Dave Heckel Update

Update #188

2009-09-02T10:08:00.003-04:00

Oh, back to school time. Gotta love the chaos...

So many updates over the past few weeks that just haven't made it online. First, for the first time in over a year, Dave isn't wearing any bandages! Yes, ladies and gentlemen, the drainage that has been the thorn in our side (okay, Dave's side) for fourteen months has stopped completely! You can't even imagine what a huge relief it has been.

Second, Dave did start driving, and it has been "much easier than I expected," he says. We started with my car, the automatic, in the high school parking lot, and when everything went smoothly, returned home to get his car to try a stick shift, which also went well. From there, he drove us to dinner that night and has been in the driver's seat on short trips ever since. He even drove me to a doctor's appointment yesterday - what a switch! Even though I'm still in the car with him as his extra set of eyes most of the time (he did drive to get pizza on his own last night), I know having the keys adds a new level of independence that he hasn't experienced since his accident. And I have to say, it's pretty nice being able to relax in the passenger seat from time to time too. :-)

Third, Dave's cane is spending a lot more time in the car and a lot less time in his hand. Aside from times when we will be standing for an extended period of time or when we will be in a crowded place where he may get knocked over, he has been walking without any assistance almost everywhere we go!

Some prayers:

1. Dave is working on getting his insurance company to pay for a voice augmenter to help clarify and magnify his voice when he is out and about. The device, which runs somewhere in the range of $7,000, will be a necessity if he wants to go back to the position he had at GE before the accident, which involved a lot of time on the loud shop floor, so be praying that the augmenter is approved.

2. Speaking of going back to work, that is the next huge question in the recovery process. With the surgery completed and finally successful, for all intents and purposes, there is very little documentable medical reason why Dave can't go back to work sometime in the near future. That being said, we have no idea at what point Dave will be asked to go back to work. In some ways, he is so much more himself and so much healthier that going back to work is technically a possibility sometime soon - BUT there are still days when he can't stop coughing or doesn't have the energy to do much of anything. He also still needs a lot more sleep than most people, so getting up at 6:00 a.m. every day would be almost out of the question. We haven't heard anything from Disability at GE yet, and in some ways don't want to call and ask questions for fear that they may take that as a sign that Dave is ready to work, but we also would like to get some guidance on what to expect going forward.

3. And speaking of sleeping, Dave hasn't been very well. Although he is normally in bed for ten hours a night, the amount that he is sleeping is much less, and the sleep that he is getting is far from restful. Dr. Hardin has been playing around with different combinations of sleep meds, and we are having a new bed delivered on Friday - be praying that both changes help Dave feel more rested.

I'm sure there is more that I am forgetting from the past few weeks, but that's the major stuff. Now that we are past surgery - and the next one won't happen for at least six months - updates will be fewer and farther between. I will continue posting the big stuff, so check back from time to time, but we are finally at a point where daily or even weekly updates on Dave's condition would be much more boring than useful to you. How great is that!

Thanks, as always, for continuing to stand by us. We love you all and feel so blessed to have had so much support through this entire ordeal.

Update #187

2009-08-07T14:35:00.002-04:00

No more leak!

Dave just got off the phone with Dr. Muskat, and the hole is closed! The CT didn't show any sign of leakage from Dave's colon, and any remaining drainage is coming from a small fluid pocket under his right kidney, which should go away soon. He is free to go back to a normal diet - yeah salad! - and should not have any problems from here on out. Thank you all so much for your prayers! Keep them coming - just in case :-) - but things are looking great.

Oh, and Dave still hasn't had a chance to drive yet, so keep praying for that too. We'll keep you posted!

Update #186

2009-08-04T12:10:00.002-04:00

We finally have Internet again! Not only that, but my laptop, which was away on a "seven to ten day" warranty repair finally came back yesterday...after only 35 days! :-) So, we are up and running with regular posts again.

Friday's Plastics appointment was what we expected - Dave's incisions are healing well, and the skin around his wound still looks good in spite of the drainage. One major change - as we were out and about on Friday before the appointment, a new drainage hole opened up. Remember just before Christmas when we got transferred to UC because of a second fistula? This hole is in the same spot. One would think that development would be disappointing, but this time, it actually turned out to be a good thing because the change in the landscape of Dave's abdomen actually allows us to cover that area with an ostomy pouch (which we couldn't do from the site where the drainage had been coming from up until now) instead of a bulky dressing, and drainage being rerouted to the new hole is allowing the other area to heal. So, believe it or not, the second fistula opening before Christmas actually benefited Dave in the long run because the tissue there was still weak enough to allow the new drainage to escape in a much more convenient location.

Then, yesterday. The Trauma appointment with Dr. Muskat was what we had really been waiting on. And...he is VERY encouraged. In spite of increasing Dave's diet from liquid to low residue a week and a half ago, the amount of drainage has not gone up at all! Not only that, the consistency of the drainage has changed dramatically, to the point that Dr. Muskat doesn't even think it is true drainage from Dave's intestines anymore but may instead be a leftover pocket of fluid from the surgery that is still leaking. All of that to say that it looks like the hole may be closing! Dave had another CT last night, and we won't get the results for a day or two, but if things still look good when we do, he'll be back on a regular diet and well on his way to being dressing-free in the near future. So, it's taking a little longer than we had hoped, but the surgery may have worked after all. Yeah!

Life overall is very positive right now. Dave is feeling as good as (if not better than) he was pre-surgery, and he is pushing himself to get stronger. We got the go-ahead from Dr. Muskat to head back to the gym to work out - very slowly at first, of course. And - get this - Dave tried RUNNING yesterday. I looked out the window while I was washing dishes and he was carefully trotting back and forth across the yard. He said it was really difficult and his feet still aren't as strong as he would like, but he didn't fall, and he was certainly moving a whole lot faster than he has since the accident (well, except when I was racing him around the mall in the wheelchair, but that doesn't count).

Next on the agenda: driving. Dave tried once a couple of months ago, but his right leg wasn't even strong enough to move between the gas and brake, so we gave up before we even started. Now, his legs are stronger, but his main concern is the blindness in his right eye. We're planning to start tomorrow (it's pouring here today) in a very large, very open parking lot with my car, which is an automatic, instead of his, which is a standard - we'll see how it goes. Please be praying that things go smoothly and Dave gets his confidence back quickly. He is very hesitant to drive at all because he wants to make sure it is completely safe (both for himself and for everyone else on the road), but him driving or not obviously will have a huge impact on our life in the future - where we live, how often we travel, etc.

More updates when we hear back on the CT and when the first drive is over. Keep praying!

Update #185

2009-07-29T10:20:00.002-04:00

So sorry for the delay...our Internet is still down.

First, the post I typed last Thursday...

"Posting from my Blackberry since the hospital's Internet is being dumb. Hope this goes through...

"The fast is over...at least for the time being. Yesterday, because the drainage from his wound had not increased from the liquids, Dave started "every man's dream diet" (mine too) - actually, it's called the "low-residue diet" - consisting almost entirely of meat and potatoes and almost no veggies. Crazy, huh? After eating only a few days in the past two weeks, I guess he deserves it. :-) Anyway, a low-residue diet is comprised of easily absorbed foods to keep drainage low, and it turns out that meat and potatoes are at the top of the list!

"Even better news, sounds like we may be going home today! After all the steak Dave ate yesterday, drainage levels actually decreased, so we can go home TPN free! The hole is still draining and hasn't closed yet, but the drainage level is going down since last week, and indications that it will close on its own are pretty promising. So that's where we are...and my fingers are tired from typing on this tiny keyboard. More soon!"

Anyway, we are home and doing well...aside from the fact that Dave is craving salad and apples. :-) On the whole, aside from the setback with the new hole opening, he is recovering much better than any of us - doctors included - anticipated. Dave and I were both planning on him being completely down and out for a week at the hospital and pretty homebound for another three or four weeks after. Instead, two days after surgery, Dave was walking the halls at the hospital, and less than two weeks after surgery, he was taking almost no pain meds and getting around nearly as well as he was pre-surgery. The setback was frustrating, but overall, things are good.

Dave goes back for a post-op with Dr. Kitzmiller (Plastics) on Friday and with Dr. Muskat (Trauma) on Monday. Please be praying for good news at both appointments. Kitzmiller should tell us that the incisions around the skin flap that he stretched are healing well and everything looks good. Hopefully, Muskat will tell us that the small amount of continuing drainage is a very good sign and he is hopeful that the hole will close on its own. He may even let Dave have his salad. :-)

We're hoping to get the Internet back up at our house this week. Until then, I'll do my best to post when we are out and about and can find a connection. At the very least, I will post after appointment #1 on Friday.

Update #184

2009-07-24T12:53:00.000-04:00

We're home and doing well. Internet was spotty at UC yesterday and down at our house completely when we got home last night, and the long post that I typed on my Blackberry (where I'm posting from now) yesterday disappeared when I tried to save it. I'll fill you in on all the details once we find a connection for Dave's laptop.

Update #183

2009-07-21T18:08:00.002-04:00

The fast is over...well, sort of. Sorry for the lack of posts yesterday, but we waited all day just to find out that Dave wouldn't get to start consuming anything orally again until today. Originally, it sounded like today's diet would include real food, or at least the milkshake I mentioned the other day. Unfortunately (although I'm sure it's better for Dave's recovery), he is restricted to a "clear liquid diet," meaning anything you can see through. Basically, his meal tray consists of jello (which Dave doesn't like), broth, tea and some kind of juice. We've also added some Sprite and some mostly clear soup. Not huge, but definitely a step in the right direction. If the drainage doesn't go up as a result, things will increase gradually from here on out, probably to "full liquid diet" (including oatmeal, ice cream, mashed potatoes, pudding, etc.), then to a regular diet.

I stopped fasting when Dave did this morning (mainly because his orange Jello looked very appealing) and will continue to eat as he does. Hopefully, there will be no more setbacks and we'll keep moving forward over the next few days.

One specific prayer request on top of getting to eat and getting to go home: we found out today that Dave is not allowed to leave the floor he is on for any reason. One of the doctors suggested this morning that we take a walk outside, but when we asked the nurses, they said hospital policy doesn't allow it. We're going to ask for a written doctor's order for outdoor privileges in the morning (sound ridiculous, doesn't it?) - be praying that we can get permission.

Update #182

2009-07-19T18:26:00.003-04:00

Well, things are getting a little better. Dr. Muskat had been "away" for a family emergency, so aside from a quick pop-in on Thursday when we got back to the hospital (when he quietly informed us that if anybody asked, we had never seen him), we hadn't heard from him at all. Finally, today he had a chance to check in. According to his reading of the CT, there are visible air bubbles coming from Dave's colon, a sign of a hole, but it is very possible that the hole is tiny, meaning more likely to close. The drainage has slowed quite a bit over the past three days (probably due in part to the fact that Dave hasn't been eating or drinking anything); if things continue that way over night, he may be able to start consuming things that are easily digested (Dr. Muskat suggested a milkshake) tomorrow. If the drainage doesn't increase from the addition of small amounts of food, it is a good sign that the hole is closing, and Dave may be off TPN soon!

If, on the other hand, the drainage increases over night or increases when Dave starts eating, the nurses will train us on operating the pump, administering TPN and cleaning Dave's PICC line, then we are headed home. From there, more watching, waiting and experimenting with small amounts of food for occasional checks on the progress of the hole.

Either way, our spirits are up, and we are finding substantial ways to amuse ourselves without thinking about snacks and meals. Dave's sister and brother-in-law were in town for the weekend - sans children - so we got to spend some quality time with them, and from the sounds of the texts and voicemails we have been getting, Dave will have many more visitors over the course of the week. Hopefully, we will be able to put in requests with our visitors by then for take-out...even if it is just a McD's milkshake. :-)

In other positive news, Dave is off antibiotics -meaning no infection at all from the new hole opening - and the PICC line is saving him from being stuck every day for blood draws and IVs. The nurses and doctors on the ninth floor have been wonderfully compassionate with regard to how disappointing it is to be back so soon, and aside from giving meds and checking in, they have left us on our own with few disturbances, a nice change from the constant in-and-out of the fifth floor last week.

Please keep praying - hopefully tomorrow I will be able to give you the news that the hole seems to be closing and Dave and I are sharing a milkshake and looking forward to going home.

Update #181

2009-07-17T11:37:00.004-04:00

[sigh] What a difference a day makes.

Okay, before I even go there, what a difference a year makes. Last year at this time, I was still trying to communicate every new development in Dave's life with some form of sugar coated optimism. However awful my posts may have seemed at the time, when I go back and reread them, all I can think is that what we were actually experiencing was almost always ten times worse. I've said before that I'm naturally an optimist, which was where some of that communication tone was coming from; it also related to the fact that Dave was still in critical condition, he was fighting his way back from a bout of sepsis, and any step forward was a huge celebration. I was also trying not to scare you. :-)

Now, a year later, Dave and I are both still optimistic, but we have also gotten used to having reality slap us in the face a bit. Hope for the best, prepare for the worst, right? And this time, I'm not sure how to sugar coat it.

That long preface was to prepare you for what comes next. Dave is healthy, I'll say that first. But everything happened so quickly that I couldn't give moment by moment updates, and by the time yesterday ended, we were both too overwhelmed to talk to anyone. I'm sorry if I give you that same feeling now. After spending 36 hours at home (we literally spent 30 of them sleeping), Dave woke up yesterday morning with drainage - not post surgery drainage, but pre-surgery drainage - all over his dressing. After a quick call to the Trauma Clinic, we put our still-packed bags back in the car and headed to the ER at UC. Our initial logical fear, that one of Dave's internal sutures had pulled free or that a new fistula had developed, was confirmed after a CT scan late yesterday afternoon. The short of it: the surgery didn't work. In Dr. Muskat's words, "This is really disappointing."

There are some differences between treating this fistula versus treating the last one. First, Dave is much healthier, and his body is much better prepared to heal. Second, the weak tissue where the first hole developed was taken out during surgery, meaning the hole this time is in healthier, less fragile tissue.

That being said, in some ways where we are today very closely resembles where we were a year ago. The hole is in the same spot and draining the same excessive amount of...stuff, which we are having a very difficult time controlling. As of yesterday, Dave was off all food AND drink (aside from small sips of water for his meds) indefinitely to clean out his system. Instead, he is back on TPN (the nutrition that flows straight into his bloodstream) and IV fluids. The central line in his neck last year will be replaced with a PIC line (better than IVs because it won't come out) for both the TPN and the fluids. Octreotide will be replaced with another treatment (I'll include the name once they say it again). And, we are in the hospital for at least another week.

On the positive, all of this comes with a much more likely hope that the hole will close on its own, which is better than waiting six months for yet another surgery. Hopefully, the doctors will be able to determine how likely that is in the next seven days. On the negative...well, you understand.

After anticipating this surgery for so many months, Dave and I are pretty disheartened. We knew that this scenario was possible, but after the surgery went so smoothly...

In the midst of this new development, here is my challenge to you: fast and pray. Dave is, in essence, fasting for at least the next week. All throughout the New Testament, we see prayer and fasting partnered; yet while we focus so much on prayer, we very rarely honor the other command. In the next week, do be praying earnestly that the hole will show signs of closing. But partner that with fasting something. Fasting all food completely may not be possible, but maybe give up one meal a day. Don't play video games. Go without coffee. And use the time - and every time you remember how much you miss whatever you have given up - to pray for Dave. Pray for his strength, his spirits, his energy, his patience, and always, his healing.

We'll keep you posted.

Update #180

2009-07-15T17:20:00.002-04:00

Well, we finally made it home just before 11:00 last night. Once the doctors told us that we were headed home, it almost seemed like they were pushing us out the door - gathering discharge paperwork, encouraging us to pack up, even seeming slightly frustrated when Dave said he wanted to take a shower (the first he was allowed since surgery because of the epidural). In the midst of the chaos, however, Dave started bleeding from one of his incisions, which caused Dr. Muskat and his partners to order blood work to make sure that there was no sign of infection or other problem.

