Update #138

I did say to take it with a grain of salt...

So Dave still needs surgery. The output from his fistula went up slightly (not back to where it was, but still up), and Dr. Muskat, the surgeon, said that after six months, even if the drainage were to stop, scar tissue has built up on the inside of the fistula, which would prevent it from closing. While he was visiting with Dave, he checked the pliability of the scar tissue on Dave's wound to determine if it is soft enough to do surgery. Although it has improved a lot, Dr. Muskat would like to wait another 30 days (early January) and check on Dave one more time before scheduling surgery.

Please don't take any of this as bad news. Considering the extent of Dave's injuries, the fact that they can even consider doing surgery only seven months after the accident is pretty impressive. Not only that, the decrease in fistula drainage is allowing the area around the fistula, which is still raw (granulation tissue, they call it), to heal much more quickly. The progress that Dave's wound has made in the past week even is incredible!

Because Dave's surgery is now farther off than just a couple of weeks, there is a possibility that he will be moving out of Drake before surgery. The decision on whether he leaves is between Drake, Dave's doctor and his insurance, but the decision on where he goes is his. According to Maura (OT) and Fran (PT), Dave has definitely made enough progress to be cleared to go home if he chooses. He can walk the length of the hallway with a walker (over a hundred feet); he can do most of his personal care on his own; yesterday he even tackled going up one stair (with the help of the parallel bars). If he came home (more info later on where "home" will be since Dave's lease expired on September), whatever care and assistance he still needs will come from me and his parents. The other option is to head to a skilled nursing facility (SNF), another live-in situation where Dave would still have nursing care while he gains more strength.

If Dave comes home, from what we understand, he would continue PT/OT, but twice per week (as opposed to five times) at home for a more extended period of time (two hours a day or more). If he goes to a SNF, he may receive PT/OT every day but for a shorter period of time.

Although no timeline has been set, the overall impression is that this new transition may happen in much the same way that the transfer from UT to Drake did. Now that the ball is rolling, the move may happen very quickly. Obviously, the decision is slightly less critical than the first move was. Dave is much more stable and will do fine in either location. But the decision is still important. If Dave will get better care and more therapy at a SNF, we don't want to compromise his progress out of a selfish desire to get him home. On the flip side, the idea of having him home before Christmas...

Please be praying for this new decision - for Dave as he makes it, and for me and his family as we support him. Hopefully, we'll have more info on Monday.