Update #87

I just got off the phone with Dave (how cool is that?!), and it sounds like today has been a better day. Although he is still pretty tired, he said he stayed awake for most of the day today, in spite of the fact that he didn't sleep very well last night. His heart rate is down in the 90s again, and according to his dad, his color seems to be better. The nurses are still waiting on the culture results, but it sounds like overall, things are okay.

Since he started breathing out of his nose and mouth, Dave has been getting a small amount of oxygen through his nose for a small added boost (if you've ever watched a medical show or visited someone in the hospital, I'm sure you've seen the small tube that hooks over each ear with two prongs that sit on the inside of the nose). This morning, they decided to get rid of that tube, and Dave continues to breathe well (his oxygen level was at 98% when I talked to him). Also, yesterday's chest x-ray showed continued improvement in the clarity of his lungs.

On the topic of talking to Dave, at the risk of sounding really hypocritcal (and incredibly selfish), although he is talking and for as much as I know many of you would love to hear his voice, it is probably not a good idea to flood his cell phone with calls yet. In an effort to soften that statement, however, he did use his laptop on Thursday, navigating the touchpad mouse and the keyboard well, and he checked his email for the first time in almost three months. I know that often, it is easier to drop a quick email than it is to send snail mail, so if you want to send him some words of encouragement directly, feel free (I haven't checked with him about posting his email address for the world to see, so if you don't have it and would like it, drop me an email at klund7atyahoo.com, and I'll hook you up).

Finally, I spoke to an air ambulance company today in order to get some information about moving Dave to Cincinnati (simply for our information - Sherri, the Case Manager, is doing the real legwork on the move). According to the company rep, the trip from Knoxville to Cincinnati, including ground transportation on both ends, a nurse, and transport for an additional passenger to keep Dave company, will cost approximately $8,500 (a regular ambulance would be well under half of that). Because of the holiday weekend, we probably won't be hearing anything else about the transfer until Tuesday, but please be praying that the insurance company will decide that the money would be well spent.

More tomorrow...

Update #86

Quick prayer request this morning - on Thursday afternoon, although he didn't have a fever, Dave was feeling really hot and clammy. He slept for a good portion of the afternoon and still slept quite a bit that night. At the time, it seemed that the exhaustion and even hot feeling might be as a result of breathing on his own through his nose and mouth. Yesterday, however, the same pattern continued. Just before I left for Cincinnati yesterday afternoon, Dave remained feverless but was still feeling hot, and his heart rate was up considerably compared to the past few days (110 to 120 as opposed to 80 to 90). Even though he didn't want to sleep for fear that he would be awake all night, every time we started to do something to keep him awake (read a story, watch TV, etc.), he would doze off without even realizing it. On top of it all, the color in his face had changed from healthy to gray/ashy.

Even though Dave wasn't showing any typical signs of infection (fever, low blood pressure, etc.), we asked Bob, his day nurse, if he could run some tests anyway. When Bob went in to draw blood, he also noticed, after only knowing Dave for a few days, that Dave did not look like himself.

In the worst case scenario, the fatigue, heartrate, coloring, etc., could be a sign of another infection. Slightly better, many of the same symptoms in the past have resulted in a blood transfusion, which the doctors try to avoid unless it is absolutely necessary. Best case scenario, Dave was just having a rough day and will wake up calm and rested this morning.

Please be praying for Dave, for the blood tests, and for the doctors and nurses as they try to determine what is going on. Dave is so close to getting out of the hospital; it would be really rough (for him and for us) to have a setback like an infection that would keep him at UT even longer.

On that note, yesterday afternoon before I left, we gave the official go-ahead to the Sherri, the Case Manager, to pursue moving Dave to the Drake Center in Cincinnati, a move that, according to Dr. Taylor, could happen as soon as late next week. We have received word that Dave has been tentatively approved as a patient by the Drake Center, but the move is contingent on getting Dave's insurance company to pay for an air transfer (to save Dave from enduring a five hour ambulance ride). Please be praying that the insurance will come through and that Dave will be ready to transfer next week.

More updates later today once I talk to Dave's parents...

Update #85

I'm sure I'll have more updates later today, but I just wanted to let you all know that Dave is officially extubated and trach free! One of the attendings (supervising doctors) came in this morning to see if he would have more luck than the resident did yesterday in getting the tube out of Dave's throat in order to insert another tube that could be capped. The tube came out without much effort today (it did have some buildup on the edges that probably made it stick), and as the doctor was getting ready to insert the new tube, he decided that it wasn't necessary and put a small piece of gauze and some tape over the hole in Dave's throat instead! Dave is breathing comfortably out of his nose and mouth and is TALKING (yeah!) without too much effort (although he told me this morning that he actually has to remind himself to force the air over his vocal chords in order to make noise since he has been only moving his lips for so long). The hole in his neck/throat should heal in a couple of days, and his voice will get stronger and stronger (and sound more and more like his own) as he continues to use it. We're trying to convince him that it is his turn to read the Chronicles of Narnia to us, but so far, no luck. :-)

We'll keep you posted as we hear anything about Dave's next move... Keep praying!

