Update #106

There are certain words that have a way of hitting you like a ton of bricks - pneumonia is one of them. It hit last night when I got to Drake after youth group. After all the coughing of the past few days, sometime yesterday afternoon, Dave spiked a fever of 102, and his breathing got extremely shallow - Amy, his night nurse, was the first to actually say the word. Taking into account the amount of time he has spent in bed and considering the injury to his diaphram, pneumonia is not unexpected, but it's still scary. So far, we are still waiting on official culture results, but the doctors started him on a round of antibiotics last night as a preemptive measure until the results come back.

In spite of the difficult Sunday (or perhaps because of it), Dave slept well last night, a blessing overall but especially in preparation for what has been a very long Monday. It started early with a trip in the ambulance to see Dr. Archdeacon, Dave's new orthopedic surgeon. After yet another round of X-rays, Dr. Archdeacon informed us that Dave's femur actually has shown some signs of healing and he does not (at least for the moment) need another surgery. Another appointment is scheduled for January 8th to reevaluate.

While visiting Dr. Archdeacon, Dave started to get another fever, and his oxygen level dropped to 87 (it should be at least 92). The paramedics put him on some oxygen to help increase the level, and immediately after returning to his room from the ambulance, Dave was carted away for his third chest X-ray in under a week. On the negative side, the X-ray does not indicate whether he has pneumonia or not. On the positive side, however, the congestion in his chest has not gotten any worse over the course of the last week.

The chest X-ray was followed by a visit from a pulmonary specialist who wrote orders for two things: the first, a spirometer (breathing test) to determine how much volume Dave is getting per breath; the second, another breathing treatment that actually vibrates the inside of his lungs to help break up some of the congestion (a treatment that he will get every four hours, day and night - I guess it's a blessing that Dave hasn't been sleeping through the night anyway). Hopefully, the new measures will help to treat whatever is causing the coughing and shortness of breath (pneumonia or otherwise).

The rest of the day was filled with the new breathing test, the new breathing treatment, and unfortunately, a lot more coughing. I'm sitting next to Dave now, and after a 45 minute coughing spell, he looks like he may be sleeping or at least relaxing for the first time since 6:00 a.m. Huge praise that the femur surger is not necessary for the moment and that the doctors have new ideas on how to treat Dave's lungs. Please be praying that the pneumonia culture will come back negative and that the new treatments will help to clear his breathing once and for all.

Update #105

The past 24 hours have been pretty rough. Because of the remaining congestion in his lungs, Dave has been coughing a lot since Thursday. Yesterday, he spent most of the morning coughing, and this morning, he woke up at 5:15 a.m. and coughed almost non-stop until 6:45 a.m. Dr. Weintz precribed an inhaler, which helped loosen up some of the congestion, and hopefully, we will also write an order for some cough syrup, at least so the coughing doesn't keep him up at night.

We also go word on Dave's X-ray to determine what was causing the extreme pain in his hip, and it looks like Dave's femur isn't healing at all. Because of the level of his pain meds (he has a pain patch on his shoulder that provides a constant stream of meds) up until this past week, he hadn't felt much pain from the break, even to the point that he hasn't needed any Oxycodone to supplement the patch. Earlier this week, however, Dr. Weintz decided to try to cut the level of meds in the patch in half, and over the course of the week, the pain from the femur started to break through. Dr. Weintz reincreased the patch, and by the end of the day yesterday, Dave was able to sit up in his wheelchair again. The X-rays from Thursday will be transferred to the orthopedic surgeon this weekend, so hopefully, we will have some information on the next steps for the femur (probably bone grafts sometime soon) on Monday.

Dave's red blood cell count has also been low again, so he received two more units of blood overnight. The blood (and all the testing that goes along with getting blood), combined with the coughing made for a pretty long night.

On the positive side (there is always a positive, in spite of how this post started), Dave is back to his target rate on his feeding tube and should be off the TPN again before Monday. The annoying cough is actually helping to clear his lungs (his chest X-rays look better and better), and he is getting stronger and stronger getting in and out of his wheelchair. Aside from being exhausted, he is still in good spirits and continues to work as hard as he can at the movements and exercises that don't cause him pain.

Please be praying that the cough will go away and that our meeting with the orthopedic surgeon on Monday will provide a plan to relieve the pain in Dave's hip. Also, be praying for Dave's sister Jen and her family who disappointingly couldn't come to Cinci this weekend because her kids have a cold.

More soon...keep praying!

