mask covering his tracheotomy. He still had to be suctioned out periodically, but was not struggling to breathe at all. They do plan on putting the ventilator on through the night for added help and protection, however.
The doctors also removed the spinal fluid drain from Dad's spine today. It has been a couple of days since Dad has had any spinal fluid leaking from his nose and the drain was no longer draining properly anyway, so they opted to remove it. The hope is, of course, that the leaks in Dad's membrane have sealed, but there is no way of knowing that for certain at this point. If he begins leaking spinal fluid from his nose again, then they will replace the drain in his spine.
The doctors had decreased Dad's sodium level to help reduce the swelling in Dad's brain. Now that the brain injury appears to not be growing, they have increased his sodium once again to allow his brain to normalize in size. They said that if the brain itself has expanded a bit, it may be filling in the leaks in the membrane and allowing them to heal. It would certainly be wonderful if the cerebral spinal fluid leakage is no longer an issue.
With the spinal drain out, Dad was cleared today for physical therapy. We are expecting him to begin that tomorrow. They hope to get him up out of bed and trying to walk a little in the next day or two. When I told this to Dad and asked him if he was ready to get out of bed, he shook his head "no" at me. He is probably still feeling so very weak and sore.
A few of us noticed that Dad seemed a little down today. He just looked sad. I can't even imagine how difficult it must be for him to be going through what he is. Not able to talk or get out of bed, in pain, and maybe even unsure of what is going on. Not to mention being stuck in the boring hospital. So I tried to think of something that might lift his spirits a bit. I asked him if he would like to listen to some music and he nodded his head. I had his ipad there, so I downloaded Pandora and played religious and classical music to him for an hour. It was amazing to me to see how much this calmed him. He moved his head toward the music and closed his eye and just listened. His blood pressure quickly dropped by 15 points. When I turned the music off after an hour his blood pressure went back up. It was still in the normal range, but I was just amazed by how quickly the music caused those physical changes.
Ashley also provided a service to him when she offered him a foot rub with lotion. We could tell that he liked that as well. In fact, after she finished she asked if he would like another foot rub and he again nodded. Hopefully we can find other little things that will help him to be more comfortable and at peace through this healing process.
It is hard to see a man who has given so much to so many of us suffer so greatly. But we are so grateful that he is improving. The Dr. today reiterated to me that he is still in critical condition and will remain classified as such as long as he is in the ICU. However, he also told me that he was doing much, much better than he was earlier this week when he was so sick. In fact, he told me that during that setback things were very "dicey" for Dad. We are grateful for all of the prayers that are being given, heard, and answered in Dad's behalf. Thank you to all of you.
Friday, April 27, 2012
Dad looked so much better today. His exterior wounds are healing, making him look like himself again. He didn't like being told he was getting skinny though. I got a big frown out of him by telling him that.
Dad didn't just look better today, his stats were better too. His temperature was normal all day, without meds. He was on the lowest ventilator settings again. And his blood pressure was back to its normal, steadiness. He has been taken off of pain medication completely and is doing fine without it.
The best sign of all is that he was no longer leaking spinal fluid out of his nose. Hopefully this means that the leak is sealing itself off. They are not ruling out the possibility that it could be draining down his throat instead, however.
Dad did have a tracheostomy this afternoon and it went smoothly. Hopefully this will allow him to start talking more quickly and also to be more comfortable. We have been told that eventually the tracheostomy site will heal over and not even be noticeable.
Another good development - the Dr. evaluated Dad's neck and decided that the neck brace could be removed. Dad has been moving his head and neck around alot since then. It probably is such a relief to him to have that off! When asked if his neck hurts, he shook his head no.
Dad has been very alert and responsive today, and still his opinionated self. When Josh went in tonight, he took some reading material with him. He asked my dad if he wanted to be read to, to which he received an affirmative head nod. He started reading one thing, which Dad shook his head no at. Then he asked if Dad wanted The Ensign read to him, to which Dad responded yes. It feels so great that he is able to make his opinion known to us.
Dad loves to hold our hands when we are there. It feels so great to feel his strong grip and to know that he is aware that we are there and love him.
Today was a definite step up on this roller coaster ride.
Dad didn't just look better today, his stats were better too. His temperature was normal all day, without meds. He was on the lowest ventilator settings again. And his blood pressure was back to its normal, steadiness. He has been taken off of pain medication completely and is doing fine without it.
The best sign of all is that he was no longer leaking spinal fluid out of his nose. Hopefully this means that the leak is sealing itself off. They are not ruling out the possibility that it could be draining down his throat instead, however.
Dad did have a tracheostomy this afternoon and it went smoothly. Hopefully this will allow him to start talking more quickly and also to be more comfortable. We have been told that eventually the tracheostomy site will heal over and not even be noticeable.
Another good development - the Dr. evaluated Dad's neck and decided that the neck brace could be removed. Dad has been moving his head and neck around alot since then. It probably is such a relief to him to have that off! When asked if his neck hurts, he shook his head no.
Dad has been very alert and responsive today, and still his opinionated self. When Josh went in tonight, he took some reading material with him. He asked my dad if he wanted to be read to, to which he received an affirmative head nod. He started reading one thing, which Dad shook his head no at. Then he asked if Dad wanted The Ensign read to him, to which Dad responded yes. It feels so great that he is able to make his opinion known to us.
Dad loves to hold our hands when we are there. It feels so great to feel his strong grip and to know that he is aware that we are there and love him.
Today was a definite step up on this roller coaster ride.
Thursday, April 26, 2012
Today was not the best day for dad. Mary updated this morning about his ventilator having to be put back in. It was really hard to see Dad struggling to get his breath this morning. So although we wish he was strong enough to go without it, I am grateful to have it back in to ease that struggle for him. Tomorrow they are going to be doing a tracheotomy. This will allow them to hook up the ventilator through that, while allowing his vocal cords to heal so he will be able to communicate. This will also allow him to be moved easier when they decide it is okay for him to get up or move about. He has been having a chest x-ray each morning. His lungs didn't look as good since they took him off ventilator. They were compressed this morning. They hope that now he is back on ventilator his lungs will bounce back and look better tomorrow. The nurse tonight said they marked down on his chart that he has pneumonia but it is treatable.
Dr. Granger, the head doctor of the trauma team on Dad's case, indicated that the CSF drain is not draining as well as it could be, which may indicate a clog (they may need to replace it). Also, the leak in his nose is subsiding (a good thing). The drainage will be how they ultimately tell if the leak has stopped. It also could be that it is draining down his throat but they are not sure at this point. They will wait to schedule the facial surgery until they know whether or not a surgery will need to be performed to repair the CSF leak. If needed, they will do both at the same time. Dr. Leyngold, the facial surgeon, also said they are waiting for him to be more stable to do the facial surgery. The surgery is easier if it happens in the first two weeks but he can still do it a month or more after the injury.
