Update #111

For anyone who buys into the "Wednesday equals Hump Day" mentality, yesterday would have confirmed your line of thinking. It's hard to describe why this particular Wednesday was so rough, but the look on Dave's face during PT/OT would have convinced you. Blame it on the weather in Cincinnati, blame it on Dave's feeding tube and wound vac continually getting clogged in the middle of the night and keeping him awake, blame it on passing the four-month mark. Whatever it was, even Maura (OT) and Fran (PT) could see that pushing Dave yesterday during therapy wasn't a good idea. He did manage some weights and a few other exercises, but the one-hour scheduled session pretty quickly became less than 30 minutes, and even that was more than Dave really wanted to do.

A rough day of therapy transitioned into an impromptu meeting in Dave's room between the Wound Care Team, Dr. Sway (one of the surgeons - pretty sure I'm not spelling her name correctly), Dr. Weintz, Dave, his dad, me and a few of the nurses. The long and the short of the meeting: stay the course with the same wound dressing and no solid food. Supposedly, when Dr. Johannigman cleared Dave to eat last week, he wasn't aware that Dave hadn't been eating up until that point and that the solid food would have an impact on the thickness of the drainage coming from the fistula. If the drainage is thick, the wound vac has to be replaced more often, painful both for Dave and for the Wound Care Team. Until Dave's wound heals quite a bit more and becomes a whole lot smaller, he is stuck with the current dressing and unfortunately without real food.

On the positive side, Dr. Weintz confirmed that Dave has an appointment with a neuro-opthamologist next Thursday for the first in-depth look at the problem with his eyes. Hopefully, at the very least, the neuro-opthamologist will be able to explain and even treat the sun spots in Dave's left eye to make sight on that side clearer.

We also got a quick explanation of what it will take to get Dave out of the hospital, four specific problems and therefore four specific prayer requests:

1. Lungs - The new breathing treatments are helping, and Dave has been able to clear more of the fluid from his lungs as a result - the most recent chest X-ray even suggests that his right lung is improving! At the same time, however, his breathing is still affecting every aspect of his treatment, including therapy, and making it very difficult to make progress. No word on scheduling the bronchial scope, but hopefully Dr. Bauer will be back to discuss that procedure soon.

2. Therapy - The most obvious issue is weakness, which PT and OT are working very hard to treat. Hopefully, we'll get a chance to ask today what condition Dave will be in when he is released from Drake and moved to an outpatient treatment plan, strictly from a PT/OT standpoint (walking normally, in a wheelchair but walking occasionally, etc.).

3. Nutrition - Dave is getting all of the calories and nutrition that he needs through his feeding tube. At the same time, being on a feeding tube is certainly not ideal, and it is still difficult to tell what percentage of the nutrition being put into his body is actually be processed and used before it becomes drainage.

4. Wound - Okay, so maybe therapy wasn't the most obvious. Dave still has a very large wound on the side of his body, and the only way to control it, keep it protected and hopefully move toward healing it is through a very complex system of plastic, tape and paste. Anne, one of the Wound Care nurses, said she always tells her children that she uses the same tools to do her job as a kindergarten teacher. No matter how simple the tools, the dressing is very complicated, requiring powerful suction and weekly changes (or more than weekly - today will be the third time in less than a week), all of which would be difficult from anywhere but a hospital.

According to Dr. Weintz, Dave could easily go home with any one of the four issues that he has. The combination of all four, however, means that Drake is his home for the time being. Ever the optimist (one of the reasons that I like him), Dr. Weintz did tell us that aside from Dave's eyes, everything is making progress and moving in the right direction. He even said that the EMG (the test on the nerves in Dave's legs) indicated a good prognosis for the nerves in Dave's left leg, something we had not heard before. One other small update on that front: Dave can now flex his entire right foot, and his progress through e-stim has been so great that Fran (PT) began stimulating a new set of muscles yesterday.

The beauty of a Hump Day is that things are supposed to get easier on the other side. Dave was doing better last night - more energy, better spirits - and he even managed to sleep through a good amount of the poking and prodding that his nurse Sarah had to do last night to keep his wound vac from exploding and his tube feed from clogging. Thursday is another day, a sunny day, and hopefully a day for moving Dave one step closer to home.

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