Update #104

New prayer request: Dave's right hip, the one that was fractured in the accident, has really been hurting recently, to the point that he is having a really hard time with PT and just sitting up in general. The pain started on Monday afternoon and is now bothering him so much that Dr. Weintz has ordered an X-ray for this afternoon. Considering how many X-rays Dave has already gotten, the speed of the order for this current X-ray is only surprising because he is actually scheduled for a round of X-rays on Monday morning at University of Cincinnati, specifically targeting his right hip and femur to see if bone grafts will be necessary. Hopefully, the X-ray this afternoon will help detemine the source of the pain so they can fix it quickly.

The wave of new doctors continued yesterday with meetings with Dr. Kitzmiller, the plastic surgeon, in the morning and another surgeon in the afternoon. According to Dr. Kitzmiller, Dave's wound is healing well (aside from the fistula), and he probably will not need a skin graft to cover the area in the center of his abdomen. No mention of whether he will be cutting the skin flap and repositioning it where it was originally intended to go (over the area where Dave's ribs used to be). The other surgeon (I wasn't here when she came, so I'm not sure of her name) said that they have not been able to determine the exact location or size of Dave's fistula but mentioned that she has noticed a substantial decrease in the amount of drainage coming from Dave's side since he has been on TPN only, so she may decide to continue without tube feed to see one last time if the hole will close on its own if the level of drainage is reduced. If she decides to move in this direction, please be praying that it works as it would eliminate the surgery to close the fistula that should occur in December.

Until that decision is made, Dave does have a new tube in his stomach for tube feed (the old tube that the nurses tugged and pulled in vain on Monday came out without a problem yesterday), and yet another X-ray yesterday confirmed that the tube is in the proper place, so he should start receiving tube feed again this afternoon.

Based on the results of the EMG (electrode test) last Friday, Dave also had his first round of e-stim yesterday, which involves stimulating the muscle along his shin on his right leg with electric shocks sent through electrodes placed along the muscle (because there is no nerve response on that muscle in his left leg, the e-stim wouldn't have any effect on that leg). Hopefully, the e-stim will assist in building the muscles that help Dave flex his foot to alleviate the foot drop on his right side.

In spite of all of the craziness and testing over the past few days, Dave seems to be doing well and seems to be moving toward a more normal life (if normal exists) every day. We hung out with our Bible study on Monday night and even had a triple date playing cards with some friends on Tuesday evening (Dave and I got crushed). Be praying for Dave's dad over the next week as he began his first break in Michigan since this accident this morning and for Dave's mom as she picks up the extra hours with Dave in his absence (I don't think she'll be complaining about the extra time with him). Also, pray for Jen (Dave's sister), Chris and their family as they head down for another visit tomorrow.

I'm guessing there are at least a few updates that I am forgetting, but it's been a busy few days. More as it happens - thanks for the continued prayers!

Update #103

Sorry for the lack of posts over the weekend - I spent Saturday mourning Notre Dame's loss to Michigan State (Dave was pretty happy), and Sunday was our youth ministry kickoff for the fall, so things were pretty crazy.

After a rough afternoon on Friday, the weekend took a more positive spin. First, Dave was switched to a new type of tube feed, and the rate was being consistently increased. When we asked why, the nurse told us that according to the notes in the computer, the barium (dye) test showed that that hole in Dave's intestines is far enough along in his digestive system that he is actually getting at least some of the nutritional benefit of the tube feed before it goes out through the side of his body (this is what we were hoping for). Because of that fact, the doctors switched his tube feed to a type that requires less volume but gives more nutrition (less volume going in means less drainage coming out), and over the course of the weekend increased the tube feed volume, decreased the TPN (IV feed), and early on Sunday morning, turned off the TPN completely! We haven't actually had a chance to talk to the doctors, but we are hoping that the change will also allow Dave to start eating some normal food beyond soup and pudding.

As a negative sidebar to that positive news, Dave actually ended up back on TPN yesterday. The new tube feed that he is getting is much thicker than what he had been on, which means that the tube is much more likely to clog. And clog it did, to the point that the nurses couldn't get it unclogged and decided that they needed to put in a new tube. Unfortunately, when they tried to remove the old tube, it was so stuck after two months inside of Dave's stomach that they couldn't get it out. Even with the expertise of a physician's assistant, and with a lot of painful pulling and twisting, the tube would not release itself from Dave's body. We will not get word from the surgeons on what the next step should be on removing the old tube and inserting a new one until tomorrow, so for the moment, Dave is back on TPN and not getting any tube feed. Fortunately, it should be a very short setback.

As for PT, Dave's continues to make progress, and today for the first time, he will be trying out the "real" PT gym on the second floor of Drake as opposed to the smaller gym on his own floor that the therapists have been using. He is doing almost all of the work to get himself into the wheelchair for therapy every day, and according to the weekend therapists, he did most of the work in standing up the other day as well.