While Dr. Leyngold was checking him, he asked dad to open his eyes, close both eyes tight and raise his eyebrows. He was able to do it on the left side but not the right side at all. He said there was probably damage to the nerve on the right eyelid but this often heals on its own – could take months. If it doesn’t after several months he may be able to perform surgery to correct. There could also be some vision loss in the right eye, as the pupil did not respond to light. The lining around the right eye was drying out due to the swelling, so he put some ointment on it and sewed part of the right eyelid shut. He will remove it sometime next week.
Dad has a low grade fever, about 101, that they are watching. They are curious if he may have another infection hiding somewhere, but don't know where it could be. They took a sample of sputum from his lungs to run a culture on. It will take a couple of days before they get those results.
On a side note: the P.A. Student came & talked to us & said they are talking about Dad a lot and even when they aren't here with him, there are 3 people in a room looking over his labs, watching his monitors, and talking about him. It's good to know he's being watched over. One day at a time, we will get through this. Thanks for all your love and support. It really means a lot to our whole family.
Another setback today. Dad was struggling to breathe and had to be intubated again. The Dr. said he just wasn't strong enough yet. They are going to leave him on the ventilator today and peform a tracheotomy tomorrow. This option will be more comfortable for him and allow his vocal chords to heal. It will also allow him to get up and moving when he is ready.
It is very disappointing that he is not yet ready to breathe completely on his own, and these setbacks are very hard on my mom. But we continue to have faith that he will get better when his body is ready.
It is very disappointing that he is not yet ready to breathe completely on his own, and these setbacks are very hard on my mom. But we continue to have faith that he will get better when his body is ready.
Wednesday, April 25, 2012
The big development of today is that Dad was extubated. The ventilator is finally out! They have kept an oxygen mask on him and there is always the possibility that the ventilator will have to be replaced, but this was a huge development in Dad's progress.
Dad has still not been able to talk, however, aside from a few feeble "yes" and "nos" to the speech therapist. For example, he did answer "yes" when they asked if the ice chip they gave him felt good on his throat. He answered "no" when asked if he remembered what had happened. He was not able to verbalize his name or age when asked to by the speech therapist. He was moving his mouth and trying to talk, but just could not get the words out. This is most likely due to his throat and vocal cords being tired, weak, and swollen from more than a week on the ventilator. It may take a few days. There is a possibility that it is a side effect of his brain injury. Sometimes patients struggle to speak with this type of injury and sometimes they are OK.
Aside from that one ice chip, Dad is not allowed to eat or drink anything until he can speak. They want to make sure that he is able to swallow safely before they give him anything so that he does not aspirate fluid into his lungs. He is still being fed with a feeding tube. His mouth must be so dry and thirsty! They did allow Shari to swab his mouth out with a cool, wet swab, which he really seemed to appreciate.
Whenever Dad is awake he wants someone right by him holding his hand. He squeezes our hands when we talk to him and in response to questions. Shari told him that he must be so tired of laying there and would rather be hiking in the Tetons. He squeezed Shari's hand several times. Shari told him that she was going to hold him to that and they would go hiking in the Tetons this summer. Dad again squeezed her hand repeatedly. In Shari's own words: "It is amazing to me that even though he can't talk, and even as injured as he is & laying there so helpless, he still has the ability to show love for his family and make everyone who holds his hand feel his love. How remarkable that is."
In addition to retaining his deep love for others, Dad still has a stubborn streak. Dad was thrashing around trying to pull off his oxygen mask when his arms were loosened. The nurse asked him if he would quit trying to pull it off if she left his arms untied and he shook his head "no." She had to restrain his arms again.
Other medical notes:
The staples were removed from Dad's head today.
Spinal fluid is still draining from Dad's nose and could continue for up to a couple of weeks before they take further action. We are still holding out hope that the leak will seal off on its own.
The infection Dad was fighting was either pneumonia or CSF infection, but it is controlled at this point. The cooling body wrap has been removed and his temperature is normal .
There are not any plans at this point to change out the metal screws on his wrist for MRI purposes. When Dad can talk again, they will take off the neck brace and have him do some physical tests for neck movement.
Getting the ventilator out today was a huge step. One step at a time . . .
Dad has still not been able to talk, however, aside from a few feeble "yes" and "nos" to the speech therapist. For example, he did answer "yes" when they asked if the ice chip they gave him felt good on his throat. He answered "no" when asked if he remembered what had happened. He was not able to verbalize his name or age when asked to by the speech therapist. He was moving his mouth and trying to talk, but just could not get the words out. This is most likely due to his throat and vocal cords being tired, weak, and swollen from more than a week on the ventilator. It may take a few days. There is a possibility that it is a side effect of his brain injury. Sometimes patients struggle to speak with this type of injury and sometimes they are OK.
Aside from that one ice chip, Dad is not allowed to eat or drink anything until he can speak. They want to make sure that he is able to swallow safely before they give him anything so that he does not aspirate fluid into his lungs. He is still being fed with a feeding tube. His mouth must be so dry and thirsty! They did allow Shari to swab his mouth out with a cool, wet swab, which he really seemed to appreciate.
Whenever Dad is awake he wants someone right by him holding his hand. He squeezes our hands when we talk to him and in response to questions. Shari told him that he must be so tired of laying there and would rather be hiking in the Tetons. He squeezed Shari's hand several times. Shari told him that she was going to hold him to that and they would go hiking in the Tetons this summer. Dad again squeezed her hand repeatedly. In Shari's own words: "It is amazing to me that even though he can't talk, and even as injured as he is & laying there so helpless, he still has the ability to show love for his family and make everyone who holds his hand feel his love. How remarkable that is."
In addition to retaining his deep love for others, Dad still has a stubborn streak. Dad was thrashing around trying to pull off his oxygen mask when his arms were loosened. The nurse asked him if he would quit trying to pull it off if she left his arms untied and he shook his head "no." She had to restrain his arms again.
Other medical notes:
The staples were removed from Dad's head today.
Spinal fluid is still draining from Dad's nose and could continue for up to a couple of weeks before they take further action. We are still holding out hope that the leak will seal off on its own.
The infection Dad was fighting was either pneumonia or CSF infection, but it is controlled at this point. The cooling body wrap has been removed and his temperature is normal .
There are not any plans at this point to change out the metal screws on his wrist for MRI purposes. When Dad can talk again, they will take off the neck brace and have him do some physical tests for neck movement.
Getting the ventilator out today was a huge step. One step at a time . . .
Tuesday, April 24, 2012
Today was a better day. Dad is improving from the setback he had over the last couple of days and the trauma team feels that they have his infection under control. Dad no longer has a fever and they were able to turn the body cooling pack off. His white blood cell count has also improved. They still are not completely sure where the infection is. They are most suspicious of pneumonia at this point and will continue to take daily chest x-rays and fluid samples from his lungs to test for it. They will also continue to monitor his blood for infection. He will remain on strong antibiotics for several days to hopefully completely wipe out whatever the infection may be.
