Update #135

For the first few weeks after Dave's accident, it seemed as if almost every day, there was something new to be praying for - both, on the negative, a new scary situation and, on the positive, a new step forward every time I updated the blog. For as overwhelming as that period of time was, as exhausting and emotional and uncertain, it was also incredible because the progress was obvious and the miracles abounding.

As time went on, I know we all continued to pray, but things slowed. For many of you, that meant fewer updates on Dave's progress to read, simply because there really wasn't much happening. I almost found myself feeling guilty for not having anything exciting to post. For Dave, his parents and me, it meant...well, to be perfectly honest, blah. Melancholy. Monotonous. Almost depressing.

If you walk - or leap (you'll understand that comment in a moment) - away from this post with only one thing today, I hope it will be a reminder to NEVER STOP PRAYING!

After a long spell of...well...blah, the times of almost overwhelming progress are back! For the past two and a half weeks, I have been humbled over and over again at how often I had forgotten to pray through the blah - and how powerfully God reminds us of his presence anyway.

Today, Dave walked with a walker for the first time! Ten steps, five feet or so, but moving forward without the stability of the parallel bars attached to the ground.

Potentially even more exciting, for the first time in almost six months, after hundreds of "bed baths," Dave has been cleared to take a real, hot, running water, so-amazing-I-never-want-to-get-out shower.

Finally...well, before I go here, a small disclaimer: the problem with being a perpetual optimist is that it is easy to drive people nuts with "false hope" that may blow up in their faces afterward. If you lean toward the pessimist or even realist side of things, please take the next paragraphs with the appropriate grain of salt (or pepper, as your taste may be). Please know, by the way, that even as an optimist, I'm pretty flabbergasted.

As most of you know, just after Dave's last abdominal surgery in June, he developed a hole somewhere in his digestive system that was causing secretions to leak from the side of his body. Over time, his body, in order to protect itself from infection, formed a fistula, a tube of scar tissue leading from the hole in his intestines directly out of a hole in the right side of his abdomen. In spite of meds to slow the secretions (remember Octreotide?), TPN (IV feed) to reduce the amount of food being put into his stomach and tube feed to keep the drainage as liquid as possible, the fistula has remained and has contributed to many of the complications with Dave's progress.

The plan was to wait until a minimum of six months after Dave's last surgery (December) for the scar tissue to heal, then to go back into his abdomen to repair the fistula surgically. Until then, it has been wound vacs and tube feeds and annoyances trying to handle the hole.

For a while, my prayer specifically, in spite of what the doctors said, was that the fistula would close on its own and save Dave from another major surgery. After a while, even I started to let that prayer fade, and the biggest good news we could hope for was surgery in December and not March or April.

There's a story in the Old Testament about a widow who comes to Elisha because she has no money to live on - all that she owns is a small amount of oil - and she is about to lose her sons to a creditor of her husbands. Elisha tells her to go out around her neighborhood, collect all of the jars she can find, and bring them back to him. When she comes back, Elisha uses the small amount of oil in her jar to fill all of the other jars, giving her resources to sell in order to pay the debt. The small amount of oil flows and flows to fill every jar to the top, but when the last jar is full, the supply runs out. If the widow had collected hundreds of thousands of jars, the implication is that the oil would have continued to flow until every jar was full. But God worked to match the greatness of her faith and filled only as many jars as she had collected.

Sometimes, like in the story of the widow, God allows himself to be limited to the amount of power we give him and the amount we truly believe he can accomplish. Sometimes, however, God decides to blow us away, reminding us he is a God who is, in fact, "able to do immeasurably more than we can ask or imagine," that his power reaches far beyond the number of jars that we decide to collect.

The reason behind this mini sermon is - how do I say this? - Dave's fistula may be closed. The doctors are not convinced...yet. The nurses are rationally skeptical. Fistulas just don't close after almost six months. But in the past 72 hours, the daily amount of drainage on Dave's dressing has been less than a fourth of what is has been every day over the past six months. Not only that, putting this as delicately as possible, his digestive system seems to be working as normally and "regularly" (think fiber commercials) as yours or mine. So not only is there very little drainage coming from Dave's fistula, in spite of how much more he has been eating, but what Dave is eating is going through his system in the way that is should be.