Now, don't get me wrong - we appreciated the caution and concern, and we would always rather be absolutely certain that Dave is as healthy as possible before leaving the hospital. That being said, three hours after Dave stared bleeding, the lab finally sent someone to draw blood. And three hours after that, around 8:00 last night, we were still waiting for results. We paged Dave's nurse to see if she could check with the lab, and two minutes later, the lab tech walked back into our room. Somehow, the lab managed to lose the first blood draw, and they needed another sample. As I mentioned before, Dave's veins are impossible for needles to find, and sure enough, the tech and three nurses (including a nurse paged from the burn unit who can find veins through charred skin) each tried unsuccessfully to find a new vein for the sample.

At that point, we were starting to believe that we would not being going home - not that big of a deal except for the fact that we had already sent most of our stuff back to the house with Dave's parents and had already cancelled our dogsitter for the night. We asked the nurse to see if Dr. Muskat and his partners would let us go home then head to a local lab in the morning to get another sample; wonder of all wonders, the lab suddenly found the original blood sample again. Sometime just before 10:00 p.m., the lab work came back fine, and we were finally discharged.

End of story, right? Not quite. Earlier in the afternoon, I had called our normal pharmacy to confirm that they had Oxycodone - Dave's new oral pain med to replace the dilaudid and the epidural - in stock since we have had problems getting it before. As it got later and later while we waited at the hospital, I called a 24 hour pharmacy to ask the same question since ours had already closed. Both locations confirmed that getting Oxy would not be a problem. After dropping Dave at home around 11:00 p.m., I headed to the 24 hour pharmacy to fill his prescriptions and quickly found out that not only did they not have the normal dose of Oxy pills in stock (5 milligram pills); the pill that the doctors had precribed (and the pharmacy assured me they had), 20 milligrams, does not even exist. And, because Oxy is a narcotic, the pharmacist couldn't substitute anything in the place of the pill without a new written prescription from Dave's doctor.

The pharmacist called UC, where all of Dave's doctors were in the midst of a trauma, to find out alternatives to get us through the night, while I headed home to wait for an answer. Finally, at 12:30 a.m., the pharmacy called to say that the doctor had allowed her to switch from Oxy in pill form to Oxy in liquid form, of which she had enough to get us through three days. Back to the pharmacy, then home just in time to give Dave his next dose of pain meds at 1:00 a.m. Dave and I both slept till noon today (aside from two more doses of Oxy at 5:00 a.m. and 9:00 a.m.), and now we too are navigating the art form that is pain control. Too much Oxy means dizziness and sleeping; too little, and we get behind on controlling Dave's pain, which will almost certainly end us up back in the hospital.

On the positive side of this whole charade, we are home, and it is wonderful. Dave's sleeping in the hospital bed again for a while, but fortunately for him, I am the only person he has to worry about waking him up, which I won't do aside from pain meds. And I am back sleeping in our bed instead of a recliner, so happy that on the whole, Dave is recovering well and we are once step closer to the end of this story.

Thanks again for praying and for continuing to partcipate in this saga with us. We are getting close to the end, and we would not have made it this far without all of you and your support. For those of you outside of Cincinnati, keep praying as we walk through recovery. And for anyone around town, we're homebound for a while (the car's seatbelt sits right along one of Dave's incisions) but always up for visitors - well, except for tonight. Tonight, we are eating the Outback take-out that Sarah dropped off for dinner last night, then heading to bed to sleep off the rest of the hospital hangover. More soon...

Update #179

2009-07-14T11:05:00.002-04:00

The weekend was full of the "art form" of pain control. Saturday morning, Dave was miserable again. Pain was at an eight on a scale of one to ten, and the Pain Management "Team" consisted of one resident trying desperately to figure out how to at least relieve the worst of Dave's pain. Up with the dilaudid - both a bolus (one time larger dose boost) and an increase in Dave's PCA (personal control button) - and by 6:00 p.m. he was out of bed for the first time and in a chair.

Sunday morning, more pain. For some reason, it took us all that long to figure out that because the majority of Dave's dilaudid was coming from his PCA, and because most people are not capable of pushing a button every six minutes in their sleep, Dave was waking up with almost none of the most effective pain meds in his system. Another bolus, plus the addition of small continuous amount of dilaudid in addition to the PCA and the epidural (which never seemed to do much), and Dave was up and walking the halls, dragging a pole full of pumps and meds, Sunday afternoon.

Throughout this entire process, Dave was also dealing with the constant joy of an IV that just wouldn't stay put. One thing we've learned over the past year is that Dave's veins are almost impossible to stick. On Wednesday during the surgery, he had an IV in both wrists, one to receive meds, etc. and one as a backup. On Friday, the first IV started leaking, so the nurses switched the line to his other wrist. Fortunately no needle stick that time. Saturday night, Dave's left hand started swelling, a sign that the IV fluids were not going into his vein, so the IV was moved to his right elbow - according to one of Dave's nurses, the "lazy man's IV" because the vein is easy to hit, but the placement of the IV is extremely annoying the patient. Sure enough, less than 24 hours later, the needle in the IV was bent because of the movement of Dave's arm, and off to the right forearm we go. 12 hours later, Dave's hand was no longer swollen, but his left forearm made him look like Popeye - another missed vein, another removed IV. This time, however, there were no veins left. After three different nurses tried four different sticks, Dave told them to leave him alone (very politely, of course) and find another way to give him his meds.

So today, he's back on Oxycodone pills, off his IV, and as of 10:00 this morning, epidural free! The best news - assuming he doesn't experience withdrawal from the epidural meds, we should be heading home late this afternoon or early this evening! Like Dr. Muskat and Dr. Kitzmiller predicted, one week, and Dave is doing even better than they could have hoped. His incisions are healing nicely, his pain is almost under control, and unlike with his femur surgery, he is walking fairly long distances with very little problem.

Thanks again for all the prayers, emails, texts, phone calls and general support. On the whole, this has gone about as well as any major abdominal surgery could go. Continue praying that Dave's pain will remain under control as we go home and that the recovery goes quickly and smoothly from here on out.

Update #178

2009-07-10T18:27:00.004-04:00

So sorry for not posting yesterday. Dead laptops, lots of doctors, Dave not feeling well, and just general laziness on my part - but the excuses are gone now, and we're back.

Wednesday night after the surgery was rough. Dave spent five hours in the post-op area waiting for a room on the floor (you'd think that scheduling a surgery two months in advance would guarantee you a room), and when he finally got moved, the only room available was a double. Read: I couldn't spend the night. In spite of the epidural and an additional PCA pain med (a pump that he controls in small doses every six minutes as needed), Dave was in a signifcant amount of pain, so it was pretty rough leaving him. Dr. Muskat also told him that he could not eat or drink anything but ice chips for 24 hours (we're at 48 and going strong right now with no word on when food may be allowed) to allow his digestive system to heal. After I tore myself away from the hospital at 9:00 p.m. - the end of visiting hours - Dave texted to tell me that he had just found out that he could not have any sleeping meds either. Great surgeries, but not a great start to the hospital stay.

Yesterday was a day of finding the right balance of pain meds, a process that is still ongoing in part. Fortunately for us, this stay at UC, unlike the stay after Dave's femur surgery, includes consults with a Pain Management Team multiple times per day, and the team truly has been working hard to make Dave comfortable. First, they upped the PCA meds and changed the type of medicine in the epidural, then upped the dose there as well. A few hours later was the first time I saw Dave stop wincing since surgery. The new meds worked for most of the day, but around 7:00 p.m. last night, Dave said he was "feeling floaty" and that his left arm was completely numb. With his head rolling around the pillow and his left arm flopped at a strange angle across his body, slightly with a lisp: "I sthink, my pain medsth are too sthrong." You think? :-) Back down on the dose of the epidural we go.

The floaty feeling disappeared around 8:30 p.m., and Dave finally got sleep meds around 9:00 p.m. last night, a huge relief. Still no private room available at that point, but he slept through the night and most of the morning. Dressing change (so minor compared to pre-surgery!), lots of doctor visits, nurses in and out, blood draws - the hospital norm.

Now, at 6:45 p.m. on Friday night, we are sitting in the last private room left in the hospital, comandeered by the charge nurse for "her newlyweds," drinking ginger ale and getting ready to watch a movie. Dave is much more alert, his pain is under control except when he coughs or moves (okay, those are both fairly major parts of his life right now, but at least it's getting better), and I get to spend the night. Not bad for Day 3. Still no food, but that should be coming tomorrow. And hopefully, we'll be home long before this time next week.

Thanks for all of your prayers - each day is getting better and better. Oh, and a huge praise (since the laptop was down, I couldn't post the prayer request this morning), our friends Mike and Kaylie had to take their baby Josiah in for surgery today (could we possible have any more people in the hospital?), and I got to sneak down to Children's Hospital (three blocks away) to sit with them until they heard that everything went fine and they could take him home tonight. Thank God for healing, in Cincinnati and beyond.

More coming soon!

Update #177

2009-07-08T15:20:00.004-04:00

No more dressing changes!

The second part of Dave's surgery is done, and Dr. Kitzmiller was very pleased. After Dr. Muskat finished taking down the fistula, Dr. Kitzmiller took the skin flap that has been the bulge on the right side of Dave's body for so many months and cut its thickness in half, separating the muscle from the skin. He managed to stretch the muscle across most of the right side of Dave's abdomen to replace the muscles and supportive tissue he lost when he hit the guardrail. He then used the skin layer cover the area, leaving only a small space between his breastbone and his bellybutton without supportive structure. The stitches and staples will be in for ten to fourteen days and will require some minor care, but after that, NO MORE DRESSING CHANGES! No more drainage leaking everywhere, no more tape tearing off Dave's skin, no more Baza cream making him smell like a medicine cabinet. Yeah!

After at least three months of recovery, we will begin to talk about continuing the reconstruction by covering the last small unprotected layer and beginning to smooth out the mountains and valleys that make up Dave's abdomen. For now, we're just enjoying the fact that surgery is over and Dave is doing very well.

One more thing, total sidenote: my girl Liz's bone marrow came back clear of any new leukemia cells, her blood counts are back to normal, and she is back on track with chemo...in fact, she is walking distance from us right now for a one night stay at Children's Hospital! Thanks for praying for her too.

It will probably be another hour before we get to see Dave, so I'll post more later. Thank you all for your prayers!

Update #176

2009-07-08T12:48:00.002-04:00

First part of the surgery is complete. They found the source of the fistula where they expected it to be - in between his colon and his small intestine, the site of a previous repair at the very beginning - and reclosed it. They also discovered another small hole that seems to be coming from his liver (his liver is under his rib cage because of the diaphragm being reattached, so they can't see it clearly), a hole that has been draining a small amount as well. Dr. Muskat cauterized the hole and said it should close on its own but has minimally invasive ideas for how to fix it later if it continues to drain.

Dr. Kitzmiller is working on reconstruction now...more when we hear...

Update #175

2009-07-08T09:54:00.003-04:00

Dave just went back for surgery. After talking to Dr. Muskat and Dr. Kitzmiller this morning, it will be approximately three hours for the first part of the surgery to close the fistula and two hours for the second part, which only includes closing Dave back up and readhering the skin flap (the beginning of the major reconstruction, including inserting supportive tissue to replace his abdominal wall, will be in a few months). I'll post as we hear...

Update #174

2009-07-08T05:46:00.002-04:00

Today is the big day! Just a reminder to be praying today as Dave undergoes what we hope will be his last major surgery. The procedure starts at 9:30 a.m. at University Hospital here in Cincinnati and will last between four and six hours - two hours for the "trauma" surgery to close the fistula (hole in his digestive track) and an additional two to four hours to begin to reconstruct his abdominal wall, including inserting something to replace his ab muscles and two ribs on the right side that he lost during the accident (the length of the second part of the surgery is dependent on how smoothly the first part goes). Recovery is seven to ten days in the hospital and an additional three to four weeks at home. Be praying for peace for Dave, his parents and me during what will be a very long day today, and for wisdom and skill for Dr. Muskat and Dr. Kitzmiller to complete the procedure without incident.

I'll be posting updates as things happen today, so keep your eyes here!

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

Update #173

2009-06-30T10:02:00.003-04:00

Alright, the honeymoon is over. :-)

The past three weeks have been wonderful. Aside from the fact that Dave doesn't have to get up and go to work every morning, we've been leading a pretty normal married life. Dave was discharged from PT, so we go to the gym four or five times a week. We cook, we unpack (I think we may have finally found our garage floor), we take Baza to the dog park, and just in general, we enjoy spending time together. It's been wonderful.

To update you on the Wedding Celebration...

Well, first, if this year has taught us anything, it is that life is full of ups and downs. The weekend was no different. Although the Wedding Celebration itself was incredible, the weekend was not without its rough points, which were, oddly enough, not related to Dave. The Thursday before the wedding, we found out that my Grandpa Harlan (my dad's dad), who insisted on driving from Montana to Ohio by himself, had passed away in his hotel room on his way to Cincinnati for the wedding. On the negative side, he was only hours from being able to see his whole family in one place for the first time in years; on the positive, we were all together to receive and mourn the news.

Then, the day after the wedding, my Grandma Dahl (my mom's mom) ended up in the hospital after passing out at the hotel. During her evaluation, she had to disclose her medical history, and she revealed that she had been diagnosed with breast cancer only a few days earlier but didn't want to tell anyone until after the wedding. My mom's sister Karen died of breast cancer only a few years ago, so the news was particularly rough, and I know my mom and her family are still really struggling a good deal.

In spite of the rocky moments, everyone, including both sides of my family, was able to celebrate Dave's recovery and our new life together, and we are both so grateful that the party could be the high point they needed during so much tragedy. The Celebration was incredible. The Underground, where Dave and I met, was the perfect backdrop for us - lots of concrete and steel with just the right amount of fluff to make it festive - and it was packed (over 300 people at last count). We vowed (again), we danced, we posed for pictures at Starbucks, we ate, we smashed cake, we took photos in the photobooth...just an incredible night overall. We're waiting on the pics from our photographer, but as soon as I have them, I'll get some up for you to see.

But now we're back...from outerspace...I just walked in to find you here... Sorry, wedding flashbacks. :-) Anyway, the event that has been lingering in the back of our minds - SURGERY - is fast approaching, and we're doing all we can to live it up before we head back to the hospital. We had an appointment with Dave's pulmonologist two weeks ago, a necessity for him to be cleared for surgery, and Dr. Nath says he is good to go. Even better, he included in his report a prescription for a walking epidural for Dave's pain so he can be up and about as soon as possible after the surgery (hopefully that will save us from a repeat of the femur surgery when he could hardly move). The final pre-op appointment is Thursday, and as long as everything looks good and comes back clear, to the hospital we go!

Some really postive news: we had an appointment with Dr. Archdeacon, Dave's orthopedic surgeon, yesterday, and his femur is finally healing! Even our untrained eyes could see the fresh bone growth on the X-rays, and Dr. Archdeacon was ecstatic when he saw how well Dave is walking and how mobile his leg is.

This update is shorter than I anticipated - Dave's awake and wants to go to the gym - but be on the lookout for more regular updates over the next few weeks as we prepare for and go through the surgery. Some specific prayer requests:

- For peace for all of us as we get ready for such a long procedure.

- For continued strength and healing over this last week so Dave will be as prepared as possible for surgery.

- For my girl Liz, whose chemo had to be stopped because all of her blood counts were too low - that her bone marrow biopsy will give some indication as to why she has had to endure so many delays.