Dave also wore real clothes for the first time since his accident on Saturday, athletic shorts and a Michigan State t-shirt to be prepared to cheer his team on to victory against my Irish (I'm only mostly bitter). I can't even describe how much better and stronger he looked, simply by being out of a hospital gown.

Dave's mom is back from Michigan, looking relaxed and well rested, and she and Den will both be in Cincinnati for a couple of days before Den takes his own break to head back to Rochester Hills on Thursday. Jen and her family will also be down this weekend for another visit.

Aside from the mishap with the feeding tube, the past few days have been overwhelmingly positive. Keep praying for progress...more updates soon.

Update #102

Today was a crazy day. When we prayed for new and exciting things to keep away from the monotony, I don't think this is what we had in mind. The day started early with a breakfast of dye (you know you are jealous) that was supposed to help trace the location of the fistula in Dave's body, a process that included two x-rays this morning and another three this afternoon.

After "breakfast" and the first two x-rays, the Wound Care Team came by and changed Dave's dressing for the first time in a week. Although the vacuum wasn't leaking, it was losing some of its suction whenever Dave sat up, so it seemed that the Team preferred being safe rather than sorry. Fortunately, the dressing change was not nearly as painful as it had been during previous changes, and his wound is showing even more signs of healing! Overall, a positive process.

Break for lunch (real lunch, not dye), then three more x-rays, followed by a test called an EMG that was supposed to help determine how much (if any) nerve damage Dave sustained to his legs during the accident. The test came because Dave was showing signs of a condition called drop foot, which basically means that he is incapable of pulling his toes up toward his face (flexing his feet). After two hours of being hooked up to electrodes and poked with needles, the doctors determined that he does have nerve damage in both legs.

On the positive side, the nerves in Dave's right leg are regenerating, and even the muscles on the tops of his legs that assist in pulling up his toes are showing "baby nerves" that will grow stronger with time.

On the negative side, oddly enough, the nerves on the top of Dave's left shin that would cause that foot to flex showed no reaction at all. If the damage is permanent, Dave may have to wear a brace on his left leg in order to avoid tripping over his toes, but the doctor said that three months may be too early to tell if or when the nerves will grow back. Thinking very positively, if the nerve damage is as a result of Dave's blood clot (which is possible), the nerves have had only seven or eight weeks (not three months) to heal, which makes it even more likely that they will regenerate.

Even with all of the uncertainty and potential for progress that the doctor communicated, the news was still hard to hear, and Dave does seem to be struggling with the possibility of needing a brace to walk, especially since the nerve damage is on the side of his body that wasn't injured. Tonight, please be praying that the damage is temporary and that Dave is able to start flexing his foot soon. Also be praying for his spirits as he processes the potentially frustrating results.

Update #101

Dave stood up for a full minute yesterday! Still with the assistance of PT and OT, and it was still quite a strain, but it was amazing! From what he says, his difficulty with standing up isn't the strain on his legs or arms (which he uses to support himself on the parallel bars) but rather the strain on his chest because the wound vac pulls tighter when he stands. We're certainly not complaining about the fact that the vac is still holding - six days straight now - but hopefully, whenever they do have to change the dressing, the Wound Care Team can find a way to relax the pressure on his lungs a bit so breathing and standing won't be so difficult.

After standing, Dave stayed in the wheelchair for an additional hour and a half, his longest time yet! During that time, he was evaluated in higher level processing by another speech therapist, and he passed with flying colors! Basically, aside from his eyes (I'll clarify the plural in a minute), the brain injury does not seem to be causing any other issues.

As for his eyes (and I apologize if I've already put this in a previous post - it's hard to remember what has been communicated), in addition to the blindness in his right eye, Dave informed us not too long before we left Knoxville that he has something similar to sunspots in his left eye, which make it even more difficult to read and focus. The spots and blindness, combined with some numbness in the fingers of his right hand, will be the only serious issues that will make going back to work difficult (difficulty focusing on a computer screen and difficulty typing and holding a pen). At some point, we will be seeing a neuro-opthamologist for his eyes, and OT is supposed to begin working on increasing bloodflow to his fingers - please be praying that both issues will be resolved quickly.