Update #84

Big things continue...

First, Dave was successfully transferred out of the ICU to the "normal" hospital, Room #1108, at 4:30 yesterday afternoon, and he is doing great. The first night went well - sleep (both of ours) was interrupted every few hours from coughing fits (Dave's not mine) as Dave continues to clear the fluid out of his lungs, but overall, it has been a good transition. His room is wonderful compared to Bed #15 of SCC2 - it has its own bathroom (not that he uses it), a beautiful view of downtown Knoxville (which he can't see since it sits on the right side of his bed) and a door instead of a curtain. Okay, so the room is probably more of a step up for his parents and me than it is for him as far as amenities are concerned, but it is much quieter and much more private, so we all appreciate that. We have uninterrupted visiting hours, and so far, the nurses and doctors have been just as responsive and wonderful as they were downstairs, so the "scary" of the move seems to have passed. When we ask Dave if he likes his new room, he just shrugs - I guess one hospital room is the same as the next for him, although he did mention that he likes the fact that I actually have somewhere to sleep now (that blue plastic chair in SCC2 where I was "watching him sleep" every night - not sleeping myself, since that would be against the rules, and I would NEVER do anything to break the rules (sarcasm, in case you didn't catch it) - was getting a little uncomfortable). Overall, Non-ICU Day #1 has been a success.

Second, I almost typed that Dave is getting settled nicely in his new room, but today has brought to light the fact that "settled" is not, in fact, the goal. Dr. Taylor, Dave's doctor who met him the first night and performed the majority of his surgeries, came by this morning to check on him and was grinning at how well he is doing. Right off the bat, she confirmed that the drainage from his colon does need to stop completely before the plastic surgeon can do the skin graft, which we expected. When I asked, however, how soon we would be able to move him after the skin graft is in place, we got an answer we did not expect - once she has seen that Dave is doing well out of the ICU for a few days, she sees no reason why he shouldn't be moved out of UT altogether, onto his next phase of recovery, without his final surgery completed. From her perspective, patients improve dramatically once they are out of the hospital (even if Dave would be moving to another hospital of sorts), and because it could be another month before the drainage stops, moving Dave soon might be the best thing for him.

This piece of news has started a whirlwind of events and information that have kept us spinning for the rest of the day. To make a very long story short, papers are being submitted to the Drake Center in Cincinnati and St. Mary's Select Specialty Hospital here in Knoxville to determine if Dave, in his current condition, qualifies for a transfer to either (or both) (SIDENOTE FOR ALL THE MICHIGANDERS: A transfer to Michigan was considered, but the Select Specialty Hospital in Pontiac did not seem to be as well suited to Dave's needs as the options in Ohio and Tennessee). Once we have confirmation that he qualifies, it will be out of UT and onto one of the two new treatment centers.

Aside from the fact that the speed at which this has all happened (they are saying he could be moved next week) is completely overwhelming, the pros and cons to both locations seem to be endless. In the end, however, this is where we are:

1. A move to the Drake Center means that Dave will be closer to family and friends at a well respected facility with a wide variety of services that will meet his needs from now through his entire recovery, including outpatient rehab. It also means a long transport (probably five hours by ambulance) or an expensive one (air ambulance), both of which may not be covered by insurance and may be very hard on Dave;

2. A move to St. Mary's means that Dave has a very short trip to a well respected facility and will remain close to his doctors (including his current plastic surgeon) for any needs that he may have in the future (including his skin graft). On the flipside, he will remain farther from friends and family and will need to be moved again for rehab once his wound is healed.

The only conclusion that we have reached as of now is that there is no easy answer. From Dave's perspective, Cincinnati is very appealing, but not if he has to spend five hours on a stretcher in the back of an ambulance. For the moment, we are waiting on word from Drake and St. Mary's as to whether or not Dave can be admitted to their facilities in his current condition. In the meantime, the Client Services person at UT is researching the possibility of getting Dave's transport to Cincinnati (by ambulance or, preferably, by plane) paid for by his insurance.

Over the next day or two, as more information comes in, please be praying for wisdom on this huge decision. In the end, we want what is best for Dave, whether that is UT, St. Mary's, Drake, or someplace else that God has yet to show us (because I feel the need to complicate my thinking further). We are trying very hard to weigh all of the options, but this whole process has come about so quickly that I think we are really hoping to have time to take a deep breath before any decision needs to be made.