- For my dad and his family as they continue to deal with the loss of his dad, my Grandpa Harlan.

- For my mom and her family as they walk with my Grandma Dahl through the scary world of cancer.

Thanks to all of you for continuing to read and continuing to pray us through this journey. More updates coming soon...

Update #172

2009-06-07T22:50:00.003-04:00

Okay, I'll post later - I need sleep before I can begin to put together a coherent explanation of how incredible this weekend was - but you have to check out http://www.cherylweaverphotography.com (click on "Artist Blog"). Just a small taste of an incredible weekend with an amazing photographer.

Oh, and I got to slow dance with my husband. :-)

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

Update #171

2009-06-03T23:28:00.002-04:00

So should have posted this three days ago...

We headed home from the hospital on Saturday and were immediately greeted by a large oxygen compressor, the newest medical addition to our home/hospital. The compressor takes oxygen from the air and compresses it into pure oxygen that Dave breathes through a tube. For the first two days he was home, it was tubes 24/7. Now, it's only when he is moving a lot or sleeping at night - yeah progress!

The Wedding Celebration is still on for Saturday - 4:00 p.m. at The Underground (1140 Smiley Ave., Cincinnati, OH) if you are in the area and want to party - and we're in the midst of the chaos of preparation, so this post is really short. Be praying for Dave's breathing and for his sleeping (he was up almost all night on Monday because he "just wasn't tired" in spite of his two sleeping meds). Also, be praying for all of our friends and family who are beginning to fly/drive in for the party from all over the country. So exciting!

The next post you see will very likely be pictures of Dave in a tux... Stay tuned!

Update #170

2009-05-29T01:24:00.003-04:00

The first number on the first machine with the first alarm that I ever understood in the ICU was the oxygen saturation level. Normal, healthy individuals generally have a saturation level of 95% or so. When Sarah and I first arrived at 4:00 a.m., we sat and watched that number climb from 79% (it had started in the twenties when Dave first arrived) to 90%, which is almost within healthy limits. That was the first sign of progress and the first critical step in Dave's recovery.

Before I go any further, Dave is fine and is being monitored closely. With that said, among the multitude of tests that Dave has endured today, his pulmonologist ordered a study of his oxygen saturation level while he sleeps. As a result, now, almost a year later, I'm sitting in a different hospital room almost as late at night (or early in the morning) watching the same number and listening to the same alarm on the same machine. Talk about deja vu. Partially because of his pneumonia and partially because of the damage to his lungs, it turns out that Dave's saturation level drops to the mid-80s when he sleeps. Yikes! We have been working with Dr. Hardin and the insurance company for weeks trying to get approval for our own saturation monitor at the house so we would know when his level was low. This may be the proof we need.

So Dave is not sleeping, I'm not sleeping, and that stupid alarm keeps beeping. The Respiratory Therapist was hoping to hold off on giving him oxygen to preserve the integrity of the study, but he's been running 83% to 85% for ten minutes, so on with the oxygen we go.

The good news, of course, is that unlike a year ago, Dave is awake, happy (well, aside from the lack of sleep) and looking forward to being released in the next few days. I guess, keeping that in perspective, we can probably deal with the annoyance of one alarm.

That being said, please do be praying for Dave's breathing. From the sounds of it, the drop in saturation may mean yet another night in the hospital. Again, so much better than last year, but I think we will both be glad to see our own bed again sometime soon.

Update #169

2009-05-28T16:50:00.002-04:00

So at least the hospitals are moving continually closer to home...

Almost immediately after I finished posting the last positive update, Dave woke up and said he was having a hard time breathing. After a call to Dr. Hardin (PCP), we headed to the ER at the new West Chester Medical Center (only 5 minutes from our house), where the nurses informed us that Dave almost certainly had pneumonia. The cultures that came back today confirmed it.

We did spend last night in the hospital and will be here at least one more night until the IV antibiotics kick in completely. Fortunately, this is the nicest hospital room we have experienced yet, and Dr. Weintz - Dave's doctor from Drake - transferred up here when the hospital opened and is Dave's attending while we are here. Dave is also feeeling (and looking) much better this afternoon, and his white blood cell count is dropping back to the normal range, so overall, things are as good as they can be.

We'll keep you posted, but for now, I'm off to help Dave try to take a shower without getting his IV wet. Fun fun!

Be praying for fast healing and that Dave doesn't lose any strength during his time here. More soon!

Update #168

2009-05-27T07:46:00.019-04:00

Da boys

Breakfast

Liquid breakfast

Airplane spoon?

Congratulations Todd and Janice!

I didn't even get a one-knee proposal!

Da girls

Da boys

So many updates. Things are getting crazy... For some reason, blogspot's formatting is messed up, so I apologize for the lack of paragraphs.

First, surgery is scheduled for July 8th! Six hour procedure - two hours for the fistula, four for reconstruction - followed by seven to ten days in the hospital and a month of recovery at home. According to Regina (PT), with the way Dave's made progress in the past few months, the surgery shouldn't have even set him back that far.

Speaking of PT, Dave's doing so well that he is getting kicked out! A few more sessions, then we are on our own! We got a gym membership last week (Fitness 19 - $14 per month for both of us!) and have already worked out a couple of times. The only issue - now we have to be self-motivated - AHH!

In other positive news (I think it's actually all good stuff this post), the blob has left the building! Surgery two weeks ago made a HUGE difference, and the purple monstrosity that was overtaking the right side of Dave's face is now only a small scar. Another follow-up in a few weeks, but for now, huge improvement.

Some fun stuff - Dave got to go on his bachelor party a week and a half ago! The first time he was away since he got out of the hospital, and as I'm sure you can see by the pictures, he had a blast. Dave's groomsmen and a bunch of his other friends took him "camping" in a cabin in Indiana with queen size beds, a jacuzzi, and our friend Ben's cooking, which in and of itself means you're living the high life. Not exactly roughing it, but a guys' weekend just the same.

Then, this past weekend - a lot of firsts over the last few weeks - we took our first post-hospital road trip to Chicago for our friends' wedding. Five hours in the car each way, an architectural boat tour of the city, lunch with one of my bridesmaids Heidi and her husband Ray (who, by the way, is getting ready to start his medical residency and is fascinated by Dave and his accident), deep dish pizza and Yatzee with my dad's college roommate and his wife, and of course Todd and Janice's wedding. A whirlwind of a weekend, but well worth it. Dave walked, danced and survived a very long drive with no major bumps.

And, on top of everything else, our Wedding Celebration is only ten days away! The chaos starts this Saturday when my sister gets to town and doesn't stop for over a week. We're in the midst of pre-wedding chaos - flowers, DJs, caterers, fittings - but we're loving every minute of it.

Sorry for the long pause without updates - I was thoroughly reprimanded by our friend Randee at the wedding - but I hope this helps! Can't wait to see you all next weekend!

Update #167

2009-05-02T08:32:00.003-04:00

Someone asked me a few weeks ago at what point Dave and I would stop updating the blog, when we would feel the need to cut people off from reading every detail of his life. We're still not sure when that day will come - maybe after the surgery in June - but I promise that whenever it does, I'll make sure to wean you gradually so the withdrawals aren't too terrible.

On that note, two and a half weeks with no update doesn't mean that there is nothing noteworthy to say; it just means that things have been SO busy, I haven't had time to crash in front of my laptop and put two (or 202) coherent sentences together. Finally, it's Saturday morning, Dave's asleep, Baza's attacking a banana (literally - I gave him a bite of my banana, and he's growling at it), youth ministry for tomorrow is ready, and we have no appointments till Monday. I should be able to get through an update before things get crazy again.

Something that I forgot to mention in the last update: Dave's visit to the Pulmonologist confirmed the pulmonary hypertension and resulted in a Pulmonary Function Test that told us Dave is at approximately 50% lung capacity for an average guy his age. The good news, though, is that lungs can take up to 18 months to heal, so there may still be some significant improvement over the next few months. The next surgery, which will include inserting some supportive tissue into his abdomen to replace is lost ribs and abdominal muscles, should also assist in improving lung function.

To get all of the bad news out of the way early, the blob has spoken, and the message isn't good. Two weeks ago, our visit to Dr. Cepela (Opthalmic Plastic Surgeon) brought a peek of light at the end of the tunnel when he said that the blob was improving. This past Thursday, however, the blob fought back and won. Dave is scheduled for surgery to incise it and scrape out the inflamed tissue on Monday, May 11th at 2:30 p.m. Aren't you jealous? :-) Because the location of the blob, numbing the area is out of the question, so Dave will (thankfully) be sleeping through the 30-minute procedure.

Onto the postive!

Dave is off his cane at home! He can walk around the house hands free, and it is amazing to watch! For the first few days, he looked like a toddler Godzilla (we'll see how often he reads this page by how soon he gets mad at me for that comment), but now, he is getting stronger and walking almost completely like he used to! He still tires quickly, and we still bring his cane when we are out, but no more wheelchair, no more crutches, and sometimes no more cane!

Dave is doing so well at PT, in fact, that Regina says she may have to discontinue him from her service and send us to a gym to work out like "normal people." We're working on choosing a gym and setting up an exercise program and could be on our own in the next two weeks!

Possibly the best indicator of Dave's progress: he's wearing his earrings again! For a while in the hospital, he said that he didn't think he would ever wear them again, but they're back. And for those of you who offered to contribute to the Dave repiercing fund, you'll be happy to know that the holes are still there, and he is regauging them back to their original size as I type.

So that's it in a very large nutshell. 35 days till the Wedding Celebration, and, if this post is any indication, Dave should be blinging, walking and even dancing the way that he was one year before. Looking forward to it!

Prayer requests:

For the surgery on May 11th, that we will finally conquer the blob.
For continued strength improvement and no more infections.
For my girl Liz who has approximately one month of quiet and calm before she starts what could be the worst chemo she has experienced yet.

Love you all! Looking forward to seeing you on June 6th! For anyone coming out for the Celebration, visit http://kendahlanddave.wordpress.com for all the details!

Update #166

2009-04-15T08:28:00.008-04:00

Two of Dave's roommates came to town for a visit a few weeks ago (I'm a little behind schedule). I knew I liked them right away, but I understood why they are such good friends with Dave when they kissed a bronze horse, spent $1.50 in quarters trying to get a pink gumball from the machine, and posed for a picture on a wooden banana. Amy and Marisa, you rock, and we can't wait to see you again in June!

Onto the update...

Dave doesn't have MRSA! Took almost two weeks but the culture came back negative. Unfortunately, the blob is still on the side of Dave's face with no sign of disappearing. We're headed back to Dr. Cepela's office tomorrow, a visit that may lead to a small plastic surgery to remove the blob. Be praying that won't be necessary.

More positive news: Dave may be walking completely on his own in less than two weeks! Regina (PT) is pushing Dave hard, and he is using his cane around the house and a single crutch when we are out. He has been working to walk unassisted at PT (I have a video that I'm trying to post) and is making amazing progress in his strength. He even used our Wii Fit (thanks, John, Terri and fam!) for the first time the other day and (I'm embarrassed to say) beat my score in most of the balance games. Humbling, but still fun to watch!

Dave's fam was down for Easter this past weekend - I'll get pictures up soon. For now, Baza is getting into something, so I should run.

Be praying for:

Healing of the blob.
Continued improvement in Dave's strength.

More soon!

Update #165

2009-04-01T08:49:00.005-04:00

Before I say anything else, I have to tell you that Dave and I have a new nephew! Born last night to my older brother Cory and sister-and-law Joei - 8 pounds, 7 ounces, 21 inches and doing great. First grandchild for my parents and Joei's, so it's quite exciting, and I've been meaning to post about her pregnancy for a while but was sworn to secrecy until her roommates all heard the news (which, granted, was six months ago...). They have their own blog (Dave and I should get a commission for everyone who signs up with blogspot.com) - http://coryandjoei.blogspot.com. No pics up there yet, but I'm sure they are coming soon...

Onto the update. Right around four months ago, while he was still at Drake, Dave developed a small sty. For anyone who has never experienced a sty, it's kind of like getting an extremely painful whitehead on your eyelid. Dave's started on his upper lid and about two weeks later migrated to his lower lid as well. Before we left Drake on January 6th, about three weeks after the sty started, the doctors told us not to worry and prescribed hot compresses four times per day for ten minutes each and a topical steroid that "should clear up quickly."

A month later, the sty had come to a head and exploded several times but was still holding on. Dave's primary, Dr. Hardin, told us not to worry but said we should ask the opthamologist when we saw him.

A week later, Dave's neuro-opthamologist, Dr. Golnik, told us not to worry, prescribed hot compresses (again) and an oral antibiotic.

You haven't heard any of this up until this point because "it's just a sty; people get them all the time."

Well, Dave's "just a sty" didn't appreciate the underappreciation. Two and a half weeks ago (at the tail end of the month's worth of antibiotics from Dr. Golnik), Dave's sty decided to migrate away from his eye downward toward his cheekbone and grow - how do they say it in The Grinch Who Stole Christmas? - three sizes bigger. Only it was more than that. Over the course of only a few days, the small whitehead evolved into a one-inch diameter purple blob on Dave's right cheekbone.

Last Tuesday, we saw Dave's primary, who, with one glance at the blob, sent us immediately to an Emergency Eye Clinic, where, after an hour of waiting, the Opthamologist told us that she couldn't do anything with it and we would need to see an Opthalmic Plastic Surgeon. We left with another antibiotic and an appointment card for yesterday for a doctor almost an hour from our house.

Are you tired yet? Yeah, Dave is too. Anyway, after an hour drive and an hour of waiting yesterday afternoon, Dr. Cepela was nice enough to stick a needle in the blob, poke, squeeze and otherwise violate it, then inform us that Dave may be battling another round of MRSA (the resistant staph infection he had when he was in the ICU). Dr. Cepela didn't seem overly concerned but did encourage us to be overly diligent about hand washing, etc. until the culture comes back. Yeah quarantine! At least it means that Dave can finally justify the pirate look (with his eye patch) that he's been perfecting...

In other news, Dave's Echo and Holter Monitor (the 24-hour EKG) came back showing signs of pulmonary hypertension, news over which the nurses didn't show much surprise (we know that Dave's lungs are messed up, which does put more stress on his heart) but that did concern PT a bit. We have an appointment with a Pulmonologist on Friday to figure out next steps.

Now to the positive: Dave's sleeping in a real bed for the first time in almost ten months! One of the things I had always looked forward to most about marriage was waking up next to my husband, so since January, Dave and I have been sharing his twin hospital bed (still tilted at a 30 degree angle) at night (yeah, we know we're crazy). Regina (PT) strongly encouraged Dave to try to lie flat for short amounts of time, so gradually, we reduced the angle and increased the time till eventually, he could lie flat all night (and sleep during parts of that time too!). So, last week, we decided to try the transition, and can I tell you how much bigger a double bed is than a twin? The mattress is more comfy, Dave's breathing is fine, and we don't wake up with our faces pressed against metal siderails anymore. Yeah!

We also have been able to leave Dave's wheelchair in the garage for almost two weeks straight! He sits in regular chairs at home and only brings his crutches when we go out (unless we know it will be for a lot of walking, like a the grocery store). He is even moving around the house with only one crutch and could be moving to a cane soon.

Lots more updates coming, but for now, we're off to PT. Have a great Wednesday!

Update #164

2009-03-18T08:03:00.003-04:00

There is no excuse.

If you want one, though, that picture is me on Sunday afternoon (from Dave's perspective, since I fell asleep in his lap) after finishing a retreat with my middle schoolers over the weekend. So that gives me a least a few days, right?

