Update #150

As long as you promise not to leave angry comments if this happens to change...

[Drum roll please] Dave's discharge date is...next Tuesday, January 6, 2009, exactly seven months after his accident. The date is just a rumor at this point - Dave's psychologist had a spy do a little research for us - but hopefully we will get confirmation tomorrow. Craziness!

PT was at 7:30 this morning - ugh! I hadn't had enough coffee at the point to hold a camera straight to video Dave walking, and honestly, I don't think he would have been very happy if I had been sticking a camera in his face at that hour anyway. But I haven't forgotten about the "walking with crutches" video or the Christmas photos and will get both up online soon.

Dave has a new roommate - Dwayne, his last roommate, got transferred to UC because he was having trouble swallowing and breathing (please be praying for him and his wife, Melissa). As always, the nurses are working to spoil him with his own room again as quickly as possible, which may happen as soon as tomorrow. We are planning to ring in 2009 with a few friends, food, and Guitar Hero World Tour (I can't wait to get my hands on the microphone - I hear there's an Ozzy song I'd be great at), so having his own room again will be wonderful.

As his first official preparation to go home, Dave got fitted for an AFO today, a brace for his left foot that will help him deal with his foot drop. Still no word on another EMG to see if any of the nerve activity has been restored in that foot, so for the moment at least, the brace is necessary. Dave has been practicing walking with a loaner over the past few days and seems to do well with it. Hopefully the custom fit brace will be even better.

PT is later tomorrow, but we'll still be up early to prepare, so it's off to bed. More info as we get it. Keep praying!

Update #149

The long awaited pics from Christmas (the one of me on the phone is "with" my family at Christmas)...

Dave's walking with crutches! I'll get video up soon, but it was pretty amazing. He even managed to walk up and down the stairs with crutches this afternoon! PT is pushing him hard to make as much progress as he can before he gets kicked out...er...released.

Speaking of which, be praying tomorrow morning. The doctors, nurses and therapists will be "conferencing" on Dave to discuss his treatment plan and, hopefully, to tell us how much longer he will be here. According to his new physical therapist, Milan, Dave is ready to go home today, and he would be surprised if Dave is still here at the end of the week. We're hoping that it will be a little longer than that (still have to finish getting the house ready and moving Dave's stuff in), but we'll see. Just be praying for an answer...

Short post, but things are going well. More soon!

Update #148

Thought this might help make your Christmas merrier. Dave walked a whole lot farther than it shows on the video, but at least you can see him with a walker. PT and OT kick off again tomorrow. I'll get Christmas pics up soon.

Special "Merry Christmas" shout-out to the folks at UT - thanks for the comments on the blog! We miss you all and can't wait to walk (both of us) into the SCC to hand-deliver a wedding invite to you. We wouldn't be where we are without you!

Update #147

Merry Christmas (well, in an hour and fifteen minutes) from back at Drake!

After some miscommunications between UC and Drake, Dave arrived back on the Rehab Floor (not the SNF unit) around 3:00 p.m. today - same room, same roommate, same plan for therapy. His room is much more bare, though - in the two day UC interim, he was actually discharged from Drake, so we had to move his stuff to my house (HUGE thank you to the McLaughlins and Todd for taking care of that), and thinking optimistically that Dave won't be here for very long, we've decided not to move back in (we're already missing the mini fridge and coffeemaker though).

Today was a really lazy day of waiting around to be transferred, but thankfully, Dave got some much needed rest last night and this morning while we waited. Tomorrow is a quiet Christmas lunch with his parents and more relaxing before therapy kicks off again on Friday.