One other prayer request: this afternoon, one of the residents came in to cap Dave's trach so that he can begin breathing out of his nose and mouth again instead of out of his neck (the cap will also allow him to talk normally). The process includes removing the current tube that is down his throat and replacing it with another type of tube, but when the doctor tried to remove the current tube, it got stuck. The whole process made Dave pretty nauseated, and in the end, he stayed on the trach collar and continues breathing out of his neck. The doctors will try again tomorrow - be praying that the current tube loosens up and comes out without a problem so that Dave can be one step closer to breathing completely normally again.

I hope nobody is too overwhelmed - we'll keep you posted as we get more news. As always, His Spirit, His will, His peace, His glory...no matter what the next few days may hold.

Update #83

No more ICU! I just talked to Den, and instead of being moved to SCC3, Dave is being moved to the 10th floor, a regular floor and a regular room! Really exciting but really scary too. Up until this point, there have only been two or three patients per nurse, but on the regular floor, there are six patients per nurse. Dave's parents and I have learned to do a lot of the things that the nurses would do to take care of Dave, so he is in good hands, but leaving the comfort of the ICU (there's a crazy phrase for you) is still pretty scary. The move will happen sometime tonight or tomorrow morning - be praying that everything goes smoothly!

Update #82

It registered again this morning how frustrating it must be to rely on blog posts for updates on Dave's progress and to go more than a day without one of those updates. As a result, I am doing my best to remember to post, even when there are no huge changes.

That statement comes because today is a day of no huge changes. According to Den, Dave is comfortable and doing well. He did make it through his first full night alone on the trach collar (I fell asleep praying hard for just that last night) and is still breathing great. Otherwise, this Sunday is truly a Sabbath, a day of rest before another week of hopefully amazing progress. Be praying that that week will include:

1. A transfer to a new room in SCC3;

2. A drastic reduction in the level of drainage from Dave's colon;

3. Increased strength and mobility in his arms and legs;

4. A meeting with the plastic surgeon to discuss at what point he will be able to perform a skin graft (hopefully Dave's final surgery) - the benchmark seems to be that the drainage must stop completely, but I don't think we've heard those actual words from anyone yet;

5. Some idea from the doctors on how long Dave will need to be in the ICU after the skin graft and at what point he will be able to be moved out of UT;

6. No more pain in Dave's hip;

7. Complete healing of his right eye (trying hard to balance the "faith that moves mountains" of Matthew 17:20 with the thorn in Paul's flesh from 2 Corinthians 12:7-10).

More news tomorrow...

Update #81

No more vent! No more vent! (Yes, I'm a dork, but you know you want to cheer too...)

It's official - the ventilator has been removed from Dave's room! I stayed with him again last night, and he slept peacefully on the trach collar from 11:00 p.m. to 3:00 a.m. and from 3:15 a.m. to 5:45 a.m (probably the most continuous sleep he has gotten since before the attack of sepsis). I had planned on leaving for Cincinnati as soon as the nurses kicked me out at 6:00 a.m., but Dave was at 46 hours straight of breathing on the trach collar, just two hours short of the 48 necessary to get rid of the vent, so I couldn't resist sticking around until visiting hours started again at 8:30 a.m. to celebrate. I just talked to Den, and Steve, one of the respiratory therapists, removed the vent from Dave's room after I left this morning. I think the presence of the machine was a reassurance to Dave even though he hasn't needed it, so Steve told him that there are 60 more just like it floating around UT and that they could get another one if necessary. Obviously, it worked, because the blue machine that has occupied the left corner of Dave's room for so many weeks is now gone.

If the vent removal isn't enough to make your day, the doctors gave Dave a shot of pain meds in his hip earlier today, and when he sat up in the chair (which he was doing when Den and I were talking), his hip didn't bother him at all. Overall, he is seeming very relaxed (probably a combination of the sleep and his 45 minute massage today) and is doing great.

In the midst of such positive progress, please remember to be praying for Dave's right eye. Of all the injuries, pains and changes that he has experienced as a result of the accident, the blindness is by far the most frustrating for him.

Short update today, but very positive. Thanks for the continued emails, blog comments, cards and letters reminding Dave (and us) of your prayers. Even now, 11 weeks after Dave's accident, I find myself looking at the map in Dave's room and smiling at just how covered he is.

His Spirit, His will, His peace, His glory...

Update #80

Aww geez (that's a good "aww geez" - I'm doing a happy dance as I type this)...

Monday - no trach collar
Tuesday - 4 hours on trach collar
Wednesday - 12 hours on trach collar
Thursday, Friday... - 33 hours and going strong!