I wish I could say that this is what I have been praying for all along (I think Dave's sister is the only one who can say that). I wish I could tell you that I had the faith to believe that it might happen. But to be completely honest, I took the "good" news of a December surgery and started placing all of my hopes there. In spite of the limitation that I placed on what God's power could do through Dave's body - kind of funny how it is possible to think that all of the "big miracles" ended in June - God may just be sending a reminder that we should never underestimate what he can do, no matter what science may say.

Dave is a miracle - have I said that recently? - whether his fistula is closed or not. But if things continue the way that they have been going for the past three days, the most recent evidence of his miracularity...miracleness...miraculaneousness (yeah, I know the real word is miraculousness) may be a whole lot closer than it was a few weeks ago. I think God is laughing at, at the very least, my lack of faith. I'm just glad his laughter is serving to heal Dave even more quickly than...well...than I could ask or imagine. :-)

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

Update #134

Dave stood up without the parallel bars today! Okay, he used them to get himself up, but once he was up, he let go with both hands for about 15 seconds! His legs are definitely getting stronger, and his breathing is not affecting his PT nearly as much. So great to see!

Dr. Kitzmiller, the plastic surgeon, came by again today and said that he is ready to go whenever Dr. Muskat is. December, anyone? We're shooting for an early Christmas present...

Otherwise, pretty chill day. Tomorrow, we'll be enjoying Thanksgiving a la Kroger (easier to keep everything hot than it would be trying to bring it from the condo) with Dave's parents, Jen, Chris and their kids. Happy Thanksgiving to you all! I'll try to get some pics up on Friday.

Update #133

So I realized after I put what I thought was an adorable comment about engagement ring #3 in a recent post that I never told you all the story of engagment rings #1 and #2.

Not too long after Dave proposed in the ICU down at UT, the nurses started giving him a hard time about not getting me a ring. I kept telling them that I didn't even need one, and that I certainly didn't need one while Dave was still in the hospital. But they were relentless.

One morning, Dave's parents and I were hanging out in his room, and Dave and his mom kept looking at each other and smiling in a weird way. Then, his mom reached over, still smiling, and started holding his hand - and he smiled too! Awkward! This is the conversation that ensued:

Me: What are you doing?

Dave: Trying to be smooth.

Me: Smooth? With your mom?!

Dave: You really didn't see what I was doing?

Me: (Confused look)

Dave: (Opening his hand) I thought you might want this.

In his hand was a three carat cubic zirconia silver plated ring with six smaller CZ stones around it. Turns out that while I was at Dave's parents' place taking a shower that morning, his mom had gone down to a $5 jewelry sale that UT was having in the cafeteria, and she had picked out two outrageously large "diamond" rings for Dave to choose from to give to me. Fake ring #1, the one his mom transferred not-so-stealthly to him and he handed me that morning, lasted two and a half months before the large stone fell out. Fake ring #2, a four carat CZ solitaire, is still going strong but has a habit of leaving another kind of ring on my hand - green is my favorite color, but not around my ring finger. Fake ring #3 came today thanks to the gift certificate to the Drake Gift Shop that Dave got from Drake for his birthday - $10 of CZ and silver and well worth the investment.

The shopping trip was just one fun part of a good Monday. More walking during PT, more "normal" tasks during OT, more solid food, more wedding planning. Praying for another good day tomorrow...

Update #132

Just a quick prayer request:

We have loved the new dressing that Dave has (just gauze, tape and a binder) - simpler, not attached to any machines, less painful to change, and most importantly, allows him to eat real food. That being said, last night, Dave had his dressing changed at 10:00 p.m.; it started leaking around 2:00 a.m. and took a half hour to change. Back to sleep for two and a half hours, then it exploded again at 5:00 a.m. Obviously, it made for a long night, especially considering the fact that it had been lasting up to nine hours before last night. Be praying that the long night was a one-time fluke and that tonight, we'll be back to a full night of sleep.

Otherwise, life is good! Four days till Turkey Day! Yum...turkey. :-)

Update #131

Dave walks. 'nuff said. :-)

(Sorry for the sideways video, but I didn't realize that my camera won't let me flip it after the fact. Also, sorry for the "Blair Witch Project" filming quality - a little bouncy.)

Update #130

Happy birthday to Dave! Definitely not the way that he expected to spend it, but at least he can eat cake. :-)

Things continue to progress well, and it should be a great day. Yesterday, during OT, Dave got himself in and out of a regular bed from his wheelchair (a whole lot easier than getting in and out of his air bed), including laying all the way down and getting all the way back up again. This morning, he cut his time getting dressed in half (probably sounds silly, but it's pretty impressive to watch, especially since his bandage prevents him from bending at the waist). Moving forward, Maura wants to work on doing more "normal" tasks in more "normal" ways - standing up while shaving, going through the motions of taking a shower so he'll be prepared once his wound is healed, etc.

