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.