Yes, folks, we may in fact be done with the ventilator! No official word from the doctors yet, but Dave has surpassed the doctors' 24-hour mark for being on the trach collar, and he is doing amazingly well! He started breathing on his own around 8:00 a.m. on Thursday and still seemed to be doing well last night when we came back from dinner, so I told him I would stay with him until he came off the trach collar. Unfortunately, I had to break my promise, because at six this morning, when the nurses kicked me out (more on that in a minute), he was still breathing comfortably, and I had to leave him breathing on his own. His heart rate is normal (better than it has been in a while actually, running consistently in the 80s), and he seems relaxed and comfortable. There is no way to describe how excited we all are - and we can't wait to get that blue machine out of his room for good.

As for getting kicked out, the SCC (Surgical Critical Care - ICU, essentially) has switched from specific visiting hours to open visiting hours for the entire unit. This means that two visitors per family can stay with each patient at all hours except during shift changes from 6:00 a.m. to 8:30 a.m. and 6:00 p.m. to 8:30 p.m. Dave's night nurse last night asked his dad and me what we think about the new arrangement, and we both had to laugh and admit that it has actually been MORE restricting for us than it was before because the nurses are actually enforcing the "two visitors per patient" rule for the first time since we got here and kicking us out during shift changes, which they haven't done in a few weeks. It has been nice not getting dirty looks or questions from other patients' families wondering why we get to stay so much, but otherwise...

Even aside from the great news about the ventilator, Dave continues to do well. His drainage levels are remaining pretty stable - even seem to be decreasing during the night shift - and his wound is healing well, growing new, healthly tissue every day. He sat up in the chair for almost two hours today, and he is moving his arms and legs more and more (he can lift his left leg - the one that had the blood clot - completely off the bed, and he also wrote a few short but completely legible sentences with his right hand this afternoon).

One other HUGE positive - for the first time in weeks, Dave said that he actually slept okay last night, which I got to see when he was asleep for three and a half hours straight at the beginning of the night (got woken up to take a chest x-ray at 3:00 a.m.) and only woke up once more between then and 6:00 a.m. when I left. The doctors have gone back to using Ambien, a slightly stronger dose, and we are working really hard to keep Dave from napping during the day so he will sleep at night. Hopefully tonight will be another great night as Dave continues to recover.

One specific prayer request - Dave's left hip continues to bother him a lot when he sits up at a 90 degree angle, when he rolls to his left or, more recently, when he coughs really hard. One of the residents stopped by today and, after talking with Dave at length about it, determined that the pain is probably an offshoot the fractures in his lower back, which are still healing. The doctor is going to talk with orthopedics to see if Dave should/could start wearing his back brace when he is sitting up to help alleviate the pain. Be praying that those fractures, as well as the break in his femur, will continue to heal and that the pain will go away.

I think that's it! Incredible update after two great days. There has been talk of moving Dave from where he is in SCC2 to SCC3 upstairs, which, from what we hear, is a slightly more mellow unit. Although it is still an ICU, it would be a step in the right direction and a positive change of scenery...even if he does have to give up his corner room with two windows. :-)

Update #79

I talked to Den this morning, and Dave's still having a rough time. First, he threw up again last night and continues to fight nausea every day. The doctors haven't said a whole lot about what may be causing it, but hopefully they will figure it out soon.

Whether it is as a result of the UTI and nausea or not is uncertain, but Dave's breathing on the ventilator was not at a level that qualified him to be on the trach collar this morning. The respiratory therapist looks at the volume of his breathing every morning to make sure he is taking large enough breaths over the vent to be able to breathe on the trach collar, and his volumes were too low for it to be safe for him. He was on the trach collar for a few hours yesterday, but it's been a rough transitition from 19.5 hours the other night.

The drainage coming from Dave's colon is no longer considered to be "high" (meaning over 500 ccs per day), but it is still hovering between 300 and 400 ccs per day, which means the hole is very clearly still there. Because I was feeling so helpless about not being able to do anything to help, I started doing some research on gastrointestinal fistulas (the drainage hole from Dave's colon) and came across something called fibrin glue that, from what I understand of the articles, has been used in cases similar to Dave's before. The extent of Dave's other injuries or any number of other factors may be preventing the doctors from trying fibrin glue, but we haven't heard the term come up yet, so it can't hurt to mention, right?

Please keep praying. The doctors have told us over and over again that there will be ups and downs, but the ride is getting exhausting for all of us.

Update #78

I just talked to Cherie (Dave's mom), and things are going better today. Although Dave is still nauseated, he seems to be getting stronger and feeling less miserable. It could take four days to a full week before the meds for the UTI work completely (and the doctors are still not absolutely certain that he has a UTI), but the infection meds do seem to be making an impact already. Dave even said he might be up for going back on the trach collar today, which, considering how he was feeling yesterday, is pretty impressive.