Really, I have thought about the blog many times in the past two weeks, but things have been insane. I'll do my best to recap:

First, no bone infection! The antibiotics that Dr. Archdeacon prescribed did the trick, and the redness around the incisions is gone. Not only that, Dave is back to walking even better than before the second surgery! Once he made it through the first two weeks, the pain subsided enormously, and even the annoying pain in his hip that he had learned to deal with is better. Dave is back down to his Fentanyl patch and an occasional Percoset, but no more Valium or Morphine. Overall, surgery was a rough experience, but he is, as promised, all the better for it. We even went for a 45 minute walk in the park yesterday, and Dave did great!

To further ensure that Dave's femur heals this time, he now has the privilege of wearing a contraption called a bone stimulator, which sends electromagnetic pulses through his leg to stimulate bone growth ten hours per day (actually, per night since he wears it while he sleeps). Although he has another follow-up with Dr. Archdeacon on April 20th, we probably won't know how well the bone is healing for at least another six months.

One of the reasons that Dave is walking so well, in addition to the surgery: we're back in PT/OT again! And I have to tell you that outpatient is nothing like inpatient or even in-home - Regina, Dave's new Physical Therapist, is not j0king around. Day 1, she had him lying flat on his back (did I mention he's been sleeping at a 30-degree angle since his accident because of his lungs and his cough?) doing exercises - he now sleeps flat every night WITHOUT COUGHING FITS! Day 2 was lots of standing. And Day 3, yesterday: Dave walked up AND down five or six steps alternating feet (left foot on one, right foot on the next step up, left foot on the next step up - the way you probably walk up steps) in both directions. It was incredible! She also had him balancing on a balancing board and walking on a treadmill, and even in the past three or four days, Dave is looking like a new person. The plan is for eight visits of PT over the next few weeks, then a "break" (for Regina, at least) while we work on endurance at home, then back to PT after the next surgery for a few more visits. Supposedly, Dave's insurance only covers 30 outpatient PT visits per year, so we are doing our best to use them wisely.

One small hiccup in the PT (sidenote: Dave has not actually had the hiccups since his accident - I know this because one of my middle school girls asked him in a Get Well card back in June and now continues to ask him every time she sees him...): the first time Dave went in for his eval, his heartrate and oxygen levels were jumping all over the place (heartrate from 60 to 130 with only mild exertion and in only a few seconds; oxygen from 94% to 85% - completely unhealthy - during the same activities). The problems may be simply as a result of Dave being severely out of shape (understandably), but the changes are enough to be worrisome. As a result, Dave now wears oxygen (back to the tubes) during exercise, including at home as soon as we get the prescription from Dr. Hardin, to keep his levels up. He also had an EKG on Friday and is currently wearing a Holter Monitor (a 24-hour EKG) to watch his heartrate and ensure that his activities are not putting any undue strain on his heart. We'll have the results from the EKG today and from the Holter sometime later this week. Be praying that everything is normal.

In the midst of all of that, we continue to enjoy our puppy, prepare for our Wedding Celebration on June 6, 2009, and live as much of a normal life as possible (went on our first official date since January to see Slumdog Millionaire on Monday - so good!). We are getting more sleep, getting out of the house almost every day, and GRADUALLY cutting down on the number of pills that we have to put in Dave's pill boxes every week (the multi-colored array was getting a little dizzying, both for me as I assembled it and for him as he took it).

I'm sure I've missed some huge pieces of our last two weeks, but hopefully, you feel at least slightly back in the loop. When I start getting messages from my dad's family from Montana asking if we are okay (which happened last night), I know it's been far too long since I updated the blog. To think positively, though, you know that you never want to go back to the days when daily - or even hourly - updates were necessary. The glass is always half full... :-)

Thanks for continuing to check in and walk alongside us (if only electronically) as each day we take more steps toward ending this blog forever. :-)

Love and prayers from all of us...

Update #163

2009-03-04T21:38:00.005-05:00

Meet Baza. :-) There are benefits to having a friend who is a professional photographer - thanks Cheryl! Small plug because she's so great to us and will be doing our wedding celebration party thing in June - go check out her site at http://www.cherylweaverphotography.com/.

Be praying - we went for Dave's Ortho follow-up on Monday, and there is a small chance that he has a bone infection in his femur. Dr. Archdeacon didn't seem overly concerned, but the bone biopsy showed a small amount of a bacteria that normally only shows up on the skin. Not a problem on its own, but the incisions where Dr. Archdeacon removed the old rod and inserted the new one are red and slightly infected (the other incisions are fine), which means that the infection may have come from the old rod itself when it was removed and rubbed on the skin (does that make any sense?). Anyway, Dave is on some pretty intense antibiotics, and if the redness around the incisions doesn't clear up by Friday, back to the doctor (and potentially back to the hospital) we go.

More soon...

Update #162

2009-02-25T21:48:00.002-05:00

We are home. Sorry for not posting sooner.

Monday kicked off with PT and OT, including stairs to be sure that Dave would be able to get into the house. It took almost 45 minutes to get up and down two steps, but he made it, so home we went, carrying presciptions for Oxycodone, Valium and long-acting Morphine. The Oxy quickly morphed into Percocet when we realized that every pharmacy in the state of Ohio has Oxy on back order from the manufacturer - is that even possible? - and the combo is helping to keep Dave's pain around a 5. Hopefully, it will continue to subside in the next few days - follow-up with Dr. Archdeacon, the Orthopedic Surgeon, on Monday.

Aside from the pain, we are good, and it is great to be home. Baza seems to have survived the weekend without us (although I think our roommate Rachel may need a few days to recover from puppy-sitting), and we are being spoiled with homemade meals from people from our church for the next few days (yeah for a few more days before Dave realizes that I can't cook).

Praises for a successful surgery, and prayers for the pain to disappear. Love from both of us...

Update #161

2009-02-22T20:36:00.002-05:00

One more night. :-(

Dave's still struggling with the pain and can't put any weight on his right leg. The doctors started the discharge process again today, but we knew that even if we could get help getting into the car today, getting out of the car and into the house would be nearly impossible if he can't put weight on his leg. So we're staying.

It's a setback, and we are definitely ready to go home, but we also want to make sure that we will be able to function on our own once we get there, which would not have been the case today. So, more TV, more relaxing, more prayers that tomorrow will be better.

I reread the past couple of posts, and they sound pretty negative and down. Please know that we are doing well and our spirits are still fine. We know this is just one more step in the journey with a few unexpected bumps, and this too shall pass. For now, we're just trying to enjoy another quiet evening and looking forward to getting home soon.

"And we know that in all things, God works for the good of those who love him, who have been called according to his purpose." This verse, Romans 8:28, is our theme with the middle schoolers this spring and one I have been reading and studying and meditating on for weeks. Sometimes, God likes to give very clear reminders what it means to believe what I teach. I remember back in the ICU, not too long after Dave woke up, he and I were talking about the amazing plan that God must have for him - for us - as a result of his accident. His response? "I hope so. And I can't wait to see what it is." Amen to that.

Still trusting, hoping, and looking toward the good. Love and prayers from both of us...

Update #160

2009-02-21T19:42:00.003-05:00

Dave's miserable.

I wish there were a better way to say it, but "miserable" is the reality right now.

I think we may have underestimated how much it hurts to shove steel into bone; I know we underestimated how much of a tolerance Dave's body has built up to painkillers. The combination of those two factors has left Dave anywhere from a six to a nine on the 10-point pain scale for more than 28 hours. Yesterday evening was Oxycodone and Morphine. Last night was long-acting Morphine, Oxycodone, IV Dilaudid and Valium, plus two sleeping pills and interruptions from nurses every two hours for "refills." Today is IV Dilaudid, Dilaudid pills and long-acting Morphine. And Dave is still in pain.

With a resemblance far too close to life in the ICU, it took fifteen minutes to get him out of bed and into a chair today and another ten later this afternoon to move to his wheelchair. And every movement sends shocks of pain through his whole leg.

Needless to say, we're spending another night at UC. According to the Ortho attending today, the pain should go down by 50% within 36 hours, so hopefully by tomorrow morning...

Please be praying. One night away from home almost sounded relaxing. Two nights in a hospital is all too much of a reliving of so many other nights lying awake waiting for the pain to go away, a situation with which we are all too familiar and of which we are getting pretty tired.

Update #159

2009-02-20T14:25:00.003-05:00

UT's Orthopedic Surgeon - spitting image of Christopher Reeve's Superman

UC's Orthopedic Surgeon - spitting image of Sean Astin somewhere between Rudy and Samwise Gamgee.

Sorry, when you've spent as much time in hospital waiting rooms as I have, you find unique ways to amuse yourself. And the name of Dr. Archdeacon's (UC) celebrity twin has been plaguing me for weeks.

Anyway, Dave's surgery went great. Pins and rod removed, biopsy taken, rod and pin inserted. And - who's the greatest wife ever? - I even asked Dr. Archdeacon to call the nurse to have her save the old rod and pins for Dave when he wakes up. If either of us is wearing unique "jewelry" at the wedding celebration in June, you'll know where it came from. :-)

The surgery has an 85% success rate for healing femur fractures, and considering the improvement in Dave's strength, mobility, nutrition and overall health since the last try, Dr. Archdeacon is pretty confident Dave will be among the successes.

An hour till I get to see him, so I'm off to get some lunch. More soon!

Update #158

2009-02-20T12:21:00.003-05:00

Dave just went back to surgery. The procedure should take two hours - put him under, remove the old rod and pins, bone biopsy, place the new rod and pin (only one this time) - with another hour in recovery before I can see him. Dave's words before they wheeled him away? "I wonder who I need to talk to about keeping the old rod and pins." This is why I love him. I'll post once I hear something.

Update #157

2009-02-15T22:04:00.003-05:00

So I'm a horrible person. Okay, not horrible person, just horrible blogger.

Yes, it's been more than two weeks since the last Dave Update. And honestly, in the midst of doctors' appointments and laundry and...well, we'll get to that last "and" in a minute.

First, after asking for prayer for Caleb, I feel awful for not telling you sooner that he is doing fine. The surgery went well, and he was home recovering after only two days in the hospital. The whole fam came over for dinner the other night, and not only is he one of the cutest babies ever, he is also one of the happiest and more normally developing I have ever met, so from my expert medical perspective, at least, the surgery was a success. :-)

As for Dave, things are picking up again, so much so, in fact, that you may actually get more than one post every two weeks. First, Dave moved his foot! Yes, I know, I thought we were past the updates on "mundane" tasks too, but remember foot drop? The EMG that said Dave had no nerve activity in his left shin, which was making it impossible for him to flex his foot toward his face? Yeah, he flexed his foot. We were at the Podiatrist's office the other day, and while we were waiting for Dr. Adams to come in, Dave was dangling his feet from the exam table, so I asked if he could flex his left foot. And he did! Talk about surprised! He did it again and again, but I have to admit that in our disbelief, I actually waited until Dr. Adams came in and asked her to confirm that Dave was, in fact, moving his foot before I actually believed that the foot drop might be getting better (pretty sure she thinks I'm crazy now...).

The reason that Dave was visiting the Podiatrist, by the way, is because on top of everything else, he has ingrown toenails. Lucky him. So, after a minor toenail clipping didn't solve the problem, he had the pleasure of having an ingrown toenail procedure that, fortunately for you, I can't describe in detail because even after everything that I have held Dave's hand through in the past eight months, and after everything he has experienced, neither he nor I could watch what the doctor did to his feet without getting nauseated. Yeah, we're wusses.

Hmm...how does that song go again? The foot bone's connected to the toe bone, the toe bone's connected to the thigh bone...maybe I need to check my anatomy book. Anyway, moving up from Dave's feet...well...he's having surgery on his femur again. After more than eight months with the rod and pins in place to fix the fracture, Dave's leg still hasn't healed. The description from Dr. Archdeacon, Dave's Orthopedic Surgeon? "Because the fracture hasn't healed, the rod could break. It doesn't generally happen in the first year, but it does happen, and if it breaks, the surgery is a whole lot harder. So you could wait a few more months..." I think we'll go with surgery. Anyway, assuming Dr. Muskat, his Trauma Surgeon, agrees that the surgery would be a good idea, he's scheduled for Friday at noon. The surgery will last approximately two hours and involves removing the current rod and replacing it with a new, larger rod that should help stimulate healing. The procedure does include an overnight at UC, but Dave will be up on his leg again as soon as he wakes up. Pretty incredible if you ask me. Hopefully, the new hardware will also help to resolve the residual pain he is experiencing in his leg and hip.

Finally, the "and" that I mentioned above - because we don't have enough going on already, Dave and I got a puppy. A word of warning in hindsight: if you aren't prepared to get a puppy today, don't start "casually browsing" the Pets section on Craig's List. His name is Baza, affectionately named for the 135 tubes of cream that we have used to protect the skin around Dave's wound, and he is adorable (we might be a little biased, but he did get a lot of attention at PetSmart where we stopped to get food on the way home). He is half beagle, that much we know. The other half is unknown, although he has the coloring of a rottweiler...good thing he has small paws or we could have a monster on our hands. Anyway, for any animal lovers out there, we will gladly post pictures soon. For anyone who turns green at sappy pet owners who coo about how cute their animals are...well, we'll still post the pictures, but you can ignore them...or post mean comments about them if you prefer. :-)

So I think that's the long and short of the past two weeks. Caleb is doing well, Dave is having surgery, and our puppy has to pee. I should go take care of that...

By the way, Sarah already texted me to let me know that she will be at the hospital with me on Friday. Maybe one day, she and I will get to hang out somewhere other than a waiting room. Keep praying!

Update #156

2009-01-30T04:04:00.002-05:00

I can still remember the look on every single person's face that I encountered during those first few hours.

It's 4:00 a.m., ironically (and I just realized this), the time that my friend Sarah and I finally arrived in Knoxville that night, and I just woke up from...can you call it a nightmare when you know that it ends well? A reliving, perhaps, of those first few hours. I can see vividly the look on Dave's friend Tommy's face when we finally found him in the waiting room, when he told us that Dave was out of surgery. I can hear Dave's parents' voices when I called them on their drive down to pass on the news, not knowing they already knew what I was about to hear. Dr. Tummers, who drew the short straw and had the unfortunate job of telling me that Dave wasn't going to make it, and Teresa, the nurse who gave me tissues and walked with me and Sarah to see him for possibly the last time.

I remember rounding the corner to his room, that first sight. I was afraid to touch him, trying not to throw up, trying to keep my legs underneath myself. And then holding his hand, standing by his bed, kneeling by his bed for so long. Trying to pray, then finally finding the only words I could think over and over and over - His Spirit, His will, His peace...

I remember Donna, Dave's night nurse for the first week, letting us stay so long past visiting hours - she did so many times that week - then gently telling Sarah that she needed to get me to leave so the nurses could change shifts.

That's when I woke up - today, not then. Then, it was a bad dream that wouldn't end. And today - today, I let my thoughts continue to wander through it all, all over again. Dave's parents and sister arriving, walking with them through the hell that I had been through already. Doctors. Nurses. Visiting hours that were so short. So many people, visitors, supporters, phone calls. Dr. Tummers is "almost hopeful." Sitting up all night waiting for 5:30 a.m. when I could see him again. The "cardiac episode." Something about "extraordinary measures" and organ donation? The dialysis. The waiting.

As I'm typing this, I can hear Dave breathing. A nice wife would probably leave the room so as not to disturb him. But I'm pretty sure I could sit here and listen to that sound forever. That's one of those sappy things that newlyweds say, right? But in this case...

We've had snow days for the past three days (one of which was actually justified, which in Cincinnati is pretty impressive). And when I woke up to the blanket of white on Wednesday morning, for a moment, everything disappeared - the dressing changes, Dave coughing from his cold, the wheelchair, the crutches, the meds, the stress of the past three weeks out of the hospital - and all I could think of was how glad I am that he is home. This morning, that feeling is magnified a thousandfold. And I just want to sit and listen to him breathe.