One other thing that I forgot to mention - Dave got moved to a new room on Saturday. Early last week, a roommatte moved in to the other side of room #420, an addition that made the room a whole lot more claustrophobic and noisy (he enjoys talking on speaker phone on his cell phone at full volume). On Saturday afternoon, when the roommate had gone out for a cigarette, his and Dave's nurse, Sue, made a side comment about how much quieter it was with him gone. When Dave and I agreed, Sue offered a move to a room across the hall. She couldn't guarantee that Dave will always have the new room to himself (in fact, there is a good chance that he will get another roommate), but for now, the room is quiet, private and much nicer. For anyone who is coming to visit or sending cards, the new address is room #421.

Finally, a friend of ours from Bible study passed on this link to a news story that came out on the night of Dave's accident - http://www.wbir.com/news/local/story.aspx?storyid=59074&catid=2. Not much information, but it is amazing to think of how far he has come since June 6th. God is incredible, and Dave and I pray nightly that He will reveal to us how this awesome story will continue to be used for His glory in the future. Can't wait to see what He has in store!

Update #100

Ever since Dave's accident in June, every time things have become too frustrating, too overwhelming, too scary, it has been amazing to see how God has sent out some small piece of encouragement to remind us that He is still working. Yesterday was one of those days.

As I'm sure you can imagine, sitting in the same bed in the same room staring at the same wall all day, completely dependent on other people, without the energy to do much of anything anyway, makes for some pretty rough times. Actually, let me rephrase that - I can't possibly imagine what it is like for Dave to be in that situation. Once again yesterday, that issue came up as Dave talked about how depressing the monotony is, and it was one of so many moments since he has been awake when I found myself desperately wishing that I could trade places with him so he could play soccer or go for a drive or even take a walk. We spent almost the entire time we were outside in the wheelchair after PT/OT discussing ways to mix things up within the bounds of what he can do, and as we talked, I was praying silently for something for him to do that would make him feel less like a lump and more like himself.

When we got back to his room a few minutes later, we found a package from my friends Marcie and Dave containing (and anyone who knows Dave will know how great this is) a miniature remote control helicopter that he can use in his hospital room. It also had a board game and some snacks, as well as some pictures of their new baby. It seems like such a small thing, but that package added some excitement and happiness to a day that was seeming really blah. Marcie and Dave, thanks so much for the package and for making Dave (and me) smile. What a great God moment...

In light of all of that, Dave really is driving himself crazy with so little to do during the day. There is only so much Mythbusters that a man can watch before his eyes glaze over. If you have suggestions for things that might help - a favorite book that his parents and I can read to him, a game that doesn't require too much strain on his eyes, an idea of something to do that will stimulate his brain a bit, please post it as a comment. As he gets stronger and stronger, things will get better and better, but for now, a few seconds of standing (with the help of three other people) and an hour sitting in the wheelchair drain almost every ounce of energy he has, so amusing ourselves in his room will have to suffice.

Although the monotony has been difficult, the past two days have been pretty good physically. Dave did stand again yesterday during PT/OT - for over five seconds! - then spent an hour and a half outside in the sun. The wound vac continues to hold (no dressing change in five days - yeah!), and his arms and legs are getting stronger every day. His chest is still really tight, and he still has a lot of congestion, but his chest x-ray showed that he is just as clear as he was last week.

Today, please pray that the tightness in Dave's chest would loosen, that his lungs will get stronger, and that his energy level and spirits will continue to go up. Also, this week he is scheduled to have a dye test that will help Dr. Weintz and the surgeons determine the location of Dave's fistula, which will impact both future surgeries and his ongoing nutrition. Be praying that the fistula will be far enough down in his digestive system to warrant turning off the TPN and even increasing what he is allowed to eat (even adding pureed foods like mashed potatoes and oatmeal would be an improvement).

Update #99

One more prayer request that I totally forgot to mention: after three months away from home, Dave's mom decided on Friday morning to take a break, and she headed back to Michigan for some recuperation time. I know how hard it is to be away for more than a few hours - please be praying that Cherie's time at home will be a time of relaxation and rejuvenation so she can come back refreshed and ready to continue walking with Dave through his recovery. Also be praying that Dave will get completely settled at Drake so his dad can feel comfortable going home for a break as well.

Update #98

Sorry for the lack of posts over the weekend. Saturday was kind of a blah day for Dave and yesterday most of the area around Drake (including my house) lost power from whatever is left of Ike that swept through Ohio. I guess that's one benefit to being in a hospital - they have power when nobody else does...

First and most excitingly, Dave stood up for the first time on Friday! During PT/OT on Friday afternoon, the therapists made Dave do a lot of the work to get himself from the bed to the wheelchair, and he did so well that they decided to see if he could use parallel bars to stand up. It took three people and a lot of effort, but Dave got vertical for the first time in over three months!