With regard to the hole in Dave's colon, the level of drainage is down again - yeah! It was actually down substantially yesterday, but that may have been a result of the nurse stopping his tube feedings - and even cutting off any fluid that we had been giving him - because he was feeling so nauseated. The doctors never figured out why the octreotide had been stopped, so he's receiving a daily dose again, which also may be impacting the level of drainage (at least we hope). From all we can tell, the drainage will have to stop completely before the doctors can do a skin graft, and the skin graft seems to be one key step in getting him out of the ICU (getting off the ventilator is the other). Still no timeline on how long the hole will take to heal, but at least things are progressing in the right direction.

Because of the bleeding in Dave's throat the other day, the nurses have replaced the hard plastic suction catheters that they normally use to clean out his trach with soft rubber catheters. Since the change, we have seen little or no blood coming from his trach. Talk about an answer to prayer!

One other update, since I haven't mentioned it in a while - Darlene's husband Tony (the one who was hit by the drunk driver) was moved out of the ICU and to another hospital closer to their home! He has certainly experienced some ups and downs since the move, and Darlene sounds like she is getting tired, but Tony is doing speech therapy and rehab and seems to be making great progress.

Hearing about what Darlene and Tony have gone through after leaving the ICU (everything from pneumonia to really high fevers) makes me almost grateful that Dave remains where he is. Although it is difficult to be patient, there is some comfort in knowing that he is getting the best care that he can possibly get and that the doctors aren't taking any chances by trying to move him too soon.

I think that's it for today! Enjoy your Sunday, and check back for more tomorrow.

Update #77

After such an amazing day yesterday, Dave's weekend has not started well. When I left Knoxville this afternoon, he was very clearly not feeling well at all, which made it really difficult to get in the car and drive away. Although he managed to sit up in the chair for two hours this morning, he was exhausted all day (not unexpected after breathing on his own for so long) and nauseated, which caused him to throw up twice this afternoon. He also has a slight fever tonight.

As a result of his symptoms, the doctors changed his catheter and started him on some medicine this evening, anticipating that the tests that they are doing will come back positive for a urinary infection. Please be praying that the nausea, exhaustion and overall discomfort pass and that the doctors can treat him quickly and effectively. After everything he has fought through already, it is really difficult to see him so uncomfortable all over again.

More tomorrow...

Update #76

19.5 hours straight on the trach collar yesterday and last night. I think that's a good enough update for today, don't you? :-)

More later...

Update #75

Yesterday morning, I was looking for something in one of the very early posts of Dave's blog and ended up rereading a good portion of the first two weeks of the website. All over again, I was blown away by how clearly God has been working in Dave's life and his recovery. Over the past few weeks, I have been finding myself getting impatient, looking in vain for major advances and becoming frustrated that Dave is still in the ICU. As I reread the early posts, however, I was completely humbled to realize just how far he has come and how much God is doing to heal him (the amount that happened in the first week will never cease to blow me away). Sometimes, it is hard to remember (I would guess it is probably even harder for those of you who haven't seen Dave in a while, or at all since the accident) how truly blessed we are. Dave may still be in the same bed that he was in 10 weeks ago, and we all still have a long road ahead of us. But in the midst of his recovery, he is Dave - he is awake, he is "talking," he is laughing, and he is inspiring so many of us to continue to fight through our own battles on a daily basis. I'm not sure if anyone else needed that reminder and reassurance of his progress, but the realization certainly hit me pretty powerfully yesterday.

As for today, no huge updates, but things continue to progress smoothly. Dave is working at least 12 hours per day consistently on the trach collar and seems to be relaxed while he is doing it. The nurses let me spend the night in a chair in his room last night, so I'm going to try to convince him to go through the night on the trach collar and sleep through it tonight if I stay with him again - be praying that he has the energy to try. He's already been going for six hours today and is doing great.

His leg seems to be feeling a lot better, and he only has some residual effects of the blood clot in his left hip and thigh and on the top of his foot (blistering mostly). He's allowing us to move both legs quite a bit and seems to be gaining some strength.

One other prayer request in addition to the breathing - the doctors changed Dave from Lovonox to a new blood thinning medicine to prevent further blood clots. The new med, Coumadin, is working, which is good, but it is causing increased bleeding in random places, specifically in his throat when the nurses suction out his trach tube. Supposedly, the amount of blood is not worrisome, but it is still pretty scary to see blood coming out of his throat when he coughs. Be praying that the doctors will find a good balance between preventing blood clots and not making him bleed unnecessarily.

Otherwise, today has been a good day. Thanks for the continued prayers!