Most of this is coming, I know, from the fact that Sarah, who drove with me that night, will be getting up soon to take her five-month-old son to his second brain surgery in just over two months. And for a moment last night, I actually considered not going to sit with her and her husband at the hospital because it was too early and there was too much going on with Dave. Now I am remembering her, six and a half months pregnant, the first person that I called because I knew she would know what to do, driving through the night with me, holding my hand, making phone calls, forcing me to eat, sleeping on the floor at the hospital so I wouldn't be alone...

If you think of it today, pray for Sarah, her husband Ben, their daughter Abby, and their little son Caleb. They've spent so much more time in the hospital than any family should, and I know they could use the extra support today. And in the midst of that prayer, thank God that Dave is home. There are still so many things to pray for, but for today, that's the only one that matters.

A few more minutes to enjoy the sound of Dave breathing. Then, I'm going to take a shower. I have a friend who needs me to sit at the hospital with her.

Update #155

2009-01-25T16:47:00.004-05:00

I promise that even with the disclaimer about a few missed days here and there included in my last post, I never intended to go a week and a half with no updates. I fear, however, that I may have made our "abnormal normal" life seem a little more routine than it really is. Just to give you a little insight...

1. Dave had a dentist appointment on Wednesday. The entire adventure, which most people could do on their lunch break, took four and a half hours. The appointment itself was thirty minutes, travel forty minutes; the rest was prep time, getting in and out of the car, getting in and out of the office...

2. Dave was a Boy Scout when he was growing up, so he's probably well practiced; I'm learning quickly what the motto "Be prepared" is all about. Everywhere we go, we have two sets of dressing change supplies, towels for any "explosions," handicapped parking pass (which I have forgotten more often than I've remembered it), meds (we actually bought one of those daily med organizers broken into morning, noon, evening and bed for each day to keep track of his 12 meds), crutches, wheelchair, ...

3. I got a cold last week; unfortunately for Dave, I learned about sharing a little too well in elementary school (in other words, Dave now has my cold). Anyone ever go to the doctor on Day 2 of a routine cold? Guess where we're headed tomorrow morning? Because of the condition of Dave's lungs, every small virus could mean something huge for him. Hopefully, his new doctor, Dr. Hardin, can help us take care of it quickly.

4. Perhaps the most difficult part for me - before Dave's accident, getting ready for bed was a 10 minute process: put on PJs, brush teeth, crash. Now, when we say we're "going to bed," we are beginning a potentially two and a half hour process of changing dressings, filling humidifiers, taking meds, adjusting bed angles... On Wednesday night (Wednesday was a rough day overall), Dave's dressing exploded at midnight. In the midst of changing it, a 30 minute coughing fit had him in tears and me (also almost in tears) with my gloved hands over both of the openings in his abdomen so his coughing wouldn't send drainage all over his bed.

This is beginning to sound much more negative than it should (although I must admit that I miss the days when our "abnormal normal" was more about spiked hair and too many piercings and less about bandages and wheelchairs). Aside from the cold, Dave and I are both doing well. We're getting unpacked (one box per day), settling into a routine, eating healthy meals, sleeping a fairly normal amount, and continuing to relish being out of the hospital. We've enjoyed "Fish Fry Night" with his old roommate Chris and our friend Todd (our kitchen still smells like the "Seafood Medley" that Chris wanted to try) and even a couple of trips to the mall to meet friends for lunch and pick out tuxes for Wedding Part II (or whatever we're calling June 6th these days).

On Friday, Dave switched from in-home care (for nursing, PT and OT) to outpatient care, which will happen once again through the Drake Center (although we may be able to do some of his appointments at a location in West Chester - five minutes from home - instead of Cincinnati - 20 minutes from home). During our appointment with the outpatient Wound Care Team at Drake on Friday, the nurse and doctor both said that Dave's wound is progressing well and that we are doing a good job away from the hospital...phew! :-)

One really cool story: the church where I work has been amazingly supportive throughout the past seven months even though many of the people praying for Dave there had never even met him. Last Sunday, Dave made his first post-accident venture to WellSpring (the church) and got a standing ovation when he came through the door. My middle schoolers surrounded him as if he was a celebrity, and our pastor brought us up to the front of the church in the middle of worship to give everyone a visible reminder that God is still alive and working miracles. For anyone who doesn't know Dave, he's not a super center-of-attention kind of guy, so I think it was a little overwhelming for him, but we were both blown away once again by the support and love we have felt from so many people through this whole process. Emotionally draining, but a visible reminder for us that God is still alive and expressing His love through His people.

I think this was longer than I had intended, but our youth activities at church are canceled for the evening because of the snow, and Dave and I are enjoying a rare quiet Sunday with time to reflect...and blog. :-) But now, my rambling ends - I'm off to make my husband some chicken noodle soup. More soon...

Update #154

2009-01-14T09:49:00.003-05:00

Never thought I would marry a high maintenance man. Dave certainly keeps us both running around! :-) Good thing it will end (at least he keeps promising it will) once he has surgery.

Speaking of surgery, we met with Dr. Muskat, Dave's surgeon, on Monday afternoon (the reason that I never posted again). We were hoping he would say that Dave was ready for surgery soon, but for as optimistic as we both are, we've seen his wound heal and change enough in certain areas to know what it probably should look like everywhere before the doctors go in to fix his fistula, and as we expected, it just isn't there yet. Dr. Muskat is impressed with Dave's progress, but he estimates at least two more months before we will be back in the hospital for what we hope will be his last major surgery.

In some ways, for as frustrating as the dressing changes can be, I think we both know that the break will be nice. The insanity of last week with his move, the excitement of the wedding on Saturday and the combination of the past seven months of...well, everything actually makes me look forward to having a routine, for as odd as that routine will be. And yesterday was the first day that it felt like we got close. Dave's nurse came in the morning to do some blood work, then I actually went to my office (crazy!) to catch up on some youth ministry stuff. We ordered a washer and dryer (we know we'll need it for all of Dave's dressing supplies - and all of my clutziness) then spent the afternoon organizing papers and medical bills and filling out disability insurance information. I headed out to the grocery store when PT and OT stopped by to do their evals on Dave. Then, we actually sat down to dinner at the kitchen table, hung out with our friend Todd, and closed out the night by watching TV. All of those mundane details are the things that make me scratch my head about bloggers - "Why would you share all of that, and why would anyone else want to read it?" - but I think Dave and I are both really starting to appreciate the calm, the ordinary, the quiet.

It's 10:00 a.m., and Dave's still sleeping, so I guess I should go try to wake him. The blogs will continue, but if we miss a few days, know that I'm just sparing you the boring details of what may soon start to feel like ordinary life. At one point, things as simple as brushing teeth were huge milestones for Dave. Now, the only excitement in that act is arguing about the best way to squeeze the toothpaste tube. :-) Quiet is good.

Update #153

2009-01-12T09:45:00.003-05:00

With so much going on over the past week, it actually seems cruel that I haven't posted. Please believe me, though, when I say that the short update I posted last Wednesday was the only free time we had between when Dave moved home on Tuesday and this morning. Let me try to fill you in...

The move Tuesday went really smoothly. We got all of the new "toys" (hospital bed, shower chair, crutches, wheelchair, etc.), supplies, prescriptions, contact numbers and advice that we needed on Tuesday morning and early afternoon then headed for home. On the way, we stopped to get Dave's twelve medicines and some necessities for life outside of the hospital (including a vibrating lumbar support cushion for his wheelchair - okay, not a necessity, but so comfy!), then drove to the house, where Dave's dressing immediately exploded all over the living room - welcome home!

The next two days were filled with dressing changes, unpacking, dressing changes, doctor appointments...did I mention dressing changes? Replace each of those "dressing changes" in that last sentence with "laundry that resulted from dressing changes" since Dave and I don't have a washer and dryer yet (guess what our first major purchase will be?), and you'll understand how Den and Cherie spent Dave's first week at home.

Oh, and by the way, did we mention that we got married on Saturday? For anyone who missed the post in the blog a ways back (and who has since gotten on Facebook and felt utterly confused at the photos of the wedding you missed), Dave and I decided to bump up the wedding to this past Saturday so we could start our new life together as soon as he got out of the hospital (okay, so he moved a few days early, but we were close). If you missed that post, though, you also missed the fact that the ceremony was very small and quick, and we are still planning a HUGE party for June 6th to celebrate the wedding and Dave's recovery, so please don't feel left out.

So back to the update... Add to the dressing changes getting a marriage license, meeting with Steve and Bryan (who married us), getting Dave's hair cut, picking out clothes, ordering food, and TWO CHRISTMASES (since neither of us got to celebrate Christmas with our siblings), and we had a pretty busy week.

Friday was Christmas #1 (Heckel) and Christmas #2 (Lund), as well as some time with my matron of honor and her family, and - you guessed it - more dressing changes.

Speaking of, Dave just woke up and needs his dressing changed, so I'll finish the update later. If you want to see some pics from the wedding that I'll tell you about later, go on Facebook and look at my profile (Kendahl Lund) - our friend Jennifer already has some great snapshots up.

More coming soon!

Update #152

2009-01-07T13:14:00.002-05:00

Dave is home! We did make it. Sorry for the lack of update, but between moving his stuff in last weekend, moving him in yesterday and getting ready for the wedding on Saturday, we haven't had much of a chance to take a deep breath. Even now, we're on our way out to get a handicapped parking sticker, so you'll have to wait on the details of the move. But he is home, and we're doing well. More later!

Update #151

2009-01-01T16:21:00.006-05:00

Happy 2009! Thought you might enjoy some New Year's Eve photos and videos (SIDENOTE: If you go back to the post from December 29th, I inserted our photos from Christmas)...

Tuesday is the day! After seven months in the hospital, Dave is finally heading home. Obviously, this is not the end of the road - there is still at least one more surgery, as well as much more outpatient rehab for him to continue to regain his strength. But going home...such a huge step!

Today, we are enjoying football (well, "enjoying" might not be the right word for the Michigan State game), leftover pizza and Wii Sports. Tomorrow, back to work for the final few days of inpatient PT and OT.

From both of us, prayers for an amazing 2009 for you all! Dave and I have never been so excited to start another year (possibly the understatement of the century). More soon!

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

Update #150

2008-12-30T23:41:00.002-05:00

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

2008-12-29T17:06:00.003-05:00

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

2008-12-25T18:56:00.002-05:00

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

2008-12-24T22:44:00.002-05:00

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

2008-12-23T16:05:00.003-05:00

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

2008-12-22T19:40:00.002-05:00

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

2008-12-22T16:33:00.002-05:00

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

2008-12-22T14:25:00.003-05:00

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

2008-12-22T11:03:00.002-05:00

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

2008-12-18T11:56:00.004-05:00

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

2008-12-11T15:42:00.002-05:00

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

2008-12-09T11:40:00.003-05:00

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

2008-12-06T07:27:00.004-05:00

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

2008-12-03T18:13:00.002-05:00

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

2008-12-01T21:01:00.002-05:00

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!

Update #135

2008-11-28T21:29:00.004-05:00

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

2008-11-26T15:06:00.002-05:00

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

2008-11-24T17:18:00.003-05:00

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

2008-11-23T16:29:00.003-05:00

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

2008-11-20T18:17:00.007-05:00

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

2008-11-19T11:17:00.004-05:00

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

2008-11-17T20:06:00.011-05:00

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

2008-11-15T08:38:00.002-05:00

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

2008-11-13T15:59:00.002-05:00

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

2008-11-13T08:09:00.003-05:00

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

2008-11-10T15:37:00.002-05:00

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

2008-11-06T09:39:00.003-05:00

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

2008-11-03T17:05:00.002-05:00

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

2008-11-02T16:42:00.002-05:00

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...

Update #121

2008-10-28T15:01:00.002-04:00

Dave's having a rough day today. His wound vac started leaking last night (still Day 1), and he got in trouble this morning when the Wound Care Team came to fix it because he may or may not be eating solid food that we may or may not be sneaking to him, which clogged his drainage tubes.

Speaking of clogging, Dave's feeding tube also clogged again this morning. The clog was bad enough that it had to be changed (for the third time in six weeks), a very painful process, and he is waiting on an X-ray to confirm that it is properly placed before he can eat again.

More upsetting than anything, and possibly as a result of the dressing and feeding tube issues, Dave's back pain was so bad this afternoon that he missed PT/OT.

I know Dave is making some amazing progress, but these small setbacks are reminders to continue praying. Also, the encouraging cards and emails are hugely helpful and reminders to Dave that you are thinking of and praying for him, so if you get a chance...

Update #120

2008-10-28T05:37:00.003-04:00

Yesterday, Dave's nurse (one he has only had a few times) asked if he was ready to get out of here. When he said that he was, she said, "That's good, because I've noticed that when patients get to that point, they are motivated to work that much harder and do whatever it takes to be released as quickly as possible." Dave was nice enough to smile and say only, "I've been ready for a while," but all I could think was, "Get to that point? He's been there since he woke up!" and "Why would anyone NOT be ready to get out of here?" and "Does she really think he hasn't been motivated and working hard up until now?" It was almost as if she was implying that until yesterday, he had just been sitting around, enjoying the mechanical bed and incredible (gag!) cuisine. I wanted to remind her of everything he has come through, every huge improvement he has made, every struggle he has fought through, and (in spite of the difficulties) every smile and joke and piece of positive attitude that he still manages in the midst of it all. I wanted to tell her about his injuries, the difficulties he has just taking a breath, the new pains that seem to show up on a daily basis almost as if as his body heals, it is finding new things that it hasn't even been able to notice up until this point. Basically, I wanted to print her a copy of the blog and force her to sit down and read it top to bottom (or bottom to top, I guess) so she would know just how ready he is and just how much work he has already done. She was just trying to be encouraging, of course, and I'm sure my reaction is attributable to the stress of a long weekend, but grr... Unless you know the whole story, don't try to tell me that Dave needs to be motivated (I'm a little protective, can you tell?). Makes me want to go Fighting Irish on her butt... :-)

That being said, when there is more than a day or two with no major updates, there are moments when I feel like I need to go back and reread the blog as well, to remind myself of everything that I felt like screaming at the nurse yesterday. Dave is doing well, and the lack of huge steps forward every single day only means that he is so far past the traumatic level of injury that progress is much slower and often more painful. Unfortunately, that doesn't make it any easier, for him or for us, to hurry up and wait.

Thankfully today, there are a few marks of progress worth mentioning:

1. Den has been doing some research and broached the idea of pulmonary rehab with the Respiratory Therapist yesterday. From the little I've read, pulmonary rehab is used primarily for patients with COPD (a chronic breathing disorder) and includes education on lungs and breathing and a specific exercise program designed to decrease the feeling of shortness of breath. Thanks to Den's research, the person in charge of pulmonary rehab will be by today at some point to determine if Dave qualifies for rehab based on whether a specific nerve is intact in his chest or not. Dave's breathing is affecting everything about his recovery, so be praying that the nerve is intact and that the rehab can start quickly.

2. In the midst of so many small steps of change, it's incredible to have an area in which improvement is actually visible and measurable every week. Dave had his dressing changed again yesterday morning, and his wound continues to get noticeably smaller, close to half the size it was when we arrived at Drake. New skin is growing all over his abdomen, and even the area where he is missing two ribs has filled in with scar tissue.

3. The final remnants of the blood clot in Dave's left hip are disappearing. When the clot was at its worst, Dave's leg swelled so badly that he had enormous blisters on his foot and hard tissue on the outside of his thigh (the swelling may be one of the causes of the nerve damage in his left leg that prevents him from flexing his foot). Both the blisters and the hard skin are getting progressively smaller and are looking better every day.

Also on the positive side, Dave's sleep meds were changed yesterday, and since I am sitting next to his bed as I type this, I can tell you that the Ambien seems to be working. So nice to see him peaceful...