After that, the weekend got a little rougher. All day Saturday, Dave had a horrible time trying to breathe, to the point that his nurse ordered a chest x-ray (I guess that's a pretty big deal at Drake on the weekend) to make sure there wasn't something serious going on. He received a couple of breathing treatments (similar to what is used for asthma) that afternoon and evening, but the congestion continued. The struggle to breathe (combined with whatever they saw on the chest x-ray) was enough to order suctioning for Dave yesterday, a horrible process that involves sticking a tube down his throat to suck out any excess fluid from his lungs. The procedure helps prevent pneumonia, so of course we are grateful that they did it, but it made for an incredibly rough Sunday.

On the positive side, the wound vac that is controlling the drainage from Dave's side has been on for 72 hours and counting! Although the Wound Care nurses still have to play with it every once in a while to clean out clogs in the tubing, this is the longest that Dave has gone without a dressing change since his accident.

I stayed at Drake with Dave last night (sitting next to him now), and it seemed like he slept soundly, so hopefully today will be a better day. The rest of the Greater Cincinnati area is on hold because of the power outage, but Drake is up and running - we'll see what they have planned...

Update #97

Yesterday was a much better day, and Dave is making a lot of progress (which is amazing to be able to say that considering the fact that I see him every day now - yeah! - so you'd think the changes would be much smaller and less noticeable).

First, we met with his surgeon, Dr. Muskat, yesterday afternoon, a meeting that was oddly reassuring. Dr. Muskat had spoken at length with Dr. Taylor down at UT, so he is very aware of everything that Dave has been through and has a well-thought-out plan of where he is going. Next week, Dave will have a procedure that involves running dye through his digestive system and will help the doctors determine the location and size of his fistula (the hole in his colon). From there, Dr. Muskat and Dr. Weintz, along with the Wound Care Team and the nutritionists, will be able to determine:

1. if the doctors should stop the tube feed and leave him on TPN (IV feed) only in an effort to get the fistula to close on its own (unlikely considering the length of time he has had it);

2. if they can switch to tube feed only (plus the full liquid diet he is on) and stop the TPN entirely - the TPN can be harmful to Dave's already weak liver but can only be stopped if the fistula is far enough down in his intestines that he is actually getting the nutritional benefit of the tube feed before the food becomes drainage that leaks out his wound;

3. if and when they will need to do surgery to repair the fistula (likely December).

In addition, next week we will also meet with the plastic surgeon to determine the necessity of additional skin grafts and/or the possibility of moving the original skin flap (which also contains a lot of supportive tissue) back up to cover the most serious part of his injury (the doctors at UT had to move it down when the aladerm (mesh) desintegrated after Dave's original graft - not sure if that makes any sense, but basically, they may try to put the graft back where they wanted it originally).

Whenever Dave has his surgery/ies, he will be transported to the University of Cincinnati Medical Center for the procedures and a short recovery period, then transported back to Drake for additional rehab.

After the meeting, Dave had his PT/OT session, which consisted of another ride in the wheelchair. It may sound small, but the amount of work and energy it takes to accomplish something that seems so simple is incredible. It was during this session that I really noticed his progress. First, Dave helped the therapists when they sat him up, using his arms and even some of his core muscles to balance and move himself. Next, he sat up by himself (no support from the therapists) for a few minutes (progress from a few seconds on Saturday). Then, he helped slide his body from the bed to the wheelchair. Finally, he wheeled himself all the way down the hall to the elevator and most of the way to the door leading outside once we got to the first floor. For anyone who knows Dave, I realize that it may be difficult to think of any of those individual steps to be a major accomplishment for him; for anyone who saw Dave immediately after his accident, you know just how major of an accomplishment it is.

One other huge thing: Dave made it through the entire process, plus an hour of sitting up outside, plus the transport back, without throwing up or even feeling sick. His blood pressure remained stable, his color was good, and he still had energy left when we arrived back in his room.

It's raining here today (I'm going to blame the weather for any incoherence or rambling you may have noticed in this post), so probably no trip outside this afternoon, but hopefully, it will be another day of progress. More later...

Update #96

Dave finally got to meet his heroes! Bill and Matt, the guys from Ludlow, Kentucky who saved Dave's life on the side of exit 141 off of I-75 in Oneida, Tennessee over three months ago, along with their wife/mom Lori, came to Drake last night, and Dave finally had a chance to shake their hands and thank them for what they did. The guys gave a little bit more detail about the accident and told Dave over and over again how good it is to see him doing so well. Afterward, Dave's parents and I went to dinner with the family, and although Dave couldn't join us, we did bring him back a root beer float (which he loved, Bill, although the ice cream was melted by the time we got back). Now that we are back in Cincinnati, we hope to be seeing them much more often, and hopefully most of you will get to meet them at the wedding! Bill and Matt, once again, thank you for being where you were and doing what you did - Dave would not be where he is without you.