Dad was breathing strongly on his own again today with the ventilator on the lowest settings. However, because of the fear that he may have pneumonia, the ventilator will have to remain in place for at least a couple more days.
Last night during the night Dad had the chills/shakes again and they had to once again administer Vec (Vecuronium) - the medication that causes temporary paralysis. Today they did not have to give him that medication again and they also took him off of Propofol (sedation medication). As a result, Dad was much more alert and responsive today than he has been the last couple of days. For example, he kept reaching for my brother's hands and responding to their questions with head shakes and nods. When Dale was holding his hand, Dad squeezed it with strength. Dale told him that it felt good to feel him squeeze his hand, so Dad then squeezed it even harder several more times. Dad had his one eye open often and was aware that we were there. (His right eye is still too swollen to open - and all of the bones surrounding it are fractured, so it is probably too painful as well). There were also times when it felt as though Dad wanted to and was trying to talk. But with the ventilator in that is not possible.
Dad was also aware when Mike and Dale gave him a priesthood blessing (his third one since the accident). When my brothers asked him if he heard the blessing, he nodded his head yes. The blessing was also reassuring to my family.
Dad's blood pressure remained within normal range today and did not skyrocket as it has the last couple of days.
There is still cerebral spinal fluid leaking from his nose, so the tear in his membrane has not yet sealed off. The drain in his spine is still in place to relieve the pressure from his brain.
We have not yet heard word on if/when they will be able to replace the metal screw in his wrist with a titanium one for MRI purposes. We have also not yet had word on when they expect his facial reconstruction surgery to take place. We assume that they are waiting until the infection is cleared up completely.
Overall, our family feels much more encouraged today than we have the last two days. Dad looked better and acted better and we hope that his progress to recovery will continue swiftly from here. The doctors have indicated that it is up to his own body to heal now and their job is just to facilitate his own healing process in whatever ways they can.
Our family continues to appreciate all the prayers, thoughts, love and support you have been giving to us. Thank you!!!
Dad was breathing strongly on his own again today with the ventilator on the lowest settings. However, because of the fear that he may have pneumonia, the ventilator will have to remain in place for at least a couple more days.
Last night during the night Dad had the chills/shakes again and they had to once again administer Vec (Vecuronium) - the medication that causes temporary paralysis. Today they did not have to give him that medication again and they also took him off of Propofol (sedation medication). As a result, Dad was much more alert and responsive today than he has been the last couple of days. For example, he kept reaching for my brother's hands and responding to their questions with head shakes and nods. When Dale was holding his hand, Dad squeezed it with strength. Dale told him that it felt good to feel him squeeze his hand, so Dad then squeezed it even harder several more times. Dad had his one eye open often and was aware that we were there. (His right eye is still too swollen to open - and all of the bones surrounding it are fractured, so it is probably too painful as well). There were also times when it felt as though Dad wanted to and was trying to talk. But with the ventilator in that is not possible.
Dad was also aware when Mike and Dale gave him a priesthood blessing (his third one since the accident). When my brothers asked him if he heard the blessing, he nodded his head yes. The blessing was also reassuring to my family.
Dad's blood pressure remained within normal range today and did not skyrocket as it has the last couple of days.
There is still cerebral spinal fluid leaking from his nose, so the tear in his membrane has not yet sealed off. The drain in his spine is still in place to relieve the pressure from his brain.
We have not yet heard word on if/when they will be able to replace the metal screw in his wrist with a titanium one for MRI purposes. We have also not yet had word on when they expect his facial reconstruction surgery to take place. We assume that they are waiting until the infection is cleared up completely.
Overall, our family feels much more encouraged today than we have the last two days. Dad looked better and acted better and we hope that his progress to recovery will continue swiftly from here. The doctors have indicated that it is up to his own body to heal now and their job is just to facilitate his own healing process in whatever ways they can.
Our family continues to appreciate all the prayers, thoughts, love and support you have been giving to us. Thank you!!!
Monday, April 23, 2012
Dad's infection is a step back right now. The doctors warned us that the recovery of such a traumatic injury will have many set backs. The cultures testing for bacteria were negative. They haven't found any sign of csf infection (meningitis.) This could be because the there is no infection, it is a minor infection or because the antibiotics are treating it appropriately. Right now they are treating him with strong antibiotics that can hopefully take care of an infection anywhere. They took a sample of the mucus from the lungs last night. While the tests were not positive, they did a chest x-ray and their best guess right now is that the infection is pneumonia brewing. The antibiotics should treat any of these infections so that is a good thing. The white blood cell count has improved.
Dad has continued to need the cooling body wrap to keep his temperature down, but his temperature is normal with it on. He started shivering in the night due to fever/body wrap. To stop the shivering they gave him Prophopal again and put him on a medicine called Vick (shortened term for a medicine that temporarily paralyzes the patient). This medicine made him slow to respond, but when they took him off for a while he responded just fine. Because of the medicines the ventilator setting was increased, assisting him more with his breathing. .
Dad has continued to need the cooling body wrap to keep his temperature down, but his temperature is normal with it on. He started shivering in the night due to fever/body wrap. To stop the shivering they gave him Prophopal again and put him on a medicine called Vick (shortened term for a medicine that temporarily paralyzes the patient). This medicine made him slow to respond, but when they took him off for a while he responded just fine. Because of the medicines the ventilator setting was increased, assisting him more with his breathing. .
We had hoped to get the facial surgery done early this week. His swelling has gone down enough that the facial surgeon approved it for surgery. However with the infection, the head doctor of the trauma team has not approved him for the surgery. So that will have to wait a little longer.
Another CT scan was done this morning just to make sure his lack of response was the meds and not his brain. They reiterated that the scan looks stable.
Sunday, April 22, 2012
From now on we will plan on posting just one update daily, usually at the end of the day. If we have any major developments we will let you know with additional posts. We were just finding that information is changing so fast, that often it is best to wait until the end of the day when we have all of the details to report.
The major development of today is that Dad has had what the doctors call a "setback". During the night Dad's fever spiked to 40c (104f), which is unusually high for an adult. They were able to cool his body temperature down with a body ice pack.
The concern with the fever (and a change in his white blood cell count) is that they feel that it indicates an infection of some type. Urine cultures, blood cultures, and cultures from the lungs were not positive for infection, which leads them to assume that the infection is in his Cerebral Spinal Fluid. This type of infection is also known as meningitis (but it is not the super scary kind that you hear about in the news). They have started him on an array of major antibiotics to try and take care of the spinal fluid infection, or whatever type of infection it may be. The tricky part is that we many never know for certain if it was a CSF infection or what type of infection it is. Any spinal fluid samples that they take may not show infection, as he is already on antibiotics. The antibiotics would suppress the culture from growing. The doctors felt that it was important to start the antibiotics immediately rather than waiting for any spinal fluid cultures to be tested.