As I mentioned above, Dave's body almost seems to be reprioritizing every day, choosing what new things can hurt as it heals other areas. Most recently, it has been his back, on the left side just above his hip, and unfortunately, because an X-ray late last week came back clear of fractures, Dr. Weintz doesn't see anything that can be done aside from relieving the pain with pain meds. Be praying that whatever is causing the pain - likely a muscle strain from PT/OT - will be resolved quickly.

One more prayer request: Cherie decided to head back up to Michigan with Jen on Sunday, and this coming Monday, Den will be joining her so they can both vote in the election. Next week will be the first time that both of Dave's parents have left at the same time, and I know it will be rough for them. Be praying that they will be able to relax and enjoy some much needed time off, and be praying for Dave and me since we will be on our own for the first time since his accident as well.

Hopefully, I'll have more updates after the meeting with pulmonary rehab today.

Update #119

2008-10-26T20:13:00.004-04:00

On Friday night around 11:00 p.m., I got a message that one of my girls was on her way to the ER with a bloody nose and high fever. At 4:30 on Saturday morning, she was diagnosed with leukemia. It was frighteningly amazing how that turn of events brought rushing back every single feeling of those first few hours and days after Dave's accident and how much empathy and compassion I was able to have for her and her family as a result (try 2 Corinthians 1). At the same time, in the midst of a new trauma, it was incredible to be able to look at Dave and remember how far he has come since that first night. Trying to see the sunshine through the shadows...

Dave has had a good weekend. Jen was in town (sans family this time), so the four Heckels got to spend quite a bit of time together, including some quality time on the Wii. Although he has not been sleeping great (we found out last week that his sleeping med had been switched when he got to Drake and nobody ever mentioned it to us), he seems to be energetic and in good spirits. His wound vac started leaking this afternoon, so it will be changed tomorrow, but it still managed a full five days between changes.

Overall, more steps in the right direction. Continue praying for his back - it is still causing him quite a bit of pain - and his breathing, which is still preventing him from making more substantial progress in PT/OT. Also, if you think of it, please pray for my girl Liz and her family as they get ready to begin the long road of cancer treatment (for updates on Liz, go to http://glittergirlliz.blogspot.com/).

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

Update #118

2008-10-24T11:22:00.003-04:00

No trach surgery!

The scope yesterday afternoon was miserable, I won't lie. Dave was asking Dr. Bauer to take the camera out of his throat the whole time, and I one point, I was tempted to reach over and yank it out myself because it was making him cough so much. But within 10 minutes, it was over, and the results were good...in a way.

On the positive side, Dave will not need a new trach, a stint or a massive throat surgery. Although there is scar tissue built up in small amounts around his trach site, the tissue is not blocking his airway, even when he coughs. Such a relief!

On the negative side, however, that means there is nothing he, we or the doctors can do to make his breathing easier aside from wait. Because his shortness of breath is not coming from scar tissue, it can only be coming from the damage to his diaphram. Unfortunately, the body's next choice for breathing assistance is the abdominal wall and muscles, which Dave also does not have. As a result, the muscles in his neck and shoulders have to compensate for the lack of strength and support in his abdomen, and building up those muscles is a matter of time and patience. In the future, there are plans to reinforce Dave's abdomen and reconstruct his injury site, but the five-year reconstruction process won't do him a whole lot of good when he is struggling to breathe during PT/OT this afternoon.

That being said, Dave's body will compensate, at least in part, without additional procedures or surgery, and that is completely an answer to prayer. Thank you all so much for continuing to be so faithful in your prayers. They are working!

One more really cool piece of news: Dave and I set the date for our wedding! Save the date - June 6, 2009, the one-year anniversary of his accident (collective "Awwww..."). :-) Now we're just praying that he'll be up and about and energetic enough to enjoy the ceremony and reception without being too worn out...

More later...

Update #117

2008-10-22T21:50:00.002-04:00

Quick prayer request tonight: tomorrow afternoon, Dave will be having the scope to see if he has damage to his trachea from the trach tube. Although not as painful as a full bronchial scope, the procedure (can't remember the name) involves putting a small camera up his nose and down his throat and will still be fairly uncomfortable. Dave will be receiving some anxiety meds before the scope, but he cannot have a sedative because he must be conscious enough to respond to some commands to swallow, etc. Be praying for his anxiety before the scope and his pain level during.

Also, Dave has had some pretty extreme pain on the left side of his lower back, to the point that it prevented him from doing much during PT/OT today. Be praying that the doctors can figure out what is causing the pain and can resolve it quickly.

I'll update tomorrow after the scope. Thanks!

Update #116

2008-10-20T19:48:00.002-04:00

Although I have not been as good about updating recently, I hope this blog is still useful to the many of you who are too far away to come see how incredible Dave looks for yourself.

New prayer request today: out of nowhere this morning, Dave started experiencing chest pain, a tightness that started around his heart and spread gradually toward the right side of his chest. Considering his two past cardiac episodes, needless to say, the issue was a little concerning. Dr. Weintz ran an EKG, which came back normal, and eventually the pain subsided, but please be praying that the pain was just a fluke (extreme heartburn or something equally minor) and not evidence of a larger problem.

Otherwise, things are going well. We continue to wait to hear from Dr. Bauer, the Pulmonary Specialist, regarding Dave's bronchial scope, but while we wait, Dave's breathing is making progress. Currently, in addition to his IPV breathing treatments that he gets five times per day (pump oxygen and Albuterol into his lungs to loosen the congestion and make him cough), Dave also has two different breathing mechanisms that he uses to help improve his lungs, both of which he has been using since he was at UT. The first, his Acapella (a.k.a. Flutter Valve, a.k.a. Pickle), also works to break up the congestion in his chest (don't really understand how, but that's why I'm marrying an engineer - I'm sure Dave could explain it without a problem). The second, the incentive spirometer, measures the volume of oxygen that he is getting on each inhale. For the incentive spirometer, Dave has been running around 750 and occasionally hitting 1,000 per inhale (a normal 26-year-old non-smoker should be around 2,000). Last night, he was consistently at 1,000 and even hit 1,250 once. His cough is getting stronger, and his lungs are sounding okay. Hopefully, whenever he finally has the bronchial scope, it will show no scar tissue in his throat but only that the muscles he uses to breathe need to get stronger to compensate for his injured diaphram.

PT/OT continues to go well. Although the length of time that Dave is standing is not increasing (still about a minute and a half twice per day with the parallel bars), the ease with which he gets up certainly is. Transfers between his bed and his chair are getting progressively easier, and Dave is gaining strength in both arms and both legs every day. The EMG has even strengthened his right leg to the point that he can now flex his whole right foot! Still praying that the nerves in his left leg will regenerate...

The biggest piece of news from my perspective is that when the Wound Care Team changed his dressing on Thursday of last week, his wound was noticeably smaller, probably only two-thirds the size it was when we arrived at Drake! Being by his side every day makes it difficult to notice progress, so it was incredible to see just how much his abdomen is healing. Dave's body is generating new skin all over the wound area, so the dressing change is getting easier and easier, and we are moving continually toward the next step of ditching the wound vac and moving to something much smaller and much less complicated.

Overall, Dave is still moving forward. Be praying for his lungs, his vision and his left foot. More soon...

Update #115

2008-10-17T19:46:00.003-04:00

I am a perpetual optimist. Unfortunately, even my level of optimism can't change the prognosis we received from the neuro-opthamologist yesterday. The short and not-so-sweet of it:

1. The optic nerve in Dave's right eye is damaged beyond repair, so the blindness is permanent;

2. There is no definite indication on what is causing the sun spots in his left eye.

On the positive (remember, perpetual optimist), there is no damage to the retina or optic nerve in Dave's left eye, so there is a chance (maybe even a good chance) that the spots will go away. There is one other test that they can do to check on his left eye, but he has to be sitting up in order to do it (he was transported on a stretcher yesterday), so he has another appointment in December for a follow up.

One of the things that I love most about Dave is that in the midst of everything he has gone through and in the face of the news yesterday, he is also a perpetual optimist, and his extremely appropriate response to the fact that he will not regain sight in his right eye was, "Hmm...I wonder where I can get a really cool eye patch." Overall, he seems to be handling the news well.

Sorry for the short post, but I just realized that I hadn't updated since the appointment. More later...

Update #114

2008-10-15T12:18:00.003-04:00

Dave has a new roommate. :-( So sad. He's actually a really nice guy and seems to be fairly quiet, but the addition means less space, less privacy, fewer chairs and (worst from my perspective) me getting kicked out at 10:00 p.m. Dave is fine overnight by himself, but I think it has given us a peace of mind when I can spend the night or at least stay until he falls asleep. It's nice to be around to silence alarms, get him a drink or just be there if he wakes up in the middle of the night. Drake seems to be getting progressively busier, especially the Wound Care Floor where Dave is, but hopefully, the new living situation won't last too long.

Aside from the roommate, things are going well. Dave's dressing is still holding well, although it was losing suction a little bit from time to time, so it sounds like the nurses will change it today (Day 6) to be safe. During PT/OT yesterday, Dave upped his weights from 30 pounds to 40 pounds for both of his arm exercises and seemed to tolerate the additional weight well. Today is a full hour of PT/OT - be praying that it doesn't go the way Hump Day last week went.

Also, please be praying tomorrow for Dave's appointment with the neuro-opthamologist. The appointment requires transport again, and we've heard rumors that Dave needs to be in a wheelchair the whole time. The appointment could last two hours or longer, and the longest he has ever been in the chair at one time is two and a half. With transport time and waiting time, it could be as long as four hours, and Dave is a little apprehensive. Be praying for the transport, for Dave's back (which has been hurting quite a bit, probably from too much time in bed) and for the appointment itself. Hopefully, we will come away with an optimistic prognosis for both eyes.

One other thing: after much anticipation and a little nervousness (or maybe much nervousness and a little anticipation), Dave finally asked my father if he could marry me. He called last night, and my dad actually left a school district meeting (he's the Chairman of the school board) to talk to him. Okay, so we called from my phone, and he thought it was me, so he really left to talk to his daughter, but he didn't hang up when he heard it was Dave, so it's all good. My dad said yes, by the way, so I guess that means I can change the password on the blog back and allow my him to start updating for me again. :-) Dave and I have been working on the guest list for the wedding (can I tell you how much of a pain in the butt it is?), and my mom and sister are coming to town this weekend to shop for dresses, so we figured with all of the wedding planning, we should probably be sure that my dad wouldn't show up on the big day with a shotgun. :-) Unfortunately for Dave, my dad is the easiest of the four men in my family to win over - Cory, Christian and Camden, if you are reading this, please be kind...

Off to get ready for PT/OT. More later...

Update #113

2008-10-13T18:43:00.002-04:00

It may be hard to believe, but there are days when it is nice that there are no updates because that means that things just are. Saturday, Sunday and even today were all that kind of day. Dave is doing well and making progress, and it's been three days with no major ups or downs. The wound vac is finishing Day 4 and holding well. Dave is getting himself in and out of the wheelchair easily. His breathing is still making PT/OT difficult, but he continues to make progress, and it was very clear today that he did most of the work getting himself up to a stand with the parallel bars. His feeding tube has not clogged in three days, and he is sleeping well. Right now, we are drinking tea and watching the History Channel, and aside from the hum of the machines and the fact that he can't get out of bed, it is almost possible to forget for a moment that we are still sitting in a hospital four months and and one week after his accident. That amount of time really helps you appreciate the little things - solid food, walking, breathing...and quiet evenings with the person you love. Off to enjoy that last one for a bit. :-) More tomorrow...

Update #112

2008-10-11T10:09:00.003-04:00

Hump Day did in fact pass. Sorry for leaving you in suspense. Thursday and Friday were much more positive, and Dave continues to make progress. His energy level was back up on both days, he is sleeping better, and he is seeming more like himself.

After Dave tolerated three dressing changes in one week, the current wound vac seems to be holding well (even with small amounts of less-than-liquid food). He also received a new feeding tube on Thursday, and so far, no clogs!

PT/OT are progressing well. On Thursday, Dave stood twice for a minute and a half each time, and he even let go of the parallel bars with one hand to put more weight on his legs! Yesterday, a minute and forty seconds and a minute. Also, his progress on strengthening his arms earned him (and us) the right to transfer himself to and from his wheelchair without a nurse's or therapist's assistance!

After another long week, we're looking forward to a mellow weekend. Dave's uncle and aunt (Den's brother and sister-in-law) are in town for the day, which should make for a nice Saturday, and hopefully, Dave will get a lot of rest in preparation for another week.

One other note: One of Dave's friends from high school started a group on Facebook for Dave. If anyone is interested in joining, search for Team Dave on Facebook Groups.

More soon...

Update #111

2008-10-09T09:27:00.002-04:00

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...

Update #110

2008-10-07T05:58:00.003-04:00

Sorry for the lack of updates, but the past few days have been fairly uneventful. Saturday and Sunday, Dave spent most of the day relaxing with his family and most of the evening relaxing with friends, and Monday was a fairly standard start to the week.

The only big (and unfortunately negative) update from yesterday is that Dr. Weintz and the Wound Care Team decided against allowing Dave to eat solid food. Although Dr. Johannigman believes that the hole in Dave's digestive system is far enough along that he is able to process the food, the discussion yesterday revolved around the fact that solid food will make the drainage coming from Dave's side thicker, which in turn will cause him to run the risk leaking far more often. More leaking equals more dressing changes, and more dressing changes equal more pain.

The argument is understandable, and even I have to admit that the drainage tubes were not working nearly as well last night after a test run weekend of solid food. The question and huge concern is that if Dave's next surgery isn't until March or April, will he be stuck on a feeding tube alone for the next six months? I can't even imagine...

More updates later...

Update #109

2008-10-04T14:28:00.003-04:00

Every time I think we've gotten the craziest, busiest days out of the way, a day like yesterday happens. A brief synopsis of the downs and ups (might as well end on a high...):

Down #1
We met with Dr. Bauer, the pulmonary specialist, again yesterday afternoon. Apparently the breathing test that Dave did on Monday showed that his difficulty with breathing may be coming from more than just the damage to his diaphram - the most likely possibility is scar tissue built up in his throat from when he had the trach tube, damage that makes it difficult for Dave to get a full inhale on each breath. Dr. Bauer wants to do a scope to determine if the damage is actually there and how severe it is. If the damage is there and substantial enough, Dave has one of three options:

1. The doctors reinsert his trach tube in order to be able to suction him when his cough is too weak to cough up the congestion in his lungs. The tube would be capped, so Dave would be able to talk and breath normally, but it would be visible and fairly permanent.

2. The "fairly permanent" relates to options #2 and #3, both of which require surgery (from the sounds of it. the trach tube would be the first step until Dave is more recovered, then surgery would be considered). If Dave does not want to leave the trach tube in permanently, the doctors can do a surgery to insert a stint, basically a tube like a trach tube that is made of metal and is completely internal (wouldn't be visible from the outside like the trach tube would be). Dr. Bauer mentioned that the surgeons at University of Cincinnati (where Dave would have the procedure) tend to avoid stints if possible.

3. As a third alternative to a permanent trach tube or a stint, Dave also could have surgery to remove the affected part of his throat, a major procedure that requires a long recovery time that even includes tying his head to his chest for a few weeks so he couldn't move his neck and risk undoing the surgery.

Obviously, none of these options is overly appealing. Unfortunately, if Dave does have damage to his throat from the trach tube, a minimum of one of the options is necessary in order to protect him from ongoing respiratory infections (including pneumonia) throughout his life and from serious breathing problems when he is under anesthesia during future surgeries. Dr. Bauer did a great job of explaining each procedure and answering our questions, but that didn't make the news any easier to hear.