The only drawback to Bill and Matt coming last night was that Dave had a really rough day yesterday and was not feeling very well during the visit. Some of the issue seemed to be related to his infection, which hopefully will be resolved soon. The main reason for his exhaustion, however, was physical therapy. On the positive side, Dave got to go outside in a wheelchair for over an hour yesterday afternoon; on the negative side, the excursion ended with him throwing up, possibly from exhaustion, possibly just from the change pressure on his wound. Either way, the nausea and fatigue continued through the afternoon, which made it difficult for Dave to enjoy his visitors.

Dave did get some rest while we were at dinner and seemed to be doing much better last night when we got back, but the past week has been rough on him. Please be praying that things will slow down and fall into a manageable routine very soon.

One more prayer request: yesterday afternoon, a physician's assistant who helps with rehab stopped by to check Dave's strength level, and she informed us that he has something called drop foot (the nurses in the ICU had warned us about it). Basically, Dave can push both of his feet down like he is pushing the gas pedal on a car, but if you ask him to pull his toes up toward his face, he doesn't have the strength. Sometime soon, he will be undergoing a test called an EMG to determine if he has nerve damage in his ankles or if the lack of strength is simply muscle weakness as a result of too much time in bed. Be praying for the latter.

More tomorrow...

Update #95

Some prayer requests for today:

1. Dave has been really exhausted over the past few days, probably the combination of the stress of the transfer, meeting so many people, and the urinary infection. Yesterday morning, when I showed up for physical therapy at 7:45 a.m., he was sitting up and watching TV while the nurse checked his vitals, which were great. Just moments after Nita (his nurse) left the room, however, Dave said he was cold and asked for a blanket. In a period of ten minutes following, he started shivering uncontrollably, the color left his face, and his blood pressure shot up. Dr. Weintz said the incident was probably just evidence that the antibiotics were working to attack his infection, and Dave recovered within a half hour, but overall, his body is worn out and his energy level is low. Please be praying that the infection would disappear quickly.

2. In a follow-up visit yesterday afternoon, Dr. Weintz told Dave that his femur is still not healing the way that they had hoped. Based on a conversation with the surgeon who fixed Dave's femur down at UT, if the bone does not heal in the next month, a bone graft may be necessary. Prayers that his femur heals soon...

3. The Wound Care Team is still having difficulty finding a method for controlling the drainage coming from Dave's colon. The most recent attempts have lasted 24 hours with only small leaks, but every dressing change with the new vacuum seal method that they are trying is very strenuous on his body. Please be praying that they'll find a solid method soon.

On the whole, in spite of all of the new prayer requests, Dave's spirits are high, and he is doing well. Since we have been in Cincinnati, there has been daily talk of what he will be doing once he gets out of Drake - where he will live, when will he go back to work, etc. - I'm not sure about how Dave feels, but for me, it is nice to be looking toward the future so much instead of focusing on the day-to-day.

For those of you who have come to visit, Dave has loved seeing you! Please keep the visits coming (in small doses, of course). Also, if anyone has any good soup recipes (broth or puree - he's not supposed to have solids yet) or ideas for fun treats (puddings, smoothies, etc.), please pass them along. The selection at Drake leaves something to be desired.

More tomorrow, keep praying...

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

Update #94

Where to start?

First, the negative. Dave has been throwing up a little bit today. Two potential explanations:

1. We found out this morning that he has another urinary infection. As we speak, the nurses are in the process of removing his catheter, which probably caused the infection.

2. He isn't getting any tube feed, so his stomach may be upset because there is nothing in it. For some reason, just before we left UT, the doctors increased Dave's tube feed from 30, where it had been consistently for a few weeks, to 65, almost the target level for the feed. Although this move seems positive, mostly, it just served to increase the level of drainage coming from his colon, which was making it very difficult for the Wound Care Team at Drake to control his wound. In an effort to slow the drainage, the weekend doctor turned off the tube feed. There is an order to start it again at a lower level sometime this afternoon, which may help to calm Dave's stomach.

Because of the nausea, the day as been rather exhausting, but Dave's spirits still seem to be fairly good.

On the positive side, at the risk of speaking too soon, it looks like the Wound Care Team may have found a method for dressing Dave's wound that will help control the drainage and possibly assist in getting the skin flap to readhere. Over the past three days, they have tried three or four different dressing methods, all involving vacuums, all of which exploded or leaked not too long after they were completed. The method that they used this morning has been holding since 8:00 a.m. or so...we'll see if it continues.