The spinal fluid infection is most likely caused from the tear he has in the membrane of his brain that is allowing spinal fluid to leak from his nose. Bacteria can enter through that tear and cause infections. It is very important that the spinal leak is repaired, or the risk of infection will remain. So today they took steps to repair the leak. Today Dad had a "spinal drain" procedure, to drain his spinal fluid down. They placed a tube in his lower lumbar (similar to an epidural) to drain the fluid. The purpose of this is to relieve pressure in the brain so that the CSF leak can seal. This can happen fairly quickly, or it can take weeks. If it is not successful, they will have to enter through the nose to try and patch the leak, or, as a last resort, go in through the skull to try to repair it. The issue is that these leaks can be very tricky to locate, like finding a needle in a haystack. We are obviously really hoping that the spinal drain will work and the leak will seal off on its own and that the additional measures will not be necessary.
Dad's infection is weakening him and may slow the healing process down in other areas as well.
The goal is still to get Dad off of the ventilator, but he did not make any progress in that area today. They are still waiting for him to cough.
We continue to hope that they can remove the ventilator soon so that Dad can be more comfortable. We would also like for them to take his neck brace off. We are hoping that the wrist surgeon will be able to replace his exterior wrist screw with a titanium one so that the MRI can be done tomorrow to rule out neck injuries. This needs to be done before they take the brace off. It is so hard seeing Dad so obviously uncomfortable. When he is alert he often thrashes around trying to get all of the various paraphernalia off of his body. He has been nicknamed the "master manipulator" by the nurses because he is so good and finding ways to wiggle out of the compressors on his legs and the ties and straps on his arms. When we talk to him it feels like he is pleading for us to help him out and make him more comfortable, so it is very difficult to see. This is especially hard on my mom. We feel that once he can get the ventilator out, he will be much more calm, so we would really love to see that happen soon.
When Dad gets agitated, his blood pressure shoots up (above 200 sometimes). Dad has never had high blood pressure before, so this is a bit concerning. He has now being given blood pressure medication to help control that.
On a positive note - Mike noted that this morning was the most alert that he has seen my dad. My dad was properly responsive to the neuro team when they stopped by.
Tomorrow will be a week since the accident occurred. As a family we would have loved to see more progress made up to this point, but realize that this whole situation is going to require much patience and love on our part. Dad is physically starting to look much better and less swollen and more like himself.
The major development of today is that Dad has had what the doctors call a "setback". During the night Dad's fever spiked to 40c (104f), which is unusually high for an adult. They were able to cool his body temperature down with a body ice pack.
The concern with the fever (and a change in his white blood cell count) is that they feel that it indicates an infection of some type. Urine cultures, blood cultures, and cultures from the lungs were not positive for infection, which leads them to assume that the infection is in his Cerebral Spinal Fluid. This type of infection is also known as meningitis (but it is not the super scary kind that you hear about in the news). They have started him on an array of major antibiotics to try and take care of the spinal fluid infection, or whatever type of infection it may be. The tricky part is that we many never know for certain if it was a CSF infection or what type of infection it is. Any spinal fluid samples that they take may not show infection, as he is already on antibiotics. The antibiotics would suppress the culture from growing. The doctors felt that it was important to start the antibiotics immediately rather than waiting for any spinal fluid cultures to be tested.
The spinal fluid infection is most likely caused from the tear he has in the membrane of his brain that is allowing spinal fluid to leak from his nose. Bacteria can enter through that tear and cause infections. It is very important that the spinal leak is repaired, or the risk of infection will remain. So today they took steps to repair the leak. Today Dad had a "spinal drain" procedure, to drain his spinal fluid down. They placed a tube in his lower lumbar (similar to an epidural) to drain the fluid. The purpose of this is to relieve pressure in the brain so that the CSF leak can seal. This can happen fairly quickly, or it can take weeks. If it is not successful, they will have to enter through the nose to try and patch the leak, or, as a last resort, go in through the skull to try to repair it. The issue is that these leaks can be very tricky to locate, like finding a needle in a haystack. We are obviously really hoping that the spinal drain will work and the leak will seal off on its own and that the additional measures will not be necessary.
Dad's infection is weakening him and may slow the healing process down in other areas as well.
The goal is still to get Dad off of the ventilator, but he did not make any progress in that area today. They are still waiting for him to cough.
We continue to hope that they can remove the ventilator soon so that Dad can be more comfortable. We would also like for them to take his neck brace off. We are hoping that the wrist surgeon will be able to replace his exterior wrist screw with a titanium one so that the MRI can be done tomorrow to rule out neck injuries. This needs to be done before they take the brace off. It is so hard seeing Dad so obviously uncomfortable. When he is alert he often thrashes around trying to get all of the various paraphernalia off of his body. He has been nicknamed the "master manipulator" by the nurses because he is so good and finding ways to wiggle out of the compressors on his legs and the ties and straps on his arms. When we talk to him it feels like he is pleading for us to help him out and make him more comfortable, so it is very difficult to see. This is especially hard on my mom. We feel that once he can get the ventilator out, he will be much more calm, so we would really love to see that happen soon.
When Dad gets agitated, his blood pressure shoots up (above 200 sometimes). Dad has never had high blood pressure before, so this is a bit concerning. He has now being given blood pressure medication to help control that.
On a positive note - Mike noted that this morning was the most alert that he has seen my dad. My dad was properly responsive to the neuro team when they stopped by.
Tomorrow will be a week since the accident occurred. As a family we would have loved to see more progress made up to this point, but realize that this whole situation is going to require much patience and love on our part. Dad is physically starting to look much better and less swollen and more like himself.
Saturday, April 21, 2012
This day has brought some tender mercies with it. As Mary stated from her morning update, Dad was much more alert and responsive today. This afternoon and evening he held a few of our hands, squeezed them, and rubbed us with his thumb. It was his way of letting us know he loves us. He opened the one eye and when we asked if he could see my mom, he nodded yes. The nurse held up two fingers and asked if he could see them, he looked and held up two fingers on his own. He also wiggled both right and left fingers when asked. He became a little agitated and wanted so bad to tell us something. His breathing started to struggle again so they turned up the ventilator slightly. We were concerned that he was digressing with his breathing, but the doctor said a little fluctuation like that is normal. The nurse told him if he coughed for them they could take it out. He tried and tried for many minutes but couldn't get a good cough out. Hopefully that will happen tomorrow. As he became more agitated his blood pressure really skyrocketed. They asked us not to interact with him for a while to stop the stimulation so that he could rest.
They were unable to do the MRI on his neck, because it turns out that a part of the rod that is screwed into his wrist is not titanium. The doctor is hoping that it will be something they can change out and replace with titanium metal since it is on the outside, but he is not sure. They will have to wait and hear back from the wrist surgeon tomorrow or Monday. Until that can be replace and an MRI can be done his neck brace must stay in place. We really hope that will be taken care of because he is miserable in the neck brace.