Update #74

I just talked to Dave's parents, and he continues to do well. He has been on the trach collar since just before lunch and seems to be fairly comfortable. Currently (as of 4:45 p.m. on Wednesday), he is sitting in his "blue chair" (air-filled and much more comfortable than the pink chair he had been using) and watching TV with his parents.

According to Den, Dave tried listening to my "hypnotic" voice on CD last night, but nobody can tell if it really helped. He did get another massage today, though, and seems to be very relaxed. He also has one of his favorite nurses, Prisila, which I'm sure makes him happy (she's the one who tried to shave his gotee early on).

No updates on drainage levels, although we did hear the other day that Dave is no longer on octreotide (the meds that were helping to control the drainage), and nobody can really tell why. Currently, the doctors are evaluating the usefulness of the meds and trying to decide whether they should put him back on it or not.

That's it for today! Shorter than normal, but that means that things are moving in the right direction. More when I get back to Knoxville tomorrow night.

His Spirit, His will, His peace, His glory,
Kendahl

Update #73

Just got back from Knoxville. Yesterday was a busy day. First, Dave worked on the trach collar for nine and a half hours straight! I think he would have gone longer, but in the midst of breathing on his own, he also:

1. Got his dressings changed - During the change yesterday morning, one of the plastic surgery residents came by and said that Dave is still not ready for a skin graft because the level of drainage from his colon, though decreasing, is still too high. On the positive side, as of last night, the doctors decided to start allowing the original skin graft (the flap that is hanging off of his side that they took off partially when the mesh didn't take) to seal over the scar tissue he has formed as opposed to dressing it so it will stay separate (not sure if that makes any sense, but basically, they are allowing the flap to heal). Also, as of this morning, they removed the two smaller drains from his side and left only the third larger one. Keep praying that the hole will close soon.

2. Got a bath - Sounds relaxing, I'm sure, but a sponge bath that requires rolling on both sides isn't a whole lot of fun, no matter how many bubbles they put in the water.

3. Got a massage - Okay, so I can't think of a downside to this. :-)

4. Did physical therapy - Although we did not meet with the orthopedic surgeon yesterday, Dave's nurse did talk to the orthopedic nurse, and she cleared Dave to sit up without a back brace, which means that the X-rays did not show any additional damage after the "experiment" of sitting him up without the brace the other day. From the sounds of it, any time Dave is up for it, he will be sitting at least a few minutes every day, either on the side of his bed or in a chair.

5. Saw a psychologist - Dr. Williams has been coming by two or three times per week to check on Dave (and us too, I'm sure) and mainly, it seems, to tell jokes. Dave enjoys his company (and his humor), and he has been working to figure out why Dave can't sleep at night (he is the reason that Dave was switched from Ambien to a different sleeping - jury is still out on whether the new med is working or not).

6. Got hypnotized - Yeah, it sounded strange to me too, but in an effort to help Dave sleep better, one of the doctors sent a psychology grad student to see if hypnosis might help. The whole process (which is very similar to meditation) was fairly simple, and Dave did, in fact, seem more relaxed afterward, so Nicole (the grad student) and I sat down this morning to create a CD that Dave can listen to every night before he goes to sleep. I never thought I would be a recorded hypnotist, but at this point, I'm willing to try anything that will make Dave more comfortable.

I'm sure that none of the above activities sound overly strenuous, but up until this past weekend, Dave has not been able to do any of them while on the trach collar. He is seeming much more relaxed and makes tremendous progress almost every day. We're shooting for 24 hours straight eventually, which would be one HUGE step closer to getting Dave out of the ICU.

I think that's it for now. Hope everyone is doing well! Keep on praying - more updates tomorrow.

Love from Cinci,
Kendahl

Update #72

Kendahl is on her way back to Knoxville after spending this weekend on a youth retreat. So she has asked me (her dad--I still haven't met Dave...) to update the blog for everything that has happened since last Thursday. Of course, since she hasn't been in Knoxville, this information is from Dave's parents....



On Thursday, there was some concern that Dave might have another infection because his heart rate was in the 130s, he had a fever of 100+ degrees, and they had to give him two units of blood. Overall, he was very tired.



But, on Friday, Dave was on the trac collar for four hours in the morning and an additional nine hours in the afternoon/evening. That's great progress...thirteen hours in one day.



Yesterday, Dave was on the the trac collar for ten or eleven hours straight. His heart rate was back in the 80s, so it doesn't look like he had an infection. And his recovery seems to be back on track.



Tomorrow they anticipate meeting with both the plastic and orthopedic surgeons. The plastic surgeon is expected to schedule Dave's last skin graft to finish closing the wound. The ortho will have results from xrays taken last week, after he had them take Dave out without using the back brace (Kendahl wasn't too crazy about this experiment...). The doctor wanted to see if going without the back brace would have any effect on the cracked vertebrae. Tomorrow they find out.