During PT yesterday, Dave continued practicing his walking (still incredible to see every single time), and Fran started having him work on his hip strength by raising his legs out to the side between steps. Dave's getting more comfortable having his picture taken now that he is looking more like himself so you may get to see walking pics tomorrow...

As a sidebar, in the same way that Dave worked his way into the hearts of everyone at UT (not to mention even deeper into mine) throughout his stay there, the nurses and staff here at Drake completely adore him as well - there are moments when I think they would do anything to make him smile. Last night, as we were getting ready for bed just before midnight, Sara, one of the nurses we have gotten closest to, popped in with a couple of pieces of chocolate cake that she had made just for us to celebrate Dave's birthday. So sweet. Since I've been typing this post, no fewer than 10 people have stopped by to say "Happy Birthday." Anyone who knows Dave knows how endearing he can be, but it's amazing to me that even with how worn out and beat up he has been, he still manages to win people over just by being him.

The social worker just stopped by with a birthday card and a $10 gift certificate for the gift shop downstairs, so we're off to shop. Maybe if I smile really sweetly, Dave will use half of it to buy me another engagement ring. #2 is starting to turn my finger green. :-)

Update #129

Short post, but I thought you might enjoy some pics from Dave's birthday celebration with his fam over the weekend. For anyone who hasn't had a chance to see Dave at all since his accident, you may not notice any difference - for anyone who has seen him, it's incredible how much he looks like himself again. :-) Enjoy the photos!

Also, more walking today! This time, instead of the small gym with the short parallel bars (six feet long or so), we hit up the long gym with the long parallel bars (12 feet long or so), and once again, Dave tackled them twice without a problem! His breathing was clearly better, his strength lasted longer, and his steps were surer. Incredible!

Update #128

Dave walked! During PT yesterday, Fran asked Dave if he wanted to try taking a step or two while holding onto the parallel bars. So he took one...then another...then walked the whole length of the parallel bars! Then, he did it again! It is impossible to describe...yeah...exciting...Dave is walking! Little at a loss for words... :-)

Dave is also, as of yesterday, tube free (at least during the day)! On Monday, all of the wound vac suction tubes disappeared, leaving only his feeding tube. Yesterday, in order to increase Dave's appetite, Dr. Weintz decided to increase his tube feed and have it on only from 7:00 p.m. to 6:00 a.m. Otherwise, Dave is on his own to eat what he wants during the day without the tube feed (sidenote: if he doesn't have the appetite to eat enough, the nurses will give him bolus feeds to supplement during the day). All of this means that Dave can now maneuver in his wheelchair, get in and out of bed, get dressed, and basically live life unattached (to his tubes - he's still stuck with me)! :-)

This week has been incredible, and we have heard over and over again from nurses, doctors, therapists and aides what amazing progress that Dave has made (not that we didn't know that already). Dave's energy is up, his nausea is down, he's eating more (Carabbas Italian and Graeter's ice cream last night), he's sleeping better, his lungs are clearer, he's smiling more - he's becoming more and more Dave every minute.

I'm sure I don't say it often enough, but on behalf of Dave, myself and his family, thank you to everyone for your continued prayers. Almost every day, I get an email or read a comment from someone that I didn't even know knew about Dave and his accident. In the midst of your own crazy lives, more than five months later, you take the time not only to pray but to let us know that you are doing so. I really wish you all could be here to see the progress and hang out with Dave, but I hope the updates continue to help make you feel like you are here experiencing this with us.

Update #127

Two posts in one day - maybe the first time that has happened for a good reason. :-)

Dave stood up three times today! Normally, he stands twice and ends up exhausted but today, he stood up the first time and marched for the first 30 seconds, then stood for another minute. The second time, he shifted his weight from left to right and let go of the parallel bars with the opposite hand (more weight on his legs) for a few seconds, and stood for a total of 1:15. When Fran asked if he would be up for a third stand, he said, "Maybe," then went for it and stood for another 1:15! So exciting!

Dr. Weintz came in this morning and said Dave's lungs sound "100% clearer than they did two days ago." Dr. Robinson, one of the surgeons who works with Dave's surgeon stopped by as well and told us that his nutrition labs are going up and confirmed that the target for the surgery is sometime around Christmas. Dave got signed off at the highest level for shaving on his own in OT this morning, including gathering the supplies, and although he was slightly nauseated during OT, he was feeling much better than he had been.