We also had a chance to speak to Dave's doctor, Dr. Weintz (there is an n in his name), again, and we got some further explanation on what will hopefully be Dave's final surgery. According to Dr. Weintz, there is a very good chance that surgery will be necessary to fix the hole in Dave's colon. Generally, the surgeons like to wait at least six months after the last surgery to go back into a patient's abdomen, so we are about three months away from that mark. The positive side is that in the meantime, once the dressing situation is completely resolved (hopefully today did it), Dave has plenty of rehab and therapy to keep him busy until he is ready for the surgery.

Dave sat up on the edge of the bed again today, which he seemed to tolerate well in spite of the nausea. He also had a follow-up meeting with speech therapy (SIDENOTE: I never realized that speech therapy also included trach care, swallowing, and cognitive rehab), and Marilyn, the therapist, seems pleased with Dave's cognitive function. She mentioned that the therapist who met with Dave over the weekend expressed some concern about higher level memory and cognitive ability (mainly things that might impact his ability to go back to work at GE full force - I'm assuming remembering engineering code and processes, etc.), so she said she may have another therapist do a higher level evaluation to pinpoint what Dave may need to work on in order to prepare his mind for returning to work in the future.

Dave's roommate Chris just showed up for a visit, so I'll finish updating later, but overall, it has been a good start to our time in Cincinnati. Keep praying...

Update #93

Note to self: never give dad the password to the blog. :-)

Sorry for the lack of updates. Dave did arrive safely in Cincinnati just after noon on Friday. He had about 45 minutes to get settled, then the fun began.

In the past two days, we have seen/met:

His attending physician, Dr. Weitz;
Five nurses;
Six nursing aides;
Two respiratory therapists;
Seven people from the Wound Care Team;
One speech therapist;
One occupational therapist; and
One physical therapist.

He has endured meetings with Dr. Weitz, his nurses and the Wound Care Team, evaluations by speech, occupational and physical therapy, two breathing treatments and three different kinds of dressing changes (they're having some difficulty figuring out the best way to control the drainage). We have discovered that he may not need a skin graft (his wound is healing itself well) but will likely need surgery to close the hole in his colon. On Friday, his room was not empty of Drake Center staff until almost 7:00 p.m., and yesterday, we saw doctors, nurses and therapists from 9:30 a.m. until after 2:00 p.m. without a break. Just after the craziness ended, Jen and Chris (Dave's sister and brother-in-law) arrived in Cincinnati for the weekend, and Dave got to see his two nieces and nephew for the first time since the accident.

All of that to say thank you all for being patient about the unreturned phone calls, lack of posts, and most importantly the request that you not visit for a few days. We have been very impressed with Drake so far, and it is clear that we made the right decision, but it has been an exhausting weekend.

Now that Dave is settled, he is very excited at being close to so many of his friends again, and as of tomorrow afternoon (Jen and her family are leaving after lunch), he will be ready for visitors. The next few days will still be a little bit crazy as he gets worked into a therapy schedule, so for anyone who wants to visit:

1. Please come during normal visiting hours (11:00 a.m. to 8:30 p.m.,, preferably more toward the evening);

2. Please call me, or call Dave's cell (which his parent are using), to let us know when you are planning to come (if you don't have the numbers, drop me an email at klund7atyahoo.com and I'll pass them along).

As things start to settle into a routine, the coordination will be less necessary, but at least for the first few weeks, Dave wants to make sure that he will actually be in his room when you come and that he won't have 50 people visiting all at the same time.

For anyone who wants to send mail, Dave's new address is:

Dave Heckel
c/o Drake Center
Room #420
151 W. Galbraith Ave.
Cincinnati, OH 45216-1096

We are so excited about this next step in Dave's recovery and can't wait to see the progress that God brings in his life next. Thanks again for all of your prayers and support, and for continuing to walk with us through this process! Hope to see many of you soon!

Update #92

Just spoke to Kendahl at 3:10 p.m. (this is her dad). Dave is successfully settled in his room in Cincinnati. She asked me to post the blog because she can't take all the phone calls/messages she's getting.... Yet she wants to let everyone know what's going on.

The trip went well. Dave slept most of the way. Kendahl couldn't ride with him in the ambulance (she learned at the last minute) because the ambulance insurance wouldn't cover her. So she followed in her car. She says they made very good time.

Dave is now resting comfortably. He has a view of the courtyard. They have met his doctor and some of the nurses, and don't expect physical therapy to start until Monday, so he'll have a couple days to rest and get acclimated.