They did a culture to determine where the infection is and so they can begin to treat it, however the results won't be back for about 48 hours. They did replace the arterial line with the thinner pic line.
So many people have asked what they can do. We asked my mom what she needed and this is what she came up with. There are so many people that are struggling and hurt that do not have the support my dad has. Some of the other patients around have few or no visitors. If you want to help us wherever you are, please reach out to someone that doesn't have that support system and help them with their struggles. Even if it is someone you don't know. Hospitals and nursing homes are full of people that never get visitors, and have no one to turn to. I know that would really please and touch my father and mother.
We are grateful we started this blog and can try and keep so many who have requested updates informed. On this blog you can also send your love and support through the comments. At the bottom of each post you can click on the word "comments" that appears in blue. This will allow you to write a small note to our family that all of us will see. If you don't have a google account you can click on "Anonymous" where it says "Comment As:" and that will allow you to write a comment.
Thanks again for all your love and support.
They were unable to do the MRI on his neck, because it turns out that a part of the rod that is screwed into his wrist is not titanium. The doctor is hoping that it will be something they can change out and replace with titanium metal since it is on the outside, but he is not sure. They will have to wait and hear back from the wrist surgeon tomorrow or Monday. Until that can be replace and an MRI can be done his neck brace must stay in place. We really hope that will be taken care of because he is miserable in the neck brace.
They did a culture to determine where the infection is and so they can begin to treat it, however the results won't be back for about 48 hours. They did replace the arterial line with the thinner pic line.
So many people have asked what they can do. We asked my mom what she needed and this is what she came up with. There are so many people that are struggling and hurt that do not have the support my dad has. Some of the other patients around have few or no visitors. If you want to help us wherever you are, please reach out to someone that doesn't have that support system and help them with their struggles. Even if it is someone you don't know. Hospitals and nursing homes are full of people that never get visitors, and have no one to turn to. I know that would really please and touch my father and mother.
We are grateful we started this blog and can try and keep so many who have requested updates informed. On this blog you can also send your love and support through the comments. At the bottom of each post you can click on the word "comments" that appears in blue. This will allow you to write a small note to our family that all of us will see. If you don't have a google account you can click on "Anonymous" where it says "Comment As:" and that will allow you to write a comment.
Thanks again for all your love and support.
Updates from my hospital visit this morning:
Dad is leaking spinal fluid from his nose. They are going to monitor it until tomorrow. If it has not stopped by then they will perform another CT scan and will take action to stop it - by either a spinal drain or surgical repair. They are concerned about that.
Dad is still on the ventilator. His breathing progress has plateaued. He is breathing on his own, they just need him to take deeper breaths and be able to cough on command. They think that he isn't coughing because he doesn't want to (broken rib pain), not because he actually can't. They are going to keep checking his progress and once he hits those milestones they will take the breathing tube out. We really hope this will happen soon for his own comfort and because it will reduce the risk of lung infection to get it out sooner rather than later. Also, he may be able to talk to us a bit if he can get that out.
Dad has been running a low grade fever, so they are checking for infections in his blood / urine. They started him on antibiotics. Another source of infection may be his arterial line. They are going to take that out and replace it with a thinner pic line that will run up his arm to his main artery.
They are running an MRI on Dad's neck today to make sure there is not any ligament damage. If his neck is fine, they are going to take off his neck brace so that he can be a bit more comfortable.
They are still getting good responses from Dad on command, but would like him to be a little more alert in between, so they have lowered his pain meds a bit.
When I was there this morning, Dad was the most responsive he has been. He opened his eye (one eye is too swollen) several times and definitely seemed to know that I was there. When I asked him to wiggle his toes and lift his arm for me, he did both. He did not give me a thumbs up, but his hands are casted/ splinted, so it may have been too hard. I told him that I was here and that I loved him and he raised his eyebrows at me in response. At one point he was making noises and it seemed like he was trying to talk to me. When I asked him if he was in pain he shook his head no. When I asked him if he knows what is going on he shrugged his shoulders.
When Kelsey told him that she was there she got the same lifted eyebrow response. She told him to get better quickly so that we can play this summer and he again raised his eyebrows in response. He is definitely still in there and he was obviously aware that we are with him. He also kept lifting his arm to me today as if he were trying to grab my hand or something.
Dad's arms and legs are tied down and restrained because otherwise he tries to pull things off. It is hard seeing him so obviously uncomfortable.
Last night when Josh was at the hospital, the nurse told Josh that she was really encouraged because Dad was moving his own body for her when she was changing the sheets. He was helping her out by turning his own body when he could tell that she wanted him to and scooting himself over. Today when they changed his sheets while I was there, he fought them on it. But that is also a good sign because it showed that he associated his pain with turning on his ribs.
So the hope for the remainder of today is that the spinal fluid leakage will stop, that he can pass the breathing tests and get off of the ventilator, that they can find the source of his fever and be able to reduce it, and that the MRI will be fine so that they can remove his neck brace and make him more comfortable.
I personally was encouraged by how he seemed today. But I know there are still some serious risks of complications and many hurdles to cross. When I asked the Dr. what the biggest risk/concern is right now he told me that there are about 10, all of them very serious. So he continues to need lots of prayers.
Thanks again for all of the love and support.
Dad is leaking spinal fluid from his nose. They are going to monitor it until tomorrow. If it has not stopped by then they will perform another CT scan and will take action to stop it - by either a spinal drain or surgical repair. They are concerned about that.
Dad is still on the ventilator. His breathing progress has plateaued. He is breathing on his own, they just need him to take deeper breaths and be able to cough on command. They think that he isn't coughing because he doesn't want to (broken rib pain), not because he actually can't. They are going to keep checking his progress and once he hits those milestones they will take the breathing tube out. We really hope this will happen soon for his own comfort and because it will reduce the risk of lung infection to get it out sooner rather than later. Also, he may be able to talk to us a bit if he can get that out.
Dad has been running a low grade fever, so they are checking for infections in his blood / urine. They started him on antibiotics. Another source of infection may be his arterial line. They are going to take that out and replace it with a thinner pic line that will run up his arm to his main artery.
They are running an MRI on Dad's neck today to make sure there is not any ligament damage. If his neck is fine, they are going to take off his neck brace so that he can be a bit more comfortable.
They are still getting good responses from Dad on command, but would like him to be a little more alert in between, so they have lowered his pain meds a bit.
When I was there this morning, Dad was the most responsive he has been. He opened his eye (one eye is too swollen) several times and definitely seemed to know that I was there. When I asked him to wiggle his toes and lift his arm for me, he did both. He did not give me a thumbs up, but his hands are casted/ splinted, so it may have been too hard. I told him that I was here and that I loved him and he raised his eyebrows at me in response. At one point he was making noises and it seemed like he was trying to talk to me. When I asked him if he was in pain he shook his head no. When I asked him if he knows what is going on he shrugged his shoulders.