The next step is the scope to see if the damage even exists, a process that can be fairly uncomfortable on its own. Please be praying that the scope goes smoothly and that it shows a clear airway so that none of the above options will be necessary. Dave's breathing and the strength of his cough both seem to be improving with the new treatment, but the only way to tell what has been causing him so many problem is by using the scope.

Down #2
Yesterday afternoon, we also got to meet with Dr. Johannigman, the Trauma Chief at UC. He, Dr. Muskat (the first surgeon that we met) and Dr. Kitzmiller (the plastic surgeon) are working together to develop a course of action for the reconstruction of Dave's abdomen (including closing the fistula, skin grafts and future reconstruction). According to Dr. Johannigman, the six month window before Dave's next surgery is not six months from his last abdominal surgery (i.e. December) but more likely six months from now (i.e. March or April). Because there is still such a large unhealed area on Dave's abdomen, the scar tissue that has built up from previous surgeries will not be soft enough to tolerate another surgery until the area is closer to healing. There is a section of the wound that the surgeons are talking about covering with skin grafts (about a 12" high, 3" wide section from Dave's rib cage to just below his belly button) in order to assist in the healing, but no definite decision on that yet. No matter what, it sounds like the earliest that Dave will be done with surgery is sometime next spring (and that doesn't include future reconstruction that will probably happen a few years from now).

Up #1
On the positive side, although Dave may not be able to have his colon fixed until March, he could be out of Drake and living a relatively normal life long before then. According to Dr. Johannigman, if Dave progresses through PT and OT, he can be equipped with a portable suction unit that will continue to take care of the drainage outside of the hospital until he can have surgery. So, at the moment, the only thing keeping Dave at Drake is weakness (which he is working quickly to eliminate).

Up #2
Dave's central line (his IV) is gone! One less tube coming out of his body - now, he is down to just the drainage tubes and his feeding tube.

Up #3
Although we are still waiting on the official order, Dave has been cleared to have real food! According to Dr. Johannigman, the hole in Dave's digestive system is far enough along that he is, in fact, getting nutrition from the food going into his stomach. This also means that Dave is capable of digesting (and getting the benefit of) real food! There will be some restrictions on things that our bodies don't digest (black beans, for example - we found that one out the hard way after a run-in with some contraband black bean soup clogged Dave's drainage tubes for three days), but if he so desires, he can finally have his surf 'n turf (crab legs and prime rib), which our friends Ben and Pat have informed us they are more than happy to prepare.

Yesterday concluded a long week filled with ups and downs. Please be praying for Dave, his family and me as we process all of the new information and try to ride the waves of recovery.

Update #108

2008-10-03T05:20:00.002-04:00

This week has gotten progressively better. The new breathing treatment continues to help Dave clear his lungs (thankfully, the respiratory therapists have decided to skip the 4:00 a.m. treatment to let him get some rest), and because he has not had a fever in a few days and his white blood cell count isn't too elevated, he is no longer on antibiotics either! Whatever was happening on Sunday, pneumonia or otherwise, is definitely well on its way out.

PT and OT are progressing really well, and Dave has been bumped up from a 30 minute PT/OT co-treat per day to a full hour. He stood twice yesterday, the first time for a minute and thirty seconds, the second time for a minute, and during the stands, Fran (PT) had him start bending his knees and shifting his weight from one foot to the other, the first step in preparing to walk - yeah! As always, although Dave's arms and legs tire quickly from the effort, it is his breathing and low lung capacity that force him to sit down. Please be praying that his lungs will continue to clear quickly and that the muscles that control his breathing will get stronger to compensate for his damaged diaphram so his breathing doesn't hinder his progress anymore.

As for OT, Maura is really working to strenthen Dave's arms (his progress is evident in how quickly he is getting from his bed to his wheelchair recently). Yesterday, his exercises included the hand bike, lateral pull-downs and a tricep exercise. Today, we play Wii! I guess we weren't kidding about Wii-habilitation. :-)

Dave's wound care continues to go fairly well, and each dressing change is lasting about a week. We are meeting with another surgeon this afternoon (a different surgeon comes every week, but Dr. Muskat will be Dave's surgeon for his fistula) to get an update on plans for his wound, but at the moment, it looks like it is "stay the course" with the current wound vac dressing, tube feed (no TPN - yeah!) and PT/OT until his body is ready for another surgery in December.

One of the wonderful things about being in a rehab hospital is being able to move more and more toward a "normal" life (although I have to admit, it's scary how "normal" the ICU at UT had begun to feel after 11 weeks). Last night, for the first time in almost four months, Dave got to participate in the Bible study that has been such an important part of our lives and such a huge support through this whole situation. We sang, we prayed, we discussed relying on God as our Source - and although Dave was tired after a long day of rehab, we both definitely appreciated being a part of the study again.

One of the passages that came up in study last night was the "Do Not Worry" section of the Sermon on the Mount in Matthew 6. After a week that started out so overwhelmingly and is moving toward such an amazing end, the passage seems particularly applicable. Dave's recovery is a day-by-day process, and sometimes the two steps forward really are accompanied by a step back. But God continues to be faithful, and I'm working to use the occasional steps back not to worry but to remind myself to pray without ceasing, knowing that we never walk alone, and tomorrow is under control.

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

Update #107

2008-10-01T11:46:00.002-04:00

In the midst of all of the uncertainty surrounding Dave's breathing on Sunday and Monday, I forgot two very important positive updates. First, for the first time since his accident, Dave is off of insulin completely, meaning his blood sugar is regulating itself again! Second, on Monday, Dave moved himself completely between the wheelchair and his bed on his own. Supposedly his weight is up to 162 (he had been down as low as 145), and I would guess that most of those extra pounds are in his arms, which have gained a considerable amount of strength since we got to Drake.

Just small reminders that in the process of Dave's recovery, the positive has always outweighed the negative. I think I lost sight of that at the beginning of the week.

As for the pneumonia, unfortunately the culture that they tested the other day (basically a spit sample) did not provide the doctors with whatever they needed to determine what caused Dave's fever on Sunday afternoon. They took another sample yesterday - we'll see what it shows - but Dave has been on antibiotics since Sunday, so hopefully whatever it is is already on its way out. We've actually seen some pretty great signs in that regard - the fever is completely gone, and according to Dr. Weintz, Dave's lungs are sounding clearer again. The new breathing treatment that the pulmonary specialist recommended on Monday seems to be helping at least a little bit - although the cough is still there, it actually seems to be looser and strong enough to get at least some of the fluid up out of his lungs completely.

The e-stim on Dave's right leg is going well, and he actually was able to flex the three smallest toes on his right foot on Monday (at one point when we first got to Drake, the foot wasn't moving at all). The process is fairly painful, but it is nice to be able to see some of the benefit.

On a much more fun note, Dave is getting his first haircut in four months as we speak, just one more step closer to having a "normal" life. Also, thanks to some gift cards from some coworkers at GE as well as a Best Buy voucher that I had, we now have a Nintendo Wii, complete with Wii Sports and Mario Kart, which we enjoyed with our friends Justin and Sara last night. We're calling it Wii-habilitation (okay, I'd like to take credit for the name, but I actually saw it in a newspaper article posted outside of Drake's library). :-) If anyone has suggestions on good games to get, especially games that would help improve Dave's strength and range of motion, we'd love to hear about them!

Dave's dad is scheduled to come back from Michigan today, and his sister and her family will be heading down to Cinci this weekend (assuming nobody gets sick before then). Be praying for safe travels!

Looking forward to a great Wednesday...

Update #106

2008-09-29T18:45:00.003-04:00

There are certain words that have a way of hitting you like a ton of bricks - pneumonia is one of them. It hit last night when I got to Drake after youth group. After all the coughing of the past few days, sometime yesterday afternoon, Dave spiked a fever of 102, and his breathing got extremely shallow - Amy, his night nurse, was the first to actually say the word. Taking into account the amount of time he has spent in bed and considering the injury to his diaphram, pneumonia is not unexpected, but it's still scary. So far, we are still waiting on official culture results, but the doctors started him on a round of antibiotics last night as a preemptive measure until the results come back.

In spite of the difficult Sunday (or perhaps because of it), Dave slept well last night, a blessing overall but especially in preparation for what has been a very long Monday. It started early with a trip in the ambulance to see Dr. Archdeacon, Dave's new orthopedic surgeon. After yet another round of X-rays, Dr. Archdeacon informed us that Dave's femur actually has shown some signs of healing and he does not (at least for the moment) need another surgery. Another appointment is scheduled for January 8th to reevaluate.

While visiting Dr. Archdeacon, Dave started to get another fever, and his oxygen level dropped to 87 (it should be at least 92). The paramedics put him on some oxygen to help increase the level, and immediately after returning to his room from the ambulance, Dave was carted away for his third chest X-ray in under a week. On the negative side, the X-ray does not indicate whether he has pneumonia or not. On the positive side, however, the congestion in his chest has not gotten any worse over the course of the last week.

The chest X-ray was followed by a visit from a pulmonary specialist who wrote orders for two things: the first, a spirometer (breathing test) to determine how much volume Dave is getting per breath; the second, another breathing treatment that actually vibrates the inside of his lungs to help break up some of the congestion (a treatment that he will get every four hours, day and night - I guess it's a blessing that Dave hasn't been sleeping through the night anyway). Hopefully, the new measures will help to treat whatever is causing the coughing and shortness of breath (pneumonia or otherwise).

The rest of the day was filled with the new breathing test, the new breathing treatment, and unfortunately, a lot more coughing. I'm sitting next to Dave now, and after a 45 minute coughing spell, he looks like he may be sleeping or at least relaxing for the first time since 6:00 a.m. Huge praise that the femur surger is not necessary for the moment and that the doctors have new ideas on how to treat Dave's lungs. Please be praying that the pneumonia culture will come back negative and that the new treatments will help to clear his breathing once and for all.

Update #105

2008-09-27T10:51:00.002-04:00

The past 24 hours have been pretty rough. Because of the remaining congestion in his lungs, Dave has been coughing a lot since Thursday. Yesterday, he spent most of the morning coughing, and this morning, he woke up at 5:15 a.m. and coughed almost non-stop until 6:45 a.m. Dr. Weintz precribed an inhaler, which helped loosen up some of the congestion, and hopefully, we will also write an order for some cough syrup, at least so the coughing doesn't keep him up at night.

We also go word on Dave's X-ray to determine what was causing the extreme pain in his hip, and it looks like Dave's femur isn't healing at all. Because of the level of his pain meds (he has a pain patch on his shoulder that provides a constant stream of meds) up until this past week, he hadn't felt much pain from the break, even to the point that he hasn't needed any Oxycodone to supplement the patch. Earlier this week, however, Dr. Weintz decided to try to cut the level of meds in the patch in half, and over the course of the week, the pain from the femur started to break through. Dr. Weintz reincreased the patch, and by the end of the day yesterday, Dave was able to sit up in his wheelchair again. The X-rays from Thursday will be transferred to the orthopedic surgeon this weekend, so hopefully, we will have some information on the next steps for the femur (probably bone grafts sometime soon) on Monday.

Dave's red blood cell count has also been low again, so he received two more units of blood overnight. The blood (and all the testing that goes along with getting blood), combined with the coughing made for a pretty long night.

On the positive side (there is always a positive, in spite of how this post started), Dave is back to his target rate on his feeding tube and should be off the TPN again before Monday. The annoying cough is actually helping to clear his lungs (his chest X-rays look better and better), and he is getting stronger and stronger getting in and out of his wheelchair. Aside from being exhausted, he is still in good spirits and continues to work as hard as he can at the movements and exercises that don't cause him pain.

Please be praying that the cough will go away and that our meeting with the orthopedic surgeon on Monday will provide a plan to relieve the pain in Dave's hip. Also, be praying for Dave's sister Jen and her family who disappointingly couldn't come to Cinci this weekend because her kids have a cold.

More soon...keep praying!

Update #104

2008-09-25T12:43:00.002-04:00

New prayer request: Dave's right hip, the one that was fractured in the accident, has really been hurting recently, to the point that he is having a really hard time with PT and just sitting up in general. The pain started on Monday afternoon and is now bothering him so much that Dr. Weintz has ordered an X-ray for this afternoon. Considering how many X-rays Dave has already gotten, the speed of the order for this current X-ray is only surprising because he is actually scheduled for a round of X-rays on Monday morning at University of Cincinnati, specifically targeting his right hip and femur to see if bone grafts will be necessary. Hopefully, the X-ray this afternoon will help detemine the source of the pain so they can fix it quickly.

The wave of new doctors continued yesterday with meetings with Dr. Kitzmiller, the plastic surgeon, in the morning and another surgeon in the afternoon. According to Dr. Kitzmiller, Dave's wound is healing well (aside from the fistula), and he probably will not need a skin graft to cover the area in the center of his abdomen. No mention of whether he will be cutting the skin flap and repositioning it where it was originally intended to go (over the area where Dave's ribs used to be). The other surgeon (I wasn't here when she came, so I'm not sure of her name) said that they have not been able to determine the exact location or size of Dave's fistula but mentioned that she has noticed a substantial decrease in the amount of drainage coming from Dave's side since he has been on TPN only, so she may decide to continue without tube feed to see one last time if the hole will close on its own if the level of drainage is reduced. If she decides to move in this direction, please be praying that it works as it would eliminate the surgery to close the fistula that should occur in December.

Until that decision is made, Dave does have a new tube in his stomach for tube feed (the old tube that the nurses tugged and pulled in vain on Monday came out without a problem yesterday), and yet another X-ray yesterday confirmed that the tube is in the proper place, so he should start receiving tube feed again this afternoon.

Based on the results of the EMG (electrode test) last Friday, Dave also had his first round of e-stim yesterday, which involves stimulating the muscle along his shin on his right leg with electric shocks sent through electrodes placed along the muscle (because there is no nerve response on that muscle in his left leg, the e-stim wouldn't have any effect on that leg). Hopefully, the e-stim will assist in building the muscles that help Dave flex his foot to alleviate the foot drop on his right side.

In spite of all of the craziness and testing over the past few days, Dave seems to be doing well and seems to be moving toward a more normal life (if normal exists) every day. We hung out with our Bible study on Monday night and even had a triple date playing cards with some friends on Tuesday evening (Dave and I got crushed). Be praying for Dave's dad over the next week as he began his first break in Michigan since this accident this morning and for Dave's mom as she picks up the extra hours with Dave in his absence (I don't think she'll be complaining about the extra time with him). Also, pray for Jen (Dave's sister), Chris and their family as they head down for another visit tomorrow.

I'm guessing there are at least a few updates that I am forgetting, but it's been a busy few days. More as it happens - thanks for the continued prayers!

Update #103

2008-09-23T09:52:00.003-04:00

Sorry for the lack of posts over the weekend - I spent Saturday mourning Notre Dame's loss to Michigan State (Dave was pretty happy), and Sunday was our youth ministry kickoff for the fall, so things were pretty crazy.

After a rough afternoon on Friday, the weekend took a more positive spin. First, Dave was switched to a new type of tube feed, and the rate was being consistently increased. When we asked why, the nurse told us that according to the notes in the computer, the barium (dye) test showed that that hole in Dave's intestines is far enough along in his digestive system that he is actually getting at least some of the nutritional benefit of the tube feed before it goes out through the side of his body (this is what we were hoping for). Because of that fact, the doctors switched his tube feed to a type that requires less volume but gives more nutrition (less volume going in means less drainage coming out), and over the course of the weekend increased the tube feed volume, decreased the TPN (IV feed), and early on Sunday morning, turned off the TPN completely! We haven't actually had a chance to talk to the doctors, but we are hoping that the change will also allow Dave to start eating some normal food beyond soup and pudding.