In the past few weeks, we have received Christmas cards from all over the country, and it has been so wonderful getting updates from everyone who has been reading ours since Update #1. Dave and I have decided to give ourselves a free pass on real Christmas cards this year - you all aleady know the basic gist of our year anyway - but from both of us to you, Merry Christmas! Time to watch The Christmas Story marathon on TBS. :-)

Update #146

I was just typing a post to say that we were heading back to Drake when Dave's social worker came in to tell us that we are at UC for another night. Supposedly, the Rehab Floor at Drake won't approve Dave to come back because of his new medical issue (the new drainage hole) and Dave's insurance won't approve him to go back to the Wound Care Floor because he doesn't have enough medical issues. Gotta love it. So, tomorrow morning, Dave will be moved to the Skilled Nursing Facility (SNF) at Drake to continue is care. When the idea of a SNF originally came up a few weeks ago, there was never any indication that there was a SNF at Drake, so we were a little confused at the news. From what we understand, though, Drake's SNF is only for short term care (less than 30 days), and the first time it was discussed as a possibility for Dave, there was a good chance he would need to stay longer than that. Now, assuming everything goes as planned, Dave will be at the SNF for the same amount of time that he would have been on the Rehab Floor (two-ish weeks) then will be headed home.

On a different note, Dave's doctor during our short stay at UC, Dr. Pritts, told us that the new hole in his side actually may be a positive thing because the drainage is no longer running over his open wound but is instead running away from the wound. Dave may actually heal faster than he would have, and the dressing changes should be much less complicated.

If we have learned anything over the past few months, we have learned to expect the unexpected. For tonight, we are enjoying being inside on a warm night in a quiet room with no roommate and waiting for the newest plan in the morning. We'll see what tomorrow brings...

Update #145

After seven hours in the ER, Dave's finally in a room. And I gotta say, it was worth the wait. Dave has a private, very nice room with a view of Cinci and plenty of room for him, his parents and me not to be tripping over each other. No word yet on how long we'll be here (Christmas at Drake or UC?) or what the next steps are, but for now, we're enjoying having some quiet time after a long day. More updates coming tomorrow. Thanks again for continuing to pray!

Update #144

No surgery for now, but Dave's being admitted to UC for a day or two so the surgeons can keep an eye on him. His white blood count - I was really hoping we wouldn't ever have to talk about that again after UT - was slightly elevated, so they want to make sure he isn't developing an infection. If everything goes okay, he'll be back at Drake sometime this week to continue therapy. We're waiting in the ER for a regular room - I'll keep you posted if we hear anything else. Thanks for the prayers!

Update #143

Thanks for posting, Dad.

Typing this from UC's cafeteria because unlike UT, this place seems to enforce the "two visitors per patient rule," even for sweet li'l old us. :-) Dave's parents are sitting with him now so I can grab some lunch.

Late last week, Dave mentioned, while I was changing his dressing, some irritation on the skin flap that was rotated to cover his injury back in June. When Wound Team came to check it out, they thought they noticed some swelling as well and decided to order a CT to rule out the possibility of something more serious than skin irritation or aggravation from Dave's increase in exercise.

Just as I was going to post all of this on the blog last Friday, one of the doctors came in and informed us that the CT seemed to be clear, so I decided it wasn't worth the hassle. Silly me thinking people don't need to pray...

Last night, as I was changing Dave's dressing again, I noticed that the irritated area had turned into what looked like a very large blister. Wound Team came this morning to check it out, and when they pulled back the dressing and touched the area, drainage pushed through the skin and poured out.

The fear last week, which was confirmed this morning, was that Dave had either developed another hole in his colon with another drainage tube (fistula) or that his current fistula was trying to find another way to drain in addition to the original hole in his side. From what I understand, the second option is less complicated to fix than the first (still only requires one section of repair in his intestines), but neither option is super surprising.

Within 45 minutes of the discovery of the new opening, Dave and I were in an ambulance on our way to UC. Since then, we have been sitting in the ER waiting for the surgeons to see him. It is likely that we will be here all day, both for the surgeons to evaluate him and for them to run some scans and tests to determine whether the problem is a new fistula or simply a new exit point. From Wound Team's perspective, Dave will likely be back at Drake by tonight to continue with the original plan for surgery in January, but there is a small chance that Dave's surgeon will decide to admit Dave to UC to do the surgery now.

I do have Internet access here, so I will do my best to post again once we hear anything. It may be a while, though, so don't worry if there is no news until late tonight. Until then, be praying. Dave is doing well, feeling fine, and his spirits are still up. That being said, seeing yet another hole in his body this morning was hard for both of us, and it will be nice when we know what is going on for sure. Keep praying...

