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...