Update #49

I have really been slacking with the posting. My apologies to everyone who refreshes the blog every five minutes - just over 1,000 refreshes later, I'm finally giving your index finger a break. Please do remember that no news is always good news...

Dave had a pretty mellow holiday weekend. The doctors and nurses did not work him nearly as hard as they have been, giving him some time to relax away from PT and ventilator work. In spite of the break (or maybe partially because of it), Dave has been pretty tired this week as he gets back into his normally strenuous recovery routine.

The opthamologist came by on Monday afternoon to check Dave's right eye, and it seems that Dave's optic nerve was pinched (but not severed) during the accident. Based on the amount of injury that the doctor saw on the MRI and CT scan, and in person, the damage should not be enough to cause complete blindness in that eye, so he asked for a consult from a retinal specialist to see if his retina is separated from his eye. Although the opthamologist did not say that the injury would heal, he also did not say that it would not heal, so we are taking the optimistic perspective and seeing the uncertainty as a good thing.

On Tuesday, Dave passed his swallowing test (yeah!), which means he is officially cleared to drink all of the fluids that we had already been giving him (the nurses did say it was okay before), a full bar that now includes Passion Fruit Iced Tea from Starbucks, orange juice, vanilla milkshake, and most recently Icees. He seems to be enjoying the various flavors, but he did protest the tomato soup that the nurse tried to serve him for lunch yesterday.

Although the nurses are still changing Dave's dressings three and four times per day, they have stopped using all tape (which was tearing his sensitive skin) and have also changed the type of drainage tube they are using in order to avoid using the plastic vacuum packs with which they had been covering his major wounds. The drainage has slowed considerably (yeah!), to the point that most of Dave's wounds are simply packed with four-by-fours and gauze, with no suction or tubes and no binding or tape to hold them in place. Drainage continues coming from the tubes in his side (I think there are only two of them now), but it seems to be more under control, and his dressing changes are not nearly as painful as they used to be.

As for breathing, although Dave's break over the weekend made ventilator work more strenuous for him, he managed to breathe on his own with only pressure support from the ventilator (called CPAP) all night last night and still managed to sleep well. Just to help clarify, there are three basic levels of "breathing" that Dave is doing right now:

1. Ventilator On -Dave initiates breaths on his own, but in the event that he does not take a breath, the vent will take it for him (this is his highest level of support);

2. CPAP - Dave breathes on his own, with the ventilator only serving to provide pressure support to help keep his lungs open between breaths and to assist him in getting the full volume of each breath;

3. Trach Collar - Dave is completely off the vent, breathing pure oxygen on his own through the tube in his neck (normal breathing, but pure oxygen instead of the air in the room).

So far, Dave alternates mostly between the ventilator and CPAP, but he did go for a full hour on the trach collar on his first try on Thursday, which, considering the injuries to his diaphragm, was very impressive.

Although Dave still has a long way to go in his recovery, this week's attending doctor said this morning that he is "doing great" and "making lots of improvements." Just a few specific prayer requests:

*For his right eye as doctors continue to try to determine why he cannot see out of it;

*For the drainage in his side - that the "controlled fistula" will become more and more controlled and dressing changes fewer and farther between;

*For his blood pressure - it was low enough on Monday night that the nurses could not give him his sleeping meds, which probably contributed to his level of exhaustion all day yesterday. His blood pressure was high enough last night to give the meds again, but the doctors are watching it carefully.

Thanks for sticking with us through the lull in posts. More updates as we get them.

Love from Knoxville,
Kendahl