Update #142

I just received a call from Kendahl (this is her dad) telling me that Dave has been taken by ambulance to University of Cinncinati Medical Center due to a development with the skin covering his wound. If I understand what Kendahl told me, over the past couple days the skin had developed something that looked like a large blister . The nurses were keeping an eye on it, and a CT scan was done to try to find out what is going on. But the CT scan didn't give any answers. When the nurse changed the dressing this morning, the "blister" broke. Speculation now is that the drainage from the hole in Dave's colon was looking for another way out....

Dave was taken to UCin because that is where his trauma surgeon is. He is waiting to see the doctor now. They do not believe that this is a serious issue. Dave is not in any discomfort. The question is whether the surgeon would want to do the surgery on the colon now or wait until its scheduled date in January, in which case Dave would return to Drake. Drake is apparently keeping his room until they know what the doctor is going to do.

Please pray for wisdom for the doctors and for Dave's continued healing. And thank you...again.

Kendahl asked me to post this blog because she doesn't have internet access at UCin. I'm sure that as soon as they have some answers, either she will update the blog, or she'll call someone to do so.

Update #141

Please don't kill me...

I know that it's been a full week with no post, and I feel terrible about it. But it has been a crazy week. No news is good news - and the past week has been full of it.

Dave did get approval from his insurance company late last week to move to the Rehab Floor, the 3rd floor at Drake, and the move happened late Tuesday evening. For anyone who wants to send mail or find him when you come visit, he is now in room 307-1. The -1 is important because sadly, he now has a roommate, although Dwayne, his roommate, and his wife Melissa are wonderful, so we got pretty lucky. Actually, if you think of it, be praying for Dwayne - he had a "cardiac event" (heart attack that is not caused by a problem with the heart, from what I understand), and when he went into cardiac arrest, he fell, hit his head, and broke his neck in two places. The accident happened on December 3rd, and so far, he is completely paralyzed. Be praying for him as he recovers and for his family, who is just starting to get used to the life that we have started to call normal.

Speaking of updates, remember Darlene and Tony? Tony was hit by the drunk driver a few days before Dave's accident? Darlene texted the other day and said that Tony had had a surgery to repair a pretty intense bed sore that was caused by a lack of care at one of the rehab facilities where he was. The surgery went very well, and he is now at another rehab center where things seem to be progressing. One very cool story - because Tony is on Worker's Comp (the accident happened while he was working), his Worker's Comp Insurance will be paying the company where Darlene works as a nurse to hire her to be his in home nurse. So basically, Tony's company is paying Darlene to take care of him! Pretty great situation. :-) Tony is still recovering very slowly - they aren't sure if he will walk, be able to take care of himself, etc. - but he is smiling and interacting and doing so much better than when we last saw Darlene.

Okay, end of sidenotes. Yesterday was a day of new therapists, new doctors, new rooms, new situations...new everything except the building. The Rehab Floor requires three hours of therapy per day, and the nurses weren't kidding when they warned Dave that it would kick his butt. Yesterday, he got dressed and out of bed on his own, then had to wheel himself all the way around the Drake Center in his wheelchair for OT. During PT, he walked 120 feet twice with is walker, then practiced the motions for getting in and out of a car (which we will work on for real tomorrow), then did calf raises and squats with his walker. The day also included another hour of Group Therapy, which involve playing a strategy game and lifting weights between turns. Welcome to rehab!

In addition to the increase in therapy, Dave officially had his last breathing treatment this morning. Although his breathing is still fairly shallow as a result of his diaphragm injury, the Pulmonary Specialist is convinced that Dave no longer needs the medicine that he has been getting for the past three months.

Somehow, in the course of the 36 hours that Dave has been on the Rehab Floor, he has already won his way into the hearts of his new nurses (big surprise). Yesterday afternoon, his nurse Greg came in and offered to set us up a "living room" area in an unused room on the floor where Dave and I can spend some time watching TV and hanging out in the evenings away from the nurses, roommates and the general bustle of the last six months. In his words, "Young people need alone time." He set up the room with a TV, a chair and a table, but no bed, so I'm pretty sure his insinuations in "alone time" were as innocent as our use of the room will be. :-)

Speaking of living rooms - okay, that was a weak transition, but I'll go with it - some info on the next steps of Dave's living situation. Before I go any further, please try to remind yourself over the course of the next few paragraphs that Dave and I are doing the best we can with a very abnormal situation. You'll understand that when I say...