Dave's parents should be arriving within a "few minutes" and his sister is coming down from Michigan tomorrow.

Knowing that everyone in the Cincinnati area will be wanting to see him, Kendahl said that she will post a blog when he is ready to have visitors. He probably couldn't handle the onslought of everyone who has been supporting and praying for him for the past 13 weeks visiting at the same time. But I'm sure he's looking forward to seeing you all.

Now, a personal note to Dave (I'm taking advantage of having access to the blog). Now that you have come this far in your recovery, you and I have some unfinished business to discuss...something about my daughter's hand...? Her three brothers also want in on that conversation...:)

Update #91

Dave's moving to Cinci! Just 38 hours shy of three months after his accident, Dave will be transported by ground ambulance from UT in Knoxville to Drake Center in Cincinnati tomorrow morning at 8:00 a.m. After much discussion, Dave chose to go by ground in order to avoid having to be transferred from his hospital bed to an ambulance stretcher, from the ambulance stretcher to the plane stretcher, from the plane stretcher to the ambulance stretcher, and from the ambulance stretcher to a bed at Drake. The doctors here will be giving him meds for pain and nausea before he leaves, which will hopefully be enough to knock him out for the duration of the five hour trip.

Please be praying tomorrow that the weather will be fair, the traffic will be flowing, and the transfer will be completely uneventful. We should be arriving in Cincinnati around 1:00 p.m. - I'll get a post up as soon as he is settled.

God is awesome, I am giddy, and Dave is one step closer to home. Love you all!

Update #90

Really quick - we have to make a decision on if and how Dave will be transported to Cincinnati by 10:00 a.m. today if he is going to be moved before the weekend (the goal is to leave at 8:00 a.m. tomorrow). Right now, the options seem to be:

1. Just under $3,800 for air transport through a company called Air Compassion (ground transport from UT to Knoxville's airport and from Cincinnati's airport to Drake Center are a separate expense, but it should be covered);

2. $2,000 for ground transport in a normal ambulance.

Either way, from the sounds of it, Dave's insurance company will only pay to have him transported to the nearest facility (i.e. he has to stay here in Knoxville), so all expenses are out of pocket.

Be praying...

Update #89

I talked to Dave and his parents tonight, and it was kind of a rough day today. Nothing serious, but the drain slipped out of his wound while the nurse was changing his dressings, and it took a while to figure out who would (and how to) get it back in under the skin flap. Dave has also thrown up for the past two days, coming not so much from nausea as from a pressure in his abdomen that seems to be pretty constant recently.

In spite of both of those issues, however, Dave still seems to be doing okay. He sat up on the edge of his bed for 10 minutes today (still supported by two physical therapists and his dad - all of his back muscles are really weak - completely normal considering how long he has been in bed, but I just want to make sure I'm being clear about where he is so you'll be able to see the progress as it happens in the future), and he said that he slept okay last night. He sounded tired on the phone but overall said he was feeling okay.

Sherri, the Case Manager, found a surgeon at Drake Center that has agreed to take on Dave as a patient, so as soon as the surgeon talks with Dr. Taylor, most of the medical logistics of the transfer should be complete. As for the insurance aspect, no word yet. If the cost of the air ambulance is approved by Dave's insurance, it sounds like he will be moving at 8:00 a.m. on Friday or early next week. Either way, we may not hear a definite go or no-go until as late as 3:00 p.m. on Thursday.

Thank you so much for the continued prayers and for everyone who has asked for Dave's email address to send him a word of encouragement. In the midst of questions about insurance and transportation, please be praying for Dave's overall state of mind as well. Although I know he is happy about the possibility of being back in Cincinnati, he also sounds pretty apprehensive about the move and how hard it will be on him. Be praying that the transfer will not only happen but that it will be uneventful and gentle on Dave and his injuries.

More tomorrow...

Update #88

I talked to Dave again last night, and he continues to do well. He still sounds really tired, which makes sense since the doctors and nurses wake him up with questions, meds and dressing changes at 2:00 a.m., 4:00 a.m., 6:00 a.m...., but overall, he said that he is doing well. His heart rate remained below 100, and he even sat up in a chair for over an hour (SIDENOTE: the chairs that Dave has been sitting in are not normal chairs but special therapeutic chairs with padding, a higher back to support his head and neck and a flat footrest so he can put pressure on the bottom of his feet). Otherwise, he spent most of the day watching TV and relaxing, and when we got off the phone, he was getting ready to have his bed turned so he could watch some Labor Day fireworks out the window of his room.

Really short post today - more once I talk to Dave and/or his fam again. Happy Labor Day! Keep praying for the insurance to come through on the transport!