Overall, Dave is doing well ("well" in an ICU is a relative term). He is sleeping more. And his nurses are pushing him to get him out of ICU.



Thank you all again for continuing to pray for Dave. I know that Kendahl has mentioned several times that there is no way that she and Dave's parents will never be able to thank everyone who has supported Dave and them through this, but they are very grateful for everyone's faithfulness.



As Kendahl says...His Spirit, His will, His peace, His glory.

Update #71

Dave continues to progress well. Yesterday, he worked on the trach collar for three and a half hours in the morning, then sat up in his chair for an hour and a half! He also got another massage, which seems to be almost a daily thing now (I think Gayle and her associate JoAnn are succumbing to Dave's charms as well), and he gets more and more relaxed every single time.

During Dave's work on the trach collar, he has used his Passey-Muir (I think that's the correct spelling) speaking valve a few times, and his voice seems to be getting a little bit stronger each time. The valve makes breathing even more difficult than just breathing on the trach collar, so he doesn't like working with it that much, and we have gotten good enough at reading his lips that I'm not sure he sees the point of speaking out loud (especially since his voice really doesn't sound like his when he uses the valve).

The drainage from Dave's colon has remained at a fairly low rate, and according to his nurses, that rate (and the progress in scar tissue growth over his wounds) has made Dave's condition closer to manageable outside of the ICU. Brenda, his day nurse for the past couple of days, has indicated that she will be talking to Dave's primary doctor to get an idea of what exactly it will take to get him on to his next location and the next phase of his recovery, which will most likely be at the Select Specialty Hospital at St. Mary's Hospital in Knoxville and will hopefully happen sooner rather than later.

Some of the levels in Dave's blood have been down (hemoglobin is one of them, I think), so there is a good possibility that he will be getting another unit of blood in the next couple of days.

One specific prayer request - Dave has a new pain in his back, near his left hip, which makes sitting in the chair extremely painful and PT on that side much more difficult. Be praying that the physical therapists, nurses and doctors can figure out what is causing the pain soon so he can continue to progress.

Just as a heads up, I'm up in Cinci to take my middle schoolers on a retreat from now until Sunday. I will continue to get updates from Dave's parents whenever I can and will do my best to get the updates posted on the website as quickly as possible. Please don't worry, however, if the website isn't updated as frequently. If anything serious comes up, I will be sure to post it. Otherwise, as always, no news is good news.

His Spirit, His will, His peace, His glory,
Kendahl

Update #70

(Sidenote: I started this post at 6:00 a.m. but am just now finishing it at 3:00 p.m., so the time on the post is probably wrong).

So after all that babble about Dave not being able to sit up anymore for a while, Dave got to sit up in a chair...and go outside!

On Saturday, I guess Dave's nurse Laura, who was with him during the first week after his accident, checked with his surgeon (Dr. Taylor), and Dr. Taylor said that the back brace wouldn't be a problem for his injuries. So Laura ordered the brace, then gave Dave a choice - either he could do the trach collar for a long time or he could put on the brace, sit in a chair, and be wheeled with all of his machines out to the helicopter pad to sit in the sun. Hard to guess which one he chose...

I haven't seen the pictures they took yet, but Den said that it was quite the experience. It took eight people and a half hour to accomplish, but Dave left his room and saw the sun for the first time in over eight weeks! When I asked him how it was being outside, he said, "Hot." August in Tennessee - go figure. He did enjoy the change of scenery, though, and his dizziness was not as bad as it was the first couple of times that he sat up.

This accomplishment, and the choice that Laura offered him between sitting up and the trach collar, begins what seems to be a new phase in Dave's recovery - I'm trying to think of a tough metaphor to use - the Rocky Phase, maybe? Anyway, Laura and Dave's night nurse Kristen have decided no more babying him. They want to get him out of the ICU, and they want to do it now. This means, unfortunately, that he is on the trach collar for a long as his body can handle it, even when he says he is tired. He handled it for five hours last night, which was the longest he has done it in a row, but he certainly didn't enjoy the experience, especially when he asked to come off and it took them over an hour to do it. He also just finished another five and a half hours, which he did fine with. From what he has been saying, he just hates being on the trach collar when he is alone at night, so we're trying to push him to work harder during the day so they will cut him some slack while he sleeps. We'll see how it goes.

Dave got his second massage today and did very well with it. Gayle, his massage therapist, said that he didn't close his eyes the entire time she was working on him last week and seemed to feel the need to stay alert even when he was supposed to be relaxing. Today, he was visibly more relaxed and had his eyes closed almost the whole time. Gayle or one of her associates will be back tomorrow to work with him again.