Overall, the week continues to be very positive. Thanks for the continued prayers!

Update #126

Monday was defintely the kick start we needed for a good week. There have certainly been some downs - Dave threw up all the solid food he ate on Monday, and his stomach has still really been bothering him; the new dressing set up for his wound leaks a whole lot more than the wound vac did - but this week, the ups seem to be winning.

Getting ready for OT or PT has become a very independent thing, to the point that all we have to do is fetch the necessary supplies, whether it be his clothes or his wheelchair. Although he is still never really hungry, it's easy to see how uplifting and freeing it is for him to know that he can eat if he wants to. During PT yesterday, he needed almost no assistance from Fran getting up to a stand from his chair, and once he was up, he stood on his own (holding the parallel bars) for a minute and a half. He did so well during the first stand that Fran had him start "marching," lifting one foot off the ground, then the other, all in preparation to start walking. Although Dave still has a difficult time breathing, especially during the stands, he does not seem as exhausted during or after and recovers much more quickly each time.

Breathing is actually going well enough that Dr. Weintz DC'd (discontinued - don't you love my use of medical terminology? Our friend Jennifer would be so proud) the midnight treatment, so Dave is down to four times per day. Each respiratory therapist who comes for the treatment mentions how much better Dave's lungs are sounding and how impressed they are with his improvement.

After the big switch on wound care on Monday, Dave and I got to see pictures of the progression of his wound size since he's been at Drake. In the past two months, the total area of his wound has been reduced by 56% and the volume (length times width times depth, for anyone who doesn't remember their high school geometry) by 98% (his wound is only .1 centimeters deep in any place now). Although I realized how much it had changed just from my memories of being at UT, it was incredible to see it in pictures.

Be praying for continued improvement and strength, and that the nausea will go away completely. Also be praying that the dressing will stop leaking so much, as it has caused Dave to miss PT at least once this week.

More soon!

Update #125

Would you like fries with that?

Yes, folks, for the first time in over five months, Dave has permission (real permission, not just mine) to eat solid food! Dave's surgeon, Dr. Muskat, came by this morning to check on his wound and (we hoped) give us some idea when the next surgery would be. In the course of Dr. Muskat's ten minute visit, Dave permanently lost the wound vac (just gauze, tape and a binder for dressings now), got permission to eat whatever he wants and found out that he may be done with his next surgery before Christmas! December was the earliest possible timeframe for the surgeons to fix the hole in Dave's colon, and it was beginning to sound like it would be closer to March or April, but after examining Dave and seeing all of his progress, Dr. Muskat was very optimistic about getting things closed up quickly.

In other, even more impressive news, Dave now puts his pants on one leg at a time just like everyone else. :-) Late last week, we found out that Dave is progressing so well with therapy that his OT and PT would be split starting this morning. So today, with Maura (OT - which, by the way, focuses on fine motor skills and completing everyday tasks like washing, shaving, etc., versus PT, which focuses on gross motor skills and large movements like walking), Dave got dressed all by himself (well, with the aid of his gripper), including pants, socks and shoes, and he managed to move his legs off the edge of the bed and sit up on the side with no assistance (which required a tremendous amount of improvement in his leg, arm and abdomen strength). He moved himself to the wheelchair on his own and got to wash his face, shave, and brush his teeth in the bathroom instead of in bed.

After a very successful OT session, Dave and I got to enjoy a real meal together, sitting at a table, with the full permission and blessing of Drake's staff. Because of a mix up in the ordering, Dave got not only a burger and potatoes but also chicken, rice and a salad, and although he doesn't have much of an appetite (he's still getting a full 2,000 calories of tube feed), he did manage to sample everything and help me finish my cherry pie. I get the feeling I may be making a surf 'n turf run for dinner. :-)

Overall, an incredible Monday, and after such a long week last week, just what we needed to remind ourselves that things are moving forward. Continue praying:

1. for the waves of nausea that are still hitting fairly frequently;

2. for the new dressing which doesn't control the drainage as well as the wound vac and has already stained a few sets of scrubs;

3. for Dave's breathing, which seems to be improving but still causes him problems;

4. that the wound will continue to heal quickly so the surgery can be done before Christmas.

Also, just a head's up, Dave's 27th birthday is November 19th (a week from Wednesday). I'm sure it will stink to be spending it in the hospital (although at least now we can celebrate with cake), so if you want to send a card...