When Kelsey told him that she was there she got the same lifted eyebrow response. She told him to get better quickly so that we can play this summer and he again raised his eyebrows in response. He is definitely still in there and he was obviously aware that we are with him. He also kept lifting his arm to me today as if he were trying to grab my hand or something.
Dad's arms and legs are tied down and restrained because otherwise he tries to pull things off. It is hard seeing him so obviously uncomfortable.
Last night when Josh was at the hospital, the nurse told Josh that she was really encouraged because Dad was moving his own body for her when she was changing the sheets. He was helping her out by turning his own body when he could tell that she wanted him to and scooting himself over. Today when they changed his sheets while I was there, he fought them on it. But that is also a good sign because it showed that he associated his pain with turning on his ribs.
So the hope for the remainder of today is that the spinal fluid leakage will stop, that he can pass the breathing tests and get off of the ventilator, that they can find the source of his fever and be able to reduce it, and that the MRI will be fine so that they can remove his neck brace and make him more comfortable.
I personally was encouraged by how he seemed today. But I know there are still some serious risks of complications and many hurdles to cross. When I asked the Dr. what the biggest risk/concern is right now he told me that there are about 10, all of them very serious. So he continues to need lots of prayers.
Thanks again for all of the love and support.
Friday, April 20, 2012
Dear family and friends,
We have been in awe at the out pouring of love and concern for Dad. It is humbling to see how respected and loved he is. I have always admired my father's ability to make friends and help people feel loved and appreciated. Going through this horrible experience has really shown me how many lives he has touched. Thank you from all of us for your prayers, thoughts, and generous hearts.
We have tried to keep you all up to date with updates, but it is hard to really understand how serious his situation is without being here at the hospital. I know first hand since I didn't arrive in town until Wednesday. He is still considered to be in critical condition and is not out of the woods yet. Our updates have been positive and our family feels a strong sense of peace that he will make it through this. However, it is still very serious. He is still in the ICU and has his own nurse assigned to him. He still has the ventilator and is not breathing completely on his own. Hopefully that will come out soon, but that will be only the first of many steps on his road to recovery. When we say he has responded to our voices, that is a simple thumbs up, or a wiggle of his toes. Today when I told him I was there and that I loved him, he raised his eyebrow. This is what we mean when we say he is responsive. Many times he doesn't even move when we talk to him. He does not talk or communicate in any other way at this point. His eyes are pretty much swollen shut and it take great effort to even get them to peak open. In fact his whole face is so swollen he does not look like himself.
It is wonderful that they were able to get the wrist and ribs surgery completed. He still has many fractures in his face, and that reconstructive surgery won't happen until sometime next week at the earliest. After that surgery his face will swell again, and may look worse that it does now for the first few days. The face, ribs, and wrist are fixable. It is the brain injury that has him in the ICU. It is his swollen brain that places him in critical condition. The responsiveness is a great sign, but it is the only thing we have to tell us about his brain right now. We don't know what the damage has done, or what his recovery will entail. The first few days after the accident, the lights in his room were kept off, we were asked to whisper around him, and touch him as little as possible. His brain needed as little stimulation as possible to prevent further injury while it continued to swell. Since the injury has started to stabilize, we are able to talk to him more, and hold his hand or touch his arm, but he still needs reduced stimulation. He is still in ICU and considered in critical condition. For this reason we ask that you please wait to come visit him. This is for his protection.
As we have stated, this is going to be a long, hard, horrible road to recovery for my Dad. We have faith that he will recover, but it won't be easy. He will need so much love and support to get through this. He will need friends and family to lift his spirits. He will need visitor and phone calls to buoy him up and help him get through. My dad is a good and loyal friend, and he will need those friends in return. We just ask that you please wait. We will let you know when he is ready for those visitors.
Thanks again for all your support, prayers, and love. Keep praying for him and my mom. Prayer is what will get us all through this.
Kathie
We have been in awe at the out pouring of love and concern for Dad. It is humbling to see how respected and loved he is. I have always admired my father's ability to make friends and help people feel loved and appreciated. Going through this horrible experience has really shown me how many lives he has touched. Thank you from all of us for your prayers, thoughts, and generous hearts.
We have tried to keep you all up to date with updates, but it is hard to really understand how serious his situation is without being here at the hospital. I know first hand since I didn't arrive in town until Wednesday. He is still considered to be in critical condition and is not out of the woods yet. Our updates have been positive and our family feels a strong sense of peace that he will make it through this. However, it is still very serious. He is still in the ICU and has his own nurse assigned to him. He still has the ventilator and is not breathing completely on his own. Hopefully that will come out soon, but that will be only the first of many steps on his road to recovery. When we say he has responded to our voices, that is a simple thumbs up, or a wiggle of his toes. Today when I told him I was there and that I loved him, he raised his eyebrow. This is what we mean when we say he is responsive. Many times he doesn't even move when we talk to him. He does not talk or communicate in any other way at this point. His eyes are pretty much swollen shut and it take great effort to even get them to peak open. In fact his whole face is so swollen he does not look like himself.
It is wonderful that they were able to get the wrist and ribs surgery completed. He still has many fractures in his face, and that reconstructive surgery won't happen until sometime next week at the earliest. After that surgery his face will swell again, and may look worse that it does now for the first few days. The face, ribs, and wrist are fixable. It is the brain injury that has him in the ICU. It is his swollen brain that places him in critical condition. The responsiveness is a great sign, but it is the only thing we have to tell us about his brain right now. We don't know what the damage has done, or what his recovery will entail. The first few days after the accident, the lights in his room were kept off, we were asked to whisper around him, and touch him as little as possible. His brain needed as little stimulation as possible to prevent further injury while it continued to swell. Since the injury has started to stabilize, we are able to talk to him more, and hold his hand or touch his arm, but he still needs reduced stimulation. He is still in ICU and considered in critical condition. For this reason we ask that you please wait to come visit him. This is for his protection.
As we have stated, this is going to be a long, hard, horrible road to recovery for my Dad. We have faith that he will recover, but it won't be easy. He will need so much love and support to get through this. He will need friends and family to lift his spirits. He will need visitor and phone calls to buoy him up and help him get through. My dad is a good and loyal friend, and he will need those friends in return. We just ask that you please wait. We will let you know when he is ready for those visitors.
Thanks again for all your support, prayers, and love. Keep praying for him and my mom. Prayer is what will get us all through this.
Kathie
I just got back from the hospital and felt encouraged as I personally witnessed Dad respond for the first time. He wiggled his toes on command and also grabbed the nurse's hand and squeezed (all while seemingly remaining out). They were encouraged by that, but they would be more encouraged if he were giving a thumbs up sign on command (or holding up 2 fingers would be even better). They encouraged our family to try to get responses from him in that way as patients often respond better to familiar voices.