Dave and I have decided to move up our wedding. I mentioned a few weeks ago that I would go into more detail on the definition of "home" later - the reason for the lack of explanation at the time was that he and I, along with his parents, were still figuring out what "home" would look like upon his release. I'll avoid boring you with the details, but the short of it is that "home" for Dave and me is, well, wherever the other person is. Originally, we set our wedding date for June 6th so that Dave would be able to enjoy the ceremony and reception (and hopefully be on his feet for them) without exhausting himself. Although he is still not ready for a large party (and trust me, June 6th still will be - we'll get to that in a minute), after a lot of discussion (and once we do premarital counseling in the next few weeks), we know that we are ready to get married.

For anyone who enjoys a more practical and less sentimental explanation (we took both into account), Dave's apartment lease expired in September. Although his parents have a place to live in Cinci, their home is in Michigan, and at some point, we know that they would like to go back to that home more permanently than just a week every few months. The condo where they are staying is on the market and could sell at any moment, and it also has six or seven stairs to get to it, which could be difficult for Dave when he is released. The house where I live, which is right next door to the church where I work, is a ranch and has only two small steps to get into it. Because of my position with the church, we can live at the house for free for as long as we like, and I will be close by, even when I am at work, if Dave needs anything. As Dave gains more independence (which happens every day), his parents will have the freedom to move back to Michigan, and Dave will be able to maneuver his way around our new home, whether using a wheelchair, a walker, a cane or nothing at all, without much assistance. Most importantly, although we both know that marriage will not be easy, and nothing Dave and I do is ever normal, we will be able to begin our "regular" life together away from a hospital and in our own home.

Because of the short notice, and because the wedding will likely be at Drake (engaged in the ICU, married in rehab - collective "Awww..."), we are having a VERY small ceremony with only immediate family and our wedding party. Trust me, we would love to have everyone at the wedding, but as we started to list off the people we would want to be there, we quickly realized the reason that our June guest list is close to 450 - Dave and I are just too well-liked. :-) Seriously, though, we do want to celebrate with all 450 of you. Because of that, we are doing an intimate ceremony now BUT are still planning a huge celebration for June 6th - bridesmaids, groomsmen, DJ, dinner, and all of you. Two pleas:

1. Don't be upset about the early wedding (it's on January 10th, by the way) or how small it is. We truly want to celebrate with all of you, and if we could invite everyone, we would. But Dave's health, the limited space, and the short notice make a small ceremony much more do-able;

2. PLEASE still come to the wedding/Welcome Home Dave!/reception/celebration/we-don't-really-know-how-to-phrase-it-yet June event. Don't let the fact that we are doing the official stuff in January keep you from coming to celebrate. Remember my disclaimer? Dave and I are doing the best we can with a difficult situation. If we had our way, we would do everything in June. But if we had our way, we wouldn't have spent the past six months in a hospital room either.

When I was living in France, one of the many things I learned about the culture is that French weddings involve two ceremonies: first, a civil ceremony at a government office; second, a religious ceremony at a church. In France, the reason for two ceremonies is the strict separation of church from state, meaning that a religious ceremony is not recognized by the state. For us, the two ceremonies will be a separation of hospital and home? Rehab and recovered? Wheelchair and dancing? However you want to look at it, June 6th is still on, and we still hope you will be there.

Dave is getting ready for a dressing change - his wound continues to improve and get smaller every day, by the way - so I have to run. Thanks, as always, for your support, prayers and constant reminders of love. Love from Cinci...

Update #140

Here's where we are...

As of this morning, Dave was approved to be moved to 3 North, Drake's Rehab Floor, a move that will happen as early as Tuesday. From there, he will have "a few weeks" (probably twoish) of intense therapy (three hours per day) before moving...are you ready?...HOME! The entire process is still pending insurance approval, but it is the under the recommendation of Dr. Weintz, Fran, Maura and the Rehab Floor, so the approval should go through. If that is the case, Dave could be home as early as a few days after Christmas!