More positive news comin' at ya tomorrow...

Update #124

Dave's dressing is on Day #3 and holding, the best we've done in a while. Unfortunately, whether it is the pressure from the wound vac or something else, the right side of Dave's stomach has really been bothering him over the past few days. The pain seems to go in waves and hits so badly sometimes that he can't move (he's in that place right now). Dr. Weintz is "almost tempted" to switch his tube feed from continuous to bolus to see if that helps, but not quite yet. Be praying that the pain will subside.

PT/OT continues to go well. When he stood on Tuesday, Fran (PT) and Maura (OT) did almost nothing to help, and for the first time, Dave said that although his arms hurt, his breathing didn't bother him much. Yesterday, he got some cool new toys - okay, that might be a slight overstatement - some gadgets to help him put on his socks and shoes without help and a gripper to grab things that are out of his reach, which he has been using to torment me ever since. :-) Getting in and out of his wheelchair gets easier and easier, and there is some visible definition in to his leg muscles for the first time since June.

Ann from Cardio-Pulmonary discontinued Dave from their services - I guess we were right when we thought it wasn't doing anything for him - but left some information on breathing that is supposed to help during exercise. Dave has tried the techniques a few times and doesn't seem sold, but we haven't given up yet.

One of the trauma surgeons (potentially even Dr. Muskat, Dave's surgeon) is supposed to be by this afternoon to check on Dave's wound, and we are hoping to get some information on how they will know when he is ready for surgery (this whole "sometime between December and April" thing isn't working for either of us). From what we understand, the scar tissue in Dave's abdomen needs to heal and soften quite a bit before they can operate again (hence the six month time frame we heard originally), but we have no idea if there is some indicator for which they will be watching to know when he is ready. In the meantime, the wound vac (when it holds) is doing a great job of helping Dave's body to create new skin and shrink the wound, a visible indication of progress every week.

There are so many moments when this process seems interminably long and almost unbearable. Dave is consistently positive (or as positive as one can be when one can't breathe), but there are definitely times when the frustration is written all over his face. At the same time, as we crossed the two month mark at Drake yesterday and sit at the five month mark since Dave's accident today, it is once again amazing to think back on how far he has come, and it is encouraging to know that one day, this will all be over. In the meantime, we enjoy the soup, endure the dressing changes, and anticipate the celebration on June 6, 2009.

Update #123

Dressing change #4 in eight days. This isn't going well. Saturday's dressing started leaking not too long after they changed it, then was fine for most of yesterday, then basically exploded last night. We managed to get the vacuum to hold through the night, but this afternoon, in place of PT/OT, Dave got yet another wound vac. Made for a pretty rough day.

Anne from Cardio-Pulmonary also came by today to do some more pulmonary rehab with Dave. So far, neither Dave nor I is sure that it is accomplishing much, but he's trying. Lots of "breathe in through the nose, out through the mouth" and diaphragmatic breathing (stomach breathing as opposed to chest breathing) to try to help him feel less out of breath. He coughed through most of the process, which made it really difficult to accomplish anything, but Anne said she would be back on Wednesday to try again.

Otherwise, pretty blah kind of Monday. Hopefully, the post tomorrow will be a little perkier. Till then...

Update #122

Quick and very non-eloquent post because I just realized I haven't written in a while...

Dave's back continues to bother him, but a CT scan came back clear. Dr. Weintz seems to think it is all muscular from being in bed so long, but that doesn't change how much it has been hurting. Dave did get his pain meds increased in order to help control the pain, which seems to be helping, but we're still working to figure out a more long-term fix.

On Thursday, Dave started pulmonary rehab, which seems to involve different breathing exercises with both his stomach and his chest. Still not sure what will happen, but at least it's a step in the right direction.

Dave had his dressing changed three times this week (Monday, Wednesday and Saturday) because his wound vac kept leaking even when he wasn't eating any contraband solids. Praying that this one will hold because it's been a pretty miserable week on that end of things.

Still moving in the direction of one more major surgery to fix Dave's intestinal system, but the doctors won't give us a definite answer on when the surgery will take place. At the moment, I think we're praying for December (the earliest it could happen) but expecting March or April.

Sorry for the short, clipped sentences, but it's almost time for youth group. More updates this week, I promise. Be praying for Dave's parents - this week is the first time that they will both be back up in Michigan since the accident.

Love you all...