At the moment, Dave is sleeping peacefully in the afterglow of his massage. Overall, he has had a great day, and it is only 3:15 p.m. Hopefully, the rest of the afternoon will be just as amazing. More tomorrow...

Update #69

I actually started to post on Friday night from Dave's room, but then he woke up, and I got distracted. I was on the road back to Cinci yesterday then at a wedding for some friends of ours all day (congrats Justin and Sara!), so I haven't had a chance to get to my laptop since then.

As of 6:30 a.m. yesterday when I left Knoxville, Dave was doing great (I'll get a more recent update from his parents later today). He continues to do work on the trach collar, and his lungs seem to be tolerating the strain well. He and I are working our way through The Chronicles of Narnia while he is breathing (thanks Janice!), which has been a great distraction for both of us. Dave definitely prefers being on the trach collar for two hours at a time multiple times per day instead of the longer intervals, and for the most part, the respiratory therapists have been fine with that arrangement. There seems to be a little bit of disagreement about how hard to push Dave to do longer intervals - some therapists think that if he never goes for longer than two hours, he'll never be able to, while some are completely comfortable with whatever he wants to do as long as he is making progress and continuing to work his lungs. Because the staff at the hospital keeps describing the process as a marathon, and from what little I know of marathon training, it would seem that multiple shorter periods should be fine, at least for now, as long as there is an occasional longer interval, but that's really just me wanting to protect him from the stress and the pain that he feels when he is on the trach collar longer than he wants to be more than anything else.

Occupational and physical therapy came by again on Friday, and unfortunately, Dave won't be sitting up again for a while. Because of the two small fractures in his back that he suffered during the accident, the orthopedic surgeon would like him to be wearing a back brace before he sits, stands or does any other substantial movements, something the therapists didn't know earlier in the week. The brace that he needs to wear would sit on top of the wounds on his right side, which his doctor doesn't think would be a good idea as it might compromise the healing that is occuring on those injuries. We also found out that his femur fracture has not completely healed yet (it can take three months or longer), so we are taking a break from moving his right leg for PT as well. The therapists did do quite a bit of work with Dave's arms, hands, feet and left leg, though, and he tolerated it all very well. He is definitely regaining some of his strength, especially on his left side, and he has been doing many more things on his own - holding a cup to drink through a straw or drinking straight from a small bottle of water, pulling his blankets up to his shoulders or pushing them back down, and he even wrote his name on the card for our friends' wedding yesterday (he had to do it with his left hand because his right one is too weak, but he was strong enough to hold the pencil, put enough pressure on the card to make marks, and control his arm enough to make it legible). Overall, lots of great progress.

The level of drainage in his side had one upward spike midweek then seemed to settle back to where it had been after the octreotide started working. Dr. Tummers (the first doctor I met when I arrived in Knoxville, who is now on a research fellowship and isn't in the ICU anymore) stopped by again to see Dave, and while he was there, he explained that the octreotide doesn't actually help to close the hole; it only helps to slow the drainage enough for the hole to close itself. I'm not sure (and neither was he) how it can slow the drainage without closing the hole, but it is doing what it is supposed to do, so we're happy. Unfortunately, although the octreotide has no impact on the hole itself, the only way to tell if the hole is closing is from the amount of drainage that is coming out, so we continue to pray for it to slow more or stop completely.

Dave's wounds continue to improve, and every nurse who helps change his dressings tells us how much better they look than the last time that he/she saw them. The nurses say that the whole area is forming scar tissue (granulating) well, and although we don't entirely know what that means, even we can see how healthy and pink the whole wound looks. He does have some areas of dead tissue (necrosis), but Dr. Chun and Dr. Tucker, the plastic surgeons, are fairly certain they will break away in time, much like a scab does when it has healed.

For the most part, Dave's spirits continue to be very positive, and I almost felt bad when I was crying before I left yesterday morning because he was being so strong (I keep telling him that one of these times, I'll be able to leave for Cincinnati without crying, but we both know it isn't true). We have heard from so many of you online and in person that reading the blog and all of the progress he is making gives you strength to fight through your own battles. Quite often, when the whole situation gets overwhelming for me (which sounds ridiculous since he is the one in the hospital bed), I find myself drawing strength from him as well - from his positive attitude, from his willingness to fight through the pain, from his peaceful strength that many of you have experienced firsthand as well. Dave still gets frustrated, and I know he is sick of being in bed, in the same room, in the ICU, in Knoxville, but he amazes me with his ability to keep smiling and continue fighting, even through the most difficult things.

Dave has received a lot of cards in the mail this week - thank you to everyone who sent them! Also, don't forget about the e-cards through the hospital if that is easier than mailing something - http://www.utmedicalcenter.org/ecards/ecard_gallery.asp.

That's it for now. Keep praying! And have a great Sunday.