Dad is breathing on his own now, but they are keeping the ventilator in place until he passes the breathing exercises that they give him. They are hoping to get it out tomorrow.
I was given a detailed explanation of his CT scan from early this morning. His injury is in the right frontal lobe and is fairly large. However, she said again that if you are going to have a brain injury, that is where you want it. In fact, when they have to do invasive procedures in the brain that is where they do them. For one thing, the right side is usually less dominant. Also, the injury is in the area that controls emotion. IF we were to see changes in Dad, it most likely would be something to do with impulse control or little personality changes. All of that is just a wait and see situation. The swelling in his brain was somewhat worse, but because he is still responding they are not planning on doing anything invasive to relieve that at this time. Brain swelling usually peaks around days 3-5 after injury, so they would expect it to start diminishing from here.
Jeff and I were slightly concerned that Dad is still so out when he has been taken off of the sedative. We asked the nurse about that. She said it could be the pain meds or just the fact that it takes the brain a while to wake up after an injury as serious as his. It is probably a combination of many factors. At least he didn't appear to be in pain. And the most important thing is that he is responding to commands, which is the most they expect at this time.
I also want to clarify that Dad is still classified as being in "critical" condition. When we have mentioned things about him being stable in other posts, it just meant that his individual injuries were stabilizing. But he is still critical. He has suffered some very serious, life-threatening injuries, but we feel very encouraged and feel as a family that he will pull through this,
Having said that, while Dad is in the ICU it is best to limit his visitors to those very closest to him at this time. Please check before coming, or wait until thins are less critical. When Dad is doing a little better and has come through the worst of this he is probably going to want visitors. (We all know how social my dad is.) We appreciate so very, very much the love and support that has been shown to Dad and our entire family at this time.
We will continue to keep everyone updated.
Dad is breathing on his own now, but they are keeping the ventilator in place until he passes the breathing exercises that they give him. They are hoping to get it out tomorrow.
I was given a detailed explanation of his CT scan from early this morning. His injury is in the right frontal lobe and is fairly large. However, she said again that if you are going to have a brain injury, that is where you want it. In fact, when they have to do invasive procedures in the brain that is where they do them. For one thing, the right side is usually less dominant. Also, the injury is in the area that controls emotion. IF we were to see changes in Dad, it most likely would be something to do with impulse control or little personality changes. All of that is just a wait and see situation. The swelling in his brain was somewhat worse, but because he is still responding they are not planning on doing anything invasive to relieve that at this time. Brain swelling usually peaks around days 3-5 after injury, so they would expect it to start diminishing from here.
Jeff and I were slightly concerned that Dad is still so out when he has been taken off of the sedative. We asked the nurse about that. She said it could be the pain meds or just the fact that it takes the brain a while to wake up after an injury as serious as his. It is probably a combination of many factors. At least he didn't appear to be in pain. And the most important thing is that he is responding to commands, which is the most they expect at this time.
I also want to clarify that Dad is still classified as being in "critical" condition. When we have mentioned things about him being stable in other posts, it just meant that his individual injuries were stabilizing. But he is still critical. He has suffered some very serious, life-threatening injuries, but we feel very encouraged and feel as a family that he will pull through this,
Having said that, while Dad is in the ICU it is best to limit his visitors to those very closest to him at this time. Please check before coming, or wait until thins are less critical. When Dad is doing a little better and has come through the worst of this he is probably going to want visitors. (We all know how social my dad is.) We appreciate so very, very much the love and support that has been shown to Dad and our entire family at this time.
We will continue to keep everyone updated.
They were unable to take Dad off of the ventilator today. They will try the breathing tests again tomorrow. So maybe then. Dad was trying to take deep breaths and was getting closer, but was not there yet. He was breathing mostly on his own, but they still needed to keep air in his lungs between breaths to prevent the lungs from collapsing. He needs to be able to cough and breathe deeper on command to get the ventilator out.
They are concerned that he may have some infections and may start antibiotics.
Dad has continued to be responsive today.
They are concerned that he may have some infections and may start antibiotics.
Dad has continued to be responsive today.
Dad has continued to respond today. He gave Mike the thumbs up sign when Mike told him that he loves him. The next step is for Dad to give deep breaths on command. He has only been able to take quick, short breaths on his own up until now. Once he is able to breathe deeply on comand, they will completely remove CPAP.
Dad responded well again this morning, although he was not differentiating between left and right (which he has been able to do in the past). They have left him off sedation and do not plan to give it to him again unless he isn't resting well.
He most likely will not be taken off of the ventilator today because he is still relying on it to breathe. So that is a little disappointing. He will have his chest tube in for a few days to drain the fluids from the rib surgery.
I just have to say that I have such an amazing family. My brothers have been taking work off and someone has been at the hospital around the clock. My sister-in-laws have put their lives on hold to take shifts at the hospital and to help my mom out. Shari had the great idea to set up a calendar and have everyone sign up for shifts, so that there is someone there at all times (except during the late night/ early morning). That way we don't have everyone there at once and then no one there at other times. My brothers make sure someone takes my mom to the hospital every day and someone brings her home at night, so she doesn't have to drive herself or be alone.
My sister came in from California two day ago as well.
For me personally, I am not able to be at the hospital as much as my brothers because of my young kids (and my husband has a brand new job and is not able to take alot of time off right now to help out). I have been able to find time every day to visit, but it has been hard for me to hear so much of this information second hand. Doing these updates makes me feel like I am doing my part. Also, I work for my dad, so I have been putting in extra hours / days working to keep his company afloat from the business end. I want to make sure that if he is able to come back to work there will still be a company for him to come back to. But it is hard not being at the hospital all of the time. I know that is where all of my family's heads and hearts are when we are not there.
I can only imagine how much harder this is for my mom than it is for the rest of us. She is really starting to show signs of physically wearing down. I tried to convince her to take a day off to stay home and rest all day, as this is sounding like it's going to be a long haul, but she of course also doesn't want to be away from my dad. So please continue to think of her and pray for her.
He most likely will not be taken off of the ventilator today because he is still relying on it to breathe. So that is a little disappointing. He will have his chest tube in for a few days to drain the fluids from the rib surgery.
I just have to say that I have such an amazing family. My brothers have been taking work off and someone has been at the hospital around the clock. My sister-in-laws have put their lives on hold to take shifts at the hospital and to help my mom out. Shari had the great idea to set up a calendar and have everyone sign up for shifts, so that there is someone there at all times (except during the late night/ early morning). That way we don't have everyone there at once and then no one there at other times. My brothers make sure someone takes my mom to the hospital every day and someone brings her home at night, so she doesn't have to drive herself or be alone.
My sister came in from California two day ago as well.