Other news: Dave walked up and down six steps today during PT (with the help of railings) and transferred to a normal chair (one without armrests) during OT. So much progress...

That's it for now. More updates as we hear...

Update #139

So there is an Option #3...

As of Friday, it sounded as if the only two options for Dave were heading to a SNF or heading home. Yesterday, Maura (OT) mentioned the possibility of a move to Drake's Rehab Floor. Dave no longer needs the amount of care that the Wound Care Floor offers, which is the reason that his insurance may not allow him to stay. But if he qualifies for the Rehab Floor, he could stay at least in the same building and continue intensive therapy until his surgery. In order to qualify, he must be able to handle three hours of therapy per day (an hour and a half of OT and an hour and a half of PT), and he must be able to do certain things on his own. From Maura's perspective, Dave is right where he needs to be to qualify.

Maura and Fran are both still comfortable with Dave going home, but from their perspective (and it makes sense), Dave might as well continue with as much therapy as possible for as long as possible until he goes for surgery.

Colleen from the Rehab Floor is supposed to be by sometime today or tomorrow to do an evaluation, which she will use to make a recommendation to Sandy, Dave's social worker. Then, tomorrow, Sandy will talk to Dave's insurance again to hopefully try to convince them to continue paying for treatment at Drake. In the end, the decision is still up to Dave's insurance, and again, Dave will be fine no matter where he ends up, but having another option is always good. Please continue to pray for the right decision...

Some positive updates:

1. Dave's pain patch has been cut in half, and he is still dealing fine.

2. He has been sleeping better over the past few nights.

3. He is gaining weight! Up to 168 or so now - thank you solid food!

One other prayer request: Dave's breathing is getting rough again. Ever since Saturday, he has had a really difficult time catching his breath after any amount of activity and has been coughing quite a bit. Dr. Weintz ordered a chest x-ray yesterday - in some ways, we are hoping that it will show bronchitis or something similar so it can actually be treated. If the x-ray comes back normal, we're back to the days of Dave not being able to breathe and not being able to do anything about it.

More pics and videos of Dave's progress coming soon. Keep praying!

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.

Update #137

Thanks for the prayers, everyone, as always! The last two days have been much better. As it turns out, Dave's pain patch that he wears on his arm had expired on Sunday and wasn't renewed until Monday afternoon, so it seems that the nausea may have been a reaction to a lack of pain meds in his system for the first time in six months. Once the patch was replaced, the nausea faded, and things have been good since.

Today, Dave walked 80 feet, then 100 feet, then another 80 feet with his walker during PT today! So much progress in only a few days - not that I'm surprised anymore. Also, during OT this morning, he worked on batting a balloon back and forth with me while standing, which meant alternating letting go of the parallel bars with one hand, then the other and putting more weight on his legs.

Be praying tomorrow for our meeting with Dr. Muskat, Dave's surgeon. Although still low, the output of drainage from Dave's fistula was higher today - pray that it was just a fluke. From what Dr. Weintz has said, Dave will likely still need surgery, but it may be much more minor than it would have been if the fistula output had stayed really high. Hopefully tomorrow will bring some clarification and timing on next steps.

Time to go watch a movie. I'll let you know what Dr. Muskat says as soon as possible!

Update #136

Kind of a rough day today - granted, that's "rough" in comparison to the amazing past three weeks we have had...

Dave was sick to his stomach for most of the morning. It started during shower #2 (#1 happened on Saturday evening) in OT this morning and lasted through PT this afternoon. Overall, Dave said he was feeling really tired (the lethargy started over the weekend) and was having a hard time breathing. He seems to be doing better this evening, however, so hopefully, tomorrow will be back to more progress.

On the positive note, still very little drainage from the fistula! The Wound Care Team was astounded today and couldn't wait to take pictures to send to Dave's surgeon, Dr. Muskat, who will be at Drake on Thursday. Be praying that the news that day is, "Maybe he doesn't need surgery after all!"

Short post today... Keep praying!