For me personally, I am not able to be at the hospital as much as my brothers because of my young kids (and my husband has a brand new job and is not able to take alot of time off right now to help out). I have been able to find time every day to visit, but it has been hard for me to hear so much of this information second hand. Doing these updates makes me feel like I am doing my part. Also, I work for my dad, so I have been putting in extra hours / days working to keep his company afloat from the business end. I want to make sure that if he is able to come back to work there will still be a company for him to come back to. But it is hard not being at the hospital all of the time. I know that is where all of my family's heads and hearts are when we are not there.
I can only imagine how much harder this is for my mom than it is for the rest of us. She is really starting to show signs of physically wearing down. I tried to convince her to take a day off to stay home and rest all day, as this is sounding like it's going to be a long haul, but she of course also doesn't want to be away from my dad. So please continue to think of her and pray for her.
Morning Post Surgery Update
Last night after surgery they turned down the sedation to check Dad's responsiveness. They were unable to get him to respond, which concerned them. So they immediately had another Cat scan done to check on his brain bleed. The Cat Scan looked unchanged from the previous one, which was good. They thought that his unresponsiveness may have been caused from all of the medication in his systerm from surgery, so they turned off his sedation overnight and turned down his pain meds. This morning they were able to get him to follow commands. He also opened his eyes. He was acting like he was in pain at that point, so they turned the meds back up.
Surgery update
Update from Jake who is still at the hospital. (The rest of us went home after we talked to the surgeon post-surgery.)
Dad's surgeries today went well, although they took longer than expected. They were able to plate six ribs in front, but the Dr was unable to get the back ribs. He said those weren't as crucial and should heal on their own. He didn't want to keep him in surgery any longer to get to them. His wrist has pins and external hardware. The orthopedic surgeon was called on an emergency surgery so we did not get a chance to talk with him.
Post surgery Dad's right lung looks outstanding with minimal bleeding at this point. The left lung was deflated a bit. This was caused by laying on that side during surgery and should be better by morning. Dad does have some punctures to his lungs, but they do not seem too concerned about those at this point.
They did not need to give Dad a transfusion but they put in a chest tube to drain fluid. Dad is still sedated from the surgery, but they will check his responsiveness level soon. They may try taking him off the ventilator tomorrow during the day.
Dad was quiet and sedated all day and the family thought that he seemed a bit less responsive, but the medical staff did not seem concerned. He may wake up a bit tomorrow if they are able to take him off of the ventilator.
Dad's surgeries today went well, although they took longer than expected. They were able to plate six ribs in front, but the Dr was unable to get the back ribs. He said those weren't as crucial and should heal on their own. He didn't want to keep him in surgery any longer to get to them. His wrist has pins and external hardware. The orthopedic surgeon was called on an emergency surgery so we did not get a chance to talk with him.
Post surgery Dad's right lung looks outstanding with minimal bleeding at this point. The left lung was deflated a bit. This was caused by laying on that side during surgery and should be better by morning. Dad does have some punctures to his lungs, but they do not seem too concerned about those at this point.
They did not need to give Dad a transfusion but they put in a chest tube to drain fluid. Dad is still sedated from the surgery, but they will check his responsiveness level soon. They may try taking him off the ventilator tomorrow during the day.
Dad was quiet and sedated all day and the family thought that he seemed a bit less responsive, but the medical staff did not seem concerned. He may wake up a bit tomorrow if they are able to take him off of the ventilator.
Thursday, April 19, 2012
Dad went into surgery at about 5:30. They said to expect about 5 hours. We have started a blog to keep updates on my dad now. That way those who are not on Facebook or not Facebook friends can also keep updated on him. The address is: updatesoned.blogspot.com. There are so many people who love my dad so we thought this would be a better way to keep everyone informed. Thank you again for all of the love and support. My mom has been holding up well, but everything is starting to take a physical toll on her. Please remember her in your prayers as well.
I just got home from the hospital. Dad was completely sedated the entire time, but we were told that he could hear us. He won't remember any of this (thank goodness) due to his medication. The nurse told me that most head trauma patients are very agitated when their sedative is decreased, but that Dad is very calm and responsive, which is a great thing. Surgery on his ribs and wrist is planned for tomorrow, pending a favorable CT scan in the early morning. They will be putting plates and screws in his ribs and wrist, which are severely fractured. His skull fractures will not require surgery, as they are straight. Facial surgery will not be for a while. It is possible that he will be taken off of the ventilator tomorrow. After that, he will be awake and aware. He will still remain in ICU for a while. Thank you again to everyone for your thoughts and prayers. Your support means so very much to my entire family. It is evident what a great man my dad is by all of the concern and love he is being shown. I should also mention that my family was told that if you have to have a brain injury, his is in the spot that you would want it. I didn't get a chance to ask why .
April 18 11:00 pm
Dad is continuing to show great responsiveness, which is the most we can wish for right now. He was asked to raise his hand and open his eye tonight, which he did. Last I heard, they had opted out of doing another CT scan today because of his level of response, but will probably do another one tomorrow to check on the brain injury. Dad is terribly banged up and the healing process will be long and tough, but we are cautiously optimistic. They are hoping to have him stabilized enough to surgically repair his wrist in the next day or so, but they will have to wait for a while for the swelling to go down to do his facial reconstruction surgeries. He has numerous facial and rib fractures. Tuesday at 8 pm
Latest update on my dad: My mom told my dad she loves him and he nodded his head yes. She asked, "can you hear me" and he nodded it again. The hospital staff is acting more encouraging about his level of responsiveness and we have been told that he is doing as well as can be hoped for. Still critical. Thank you for all of your prayers and kind words.
Thank you for the prayers everyone. Latest update: my dad did well through the night and continued to respond to commands. The biggest concern right now is the bleeding on the brain. It will most likely get worse before it gets better, so they are monitoring that closely. If that is able to heal, then they will deal with the multiple facial fractures, rib fractures, hand and wrist fractures, eye injuries, and any other problems they discover. Right now, however, all of their focus is on his brain. The next few days are critical, so please continue to pray for him. Thank you!!!
I have had a few people ask me about my dad's accident, so I will tell you what we know. My dad is a general contractor and was at a vacant car dealership looking at a roof for a bid. He was either about to get on the ladder from the roof, or at the top of the ladder when somehow the ladder slipped and he fell with it. It is estimated that he fell around 15 feet. He fell on the right side of his face and head. Most of his major injuries are on his right side. The miracle in all of this is that the owner of the building just "happened" to arrive at the building right before my dad fell. He pulled up and saw my dad up on the roof. Then he pulled around to the other side of the building, went inside, looked out the window and noticed the ladder was gone. He looked again and saw my dad on the ground. He got to him within a minute or two of the fall and immediately called 911. Luckily, the accident occurred within a mile of the hospital and the paramedics were there within 5 minutes. With serious head injuries, it is so crucial to respond quickly. My dad fell on the side of a vacant building, and normally there is not anyone there. If the owner hadn't visited just when he did, it could have been hours before my dad was found and he probably would not have survived.
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