As a negative sidebar to that positive news, Dave actually ended up back on TPN yesterday. The new tube feed that he is getting is much thicker than what he had been on, which means that the tube is much more likely to clog. And clog it did, to the point that the nurses couldn't get it unclogged and decided that they needed to put in a new tube. Unfortunately, when they tried to remove the old tube, it was so stuck after two months inside of Dave's stomach that they couldn't get it out. Even with the expertise of a physician's assistant, and with a lot of painful pulling and twisting, the tube would not release itself from Dave's body. We will not get word from the surgeons on what the next step should be on removing the old tube and inserting a new one until tomorrow, so for the moment, Dave is back on TPN and not getting any tube feed. Fortunately, it should be a very short setback.

As for PT, Dave's continues to make progress, and today for the first time, he will be trying out the "real" PT gym on the second floor of Drake as opposed to the smaller gym on his own floor that the therapists have been using. He is doing almost all of the work to get himself into the wheelchair for therapy every day, and according to the weekend therapists, he did most of the work in standing up the other day as well.

Dave also wore real clothes for the first time since his accident on Saturday, athletic shorts and a Michigan State t-shirt to be prepared to cheer his team on to victory against my Irish (I'm only mostly bitter). I can't even describe how much better and stronger he looked, simply by being out of a hospital gown.

Dave's mom is back from Michigan, looking relaxed and well rested, and she and Den will both be in Cincinnati for a couple of days before Den takes his own break to head back to Rochester Hills on Thursday. Jen and her family will also be down this weekend for another visit.

Aside from the mishap with the feeding tube, the past few days have been overwhelmingly positive. Keep praying for progress...more updates soon.

Update #102

2008-09-19T20:27:00.002-04:00

Today was a crazy day. When we prayed for new and exciting things to keep away from the monotony, I don't think this is what we had in mind. The day started early with a breakfast of dye (you know you are jealous) that was supposed to help trace the location of the fistula in Dave's body, a process that included two x-rays this morning and another three this afternoon.

After "breakfast" and the first two x-rays, the Wound Care Team came by and changed Dave's dressing for the first time in a week. Although the vacuum wasn't leaking, it was losing some of its suction whenever Dave sat up, so it seemed that the Team preferred being safe rather than sorry. Fortunately, the dressing change was not nearly as painful as it had been during previous changes, and his wound is showing even more signs of healing! Overall, a positive process.

Break for lunch (real lunch, not dye), then three more x-rays, followed by a test called an EMG that was supposed to help determine how much (if any) nerve damage Dave sustained to his legs during the accident. The test came because Dave was showing signs of a condition called drop foot, which basically means that he is incapable of pulling his toes up toward his face (flexing his feet). After two hours of being hooked up to electrodes and poked with needles, the doctors determined that he does have nerve damage in both legs.

On the positive side, the nerves in Dave's right leg are regenerating, and even the muscles on the tops of his legs that assist in pulling up his toes are showing "baby nerves" that will grow stronger with time.

On the negative side, oddly enough, the nerves on the top of Dave's left shin that would cause that foot to flex showed no reaction at all. If the damage is permanent, Dave may have to wear a brace on his left leg in order to avoid tripping over his toes, but the doctor said that three months may be too early to tell if or when the nerves will grow back. Thinking very positively, if the nerve damage is as a result of Dave's blood clot (which is possible), the nerves have had only seven or eight weeks (not three months) to heal, which makes it even more likely that they will regenerate.

Even with all of the uncertainty and potential for progress that the doctor communicated, the news was still hard to hear, and Dave does seem to be struggling with the possibility of needing a brace to walk, especially since the nerve damage is on the side of his body that wasn't injured. Tonight, please be praying that the damage is temporary and that Dave is able to start flexing his foot soon. Also be praying for his spirits as he processes the potentially frustrating results.

Update #101

2008-09-18T10:52:00.003-04:00

Dave stood up for a full minute yesterday! Still with the assistance of PT and OT, and it was still quite a strain, but it was amazing! From what he says, his difficulty with standing up isn't the strain on his legs or arms (which he uses to support himself on the parallel bars) but rather the strain on his chest because the wound vac pulls tighter when he stands. We're certainly not complaining about the fact that the vac is still holding - six days straight now - but hopefully, whenever they do have to change the dressing, the Wound Care Team can find a way to relax the pressure on his lungs a bit so breathing and standing won't be so difficult.

After standing, Dave stayed in the wheelchair for an additional hour and a half, his longest time yet! During that time, he was evaluated in higher level processing by another speech therapist, and he passed with flying colors! Basically, aside from his eyes (I'll clarify the plural in a minute), the brain injury does not seem to be causing any other issues.

As for his eyes (and I apologize if I've already put this in a previous post - it's hard to remember what has been communicated), in addition to the blindness in his right eye, Dave informed us not too long before we left Knoxville that he has something similar to sunspots in his left eye, which make it even more difficult to read and focus. The spots and blindness, combined with some numbness in the fingers of his right hand, will be the only serious issues that will make going back to work difficult (difficulty focusing on a computer screen and difficulty typing and holding a pen). At some point, we will be seeing a neuro-opthamologist for his eyes, and OT is supposed to begin working on increasing bloodflow to his fingers - please be praying that both issues will be resolved quickly.

One other thing that I forgot to mention - Dave got moved to a new room on Saturday. Early last week, a roommatte moved in to the other side of room #420, an addition that made the room a whole lot more claustrophobic and noisy (he enjoys talking on speaker phone on his cell phone at full volume). On Saturday afternoon, when the roommate had gone out for a cigarette, his and Dave's nurse, Sue, made a side comment about how much quieter it was with him gone. When Dave and I agreed, Sue offered a move to a room across the hall. She couldn't guarantee that Dave will always have the new room to himself (in fact, there is a good chance that he will get another roommate), but for now, the room is quiet, private and much nicer. For anyone who is coming to visit or sending cards, the new address is room #421.

Finally, a friend of ours from Bible study passed on this link to a news story that came out on the night of Dave's accident - http://www.wbir.com/news/local/story.aspx?storyid=59074&catid=2. Not much information, but it is amazing to think of how far he has come since June 6th. God is incredible, and Dave and I pray nightly that He will reveal to us how this awesome story will continue to be used for His glory in the future. Can't wait to see what He has in store!

Update #100

2008-09-17T08:45:00.003-04:00

Ever since Dave's accident in June, every time things have become too frustrating, too overwhelming, too scary, it has been amazing to see how God has sent out some small piece of encouragement to remind us that He is still working. Yesterday was one of those days.

As I'm sure you can imagine, sitting in the same bed in the same room staring at the same wall all day, completely dependent on other people, without the energy to do much of anything anyway, makes for some pretty rough times. Actually, let me rephrase that - I can't possibly imagine what it is like for Dave to be in that situation. Once again yesterday, that issue came up as Dave talked about how depressing the monotony is, and it was one of so many moments since he has been awake when I found myself desperately wishing that I could trade places with him so he could play soccer or go for a drive or even take a walk. We spent almost the entire time we were outside in the wheelchair after PT/OT discussing ways to mix things up within the bounds of what he can do, and as we talked, I was praying silently for something for him to do that would make him feel less like a lump and more like himself.

When we got back to his room a few minutes later, we found a package from my friends Marcie and Dave containing (and anyone who knows Dave will know how great this is) a miniature remote control helicopter that he can use in his hospital room. It also had a board game and some snacks, as well as some pictures of their new baby. It seems like such a small thing, but that package added some excitement and happiness to a day that was seeming really blah. Marcie and Dave, thanks so much for the package and for making Dave (and me) smile. What a great God moment...

In light of all of that, Dave really is driving himself crazy with so little to do during the day. There is only so much Mythbusters that a man can watch before his eyes glaze over. If you have suggestions for things that might help - a favorite book that his parents and I can read to him, a game that doesn't require too much strain on his eyes, an idea of something to do that will stimulate his brain a bit, please post it as a comment. As he gets stronger and stronger, things will get better and better, but for now, a few seconds of standing (with the help of three other people) and an hour sitting in the wheelchair drain almost every ounce of energy he has, so amusing ourselves in his room will have to suffice.

Although the monotony has been difficult, the past two days have been pretty good physically. Dave did stand again yesterday during PT/OT - for over five seconds! - then spent an hour and a half outside in the sun. The wound vac continues to hold (no dressing change in five days - yeah!), and his arms and legs are getting stronger every day. His chest is still really tight, and he still has a lot of congestion, but his chest x-ray showed that he is just as clear as he was last week.

Today, please pray that the tightness in Dave's chest would loosen, that his lungs will get stronger, and that his energy level and spirits will continue to go up. Also, this week he is scheduled to have a dye test that will help Dr. Weintz and the surgeons determine the location of Dave's fistula, which will impact both future surgeries and his ongoing nutrition. Be praying that the fistula will be far enough down in his digestive system to warrant turning off the TPN and even increasing what he is allowed to eat (even adding pureed foods like mashed potatoes and oatmeal would be an improvement).

Update #99

2008-09-15T12:17:00.002-04:00

One more prayer request that I totally forgot to mention: after three months away from home, Dave's mom decided on Friday morning to take a break, and she headed back to Michigan for some recuperation time. I know how hard it is to be away for more than a few hours - please be praying that Cherie's time at home will be a time of relaxation and rejuvenation so she can come back refreshed and ready to continue walking with Dave through his recovery. Also be praying that Dave will get completely settled at Drake so his dad can feel comfortable going home for a break as well.

Update #98

2008-09-15T08:35:00.003-04:00

Sorry for the lack of posts over the weekend. Saturday was kind of a blah day for Dave and yesterday most of the area around Drake (including my house) lost power from whatever is left of Ike that swept through Ohio. I guess that's one benefit to being in a hospital - they have power when nobody else does...

First and most excitingly, Dave stood up for the first time on Friday! During PT/OT on Friday afternoon, the therapists made Dave do a lot of the work to get himself from the bed to the wheelchair, and he did so well that they decided to see if he could use parallel bars to stand up. It took three people and a lot of effort, but Dave got vertical for the first time in over three months!

After that, the weekend got a little rougher. All day Saturday, Dave had a horrible time trying to breathe, to the point that his nurse ordered a chest x-ray (I guess that's a pretty big deal at Drake on the weekend) to make sure there wasn't something serious going on. He received a couple of breathing treatments (similar to what is used for asthma) that afternoon and evening, but the congestion continued. The struggle to breathe (combined with whatever they saw on the chest x-ray) was enough to order suctioning for Dave yesterday, a horrible process that involves sticking a tube down his throat to suck out any excess fluid from his lungs. The procedure helps prevent pneumonia, so of course we are grateful that they did it, but it made for an incredibly rough Sunday.

On the positive side, the wound vac that is controlling the drainage from Dave's side has been on for 72 hours and counting! Although the Wound Care nurses still have to play with it every once in a while to clean out clogs in the tubing, this is the longest that Dave has gone without a dressing change since his accident.

I stayed at Drake with Dave last night (sitting next to him now), and it seemed like he slept soundly, so hopefully today will be a better day. The rest of the Greater Cincinnati area is on hold because of the power outage, but Drake is up and running - we'll see what they have planned...

Update #97

2008-09-12T10:36:00.002-04:00

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...

Update #96

2008-09-11T05:57:00.003-04:00

Dave finally got to meet his heroes! Bill and Matt, the guys from Ludlow, Kentucky who saved Dave's life on the side of exit 141 off of I-75 in Oneida, Tennessee over three months ago, along with their wife/mom Lori, came to Drake last night, and Dave finally had a chance to shake their hands and thank them for what they did. The guys gave a little bit more detail about the accident and told Dave over and over again how good it is to see him doing so well. Afterward, Dave's parents and I went to dinner with the family, and although Dave couldn't join us, we did bring him back a root beer float (which he loved, Bill, although the ice cream was melted by the time we got back). Now that we are back in Cincinnati, we hope to be seeing them much more often, and hopefully most of you will get to meet them at the wedding! Bill and Matt, once again, thank you for being where you were and doing what you did - Dave would not be where he is without you.

The only drawback to Bill and Matt coming last night was that Dave had a really rough day yesterday and was not feeling very well during the visit. Some of the issue seemed to be related to his infection, which hopefully will be resolved soon. The main reason for his exhaustion, however, was physical therapy. On the positive side, Dave got to go outside in a wheelchair for over an hour yesterday afternoon; on the negative side, the excursion ended with him throwing up, possibly from exhaustion, possibly just from the change pressure on his wound. Either way, the nausea and fatigue continued through the afternoon, which made it difficult for Dave to enjoy his visitors.

Dave did get some rest while we were at dinner and seemed to be doing much better last night when we got back, but the past week has been rough on him. Please be praying that things will slow down and fall into a manageable routine very soon.

One more prayer request: yesterday afternoon, a physician's assistant who helps with rehab stopped by to check Dave's strength level, and she informed us that he has something called drop foot (the nurses in the ICU had warned us about it). Basically, Dave can push both of his feet down like he is pushing the gas pedal on a car, but if you ask him to pull his toes up toward his face, he doesn't have the strength. Sometime soon, he will be undergoing a test called an EMG to determine if he has nerve damage in his ankles or if the lack of strength is simply muscle weakness as a result of too much time in bed. Be praying for the latter.

More tomorrow...

Update #95

2008-09-10T12:36:00.003-04:00

Some prayer requests for today:

1. Dave has been really exhausted over the past few days, probably the combination of the stress of the transfer, meeting so many people, and the urinary infection. Yesterday morning, when I showed up for physical therapy at 7:45 a.m., he was sitting up and watching TV while the nurse checked his vitals, which were great. Just moments after Nita (his nurse) left the room, however, Dave said he was cold and asked for a blanket. In a period of ten minutes following, he started shivering uncontrollably, the color left his face, and his blood pressure shot up. Dr. Weintz said the incident was probably just evidence that the antibiotics were working to attack his infection, and Dave recovered within a half hour, but overall, his body is worn out and his energy level is low. Please be praying that the infection would disappear quickly.

2. In a follow-up visit yesterday afternoon, Dr. Weintz told Dave that his femur is still not healing the way that they had hoped. Based on a conversation with the surgeon who fixed Dave's femur down at UT, if the bone does not heal in the next month, a bone graft may be necessary. Prayers that his femur heals soon...

3. The Wound Care Team is still having difficulty finding a method for controlling the drainage coming from Dave's colon. The most recent attempts have lasted 24 hours with only small leaks, but every dressing change with the new vacuum seal method that they are trying is very strenuous on his body. Please be praying that they'll find a solid method soon.

On the whole, in spite of all of the new prayer requests, Dave's spirits are high, and he is doing well. Since we have been in Cincinnati, there has been daily talk of what he will be doing once he gets out of Drake - where he will live, when will he go back to work, etc. - I'm not sure about how Dave feels, but for me, it is nice to be looking toward the future so much instead of focusing on the day-to-day.

For those of you who have come to visit, Dave has loved seeing you! Please keep the visits coming (in small doses, of course). Also, if anyone has any good soup recipes (broth or puree - he's not supposed to have solids yet) or ideas for fun treats (puddings, smoothies, etc.), please pass them along. The selection at Drake leaves something to be desired.

More tomorrow, keep praying...

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

Update #94

2008-09-08T16:45:00.004-04:00

Where to start?

First, the negative. Dave has been throwing up a little bit today. Two potential explanations:

1. We found out this morning that he has another urinary infection. As we speak, the nurses are in the process of removing his catheter, which probably caused the infection.

2. He isn't getting any tube feed, so his stomach may be upset because there is nothing in it. For some reason, just before we left UT, the doctors increased Dave's tube feed from 30, where it had been consistently for a few weeks, to 65, almost the target level for the feed. Although this move seems positive, mostly, it just served to increase the level of drainage coming from his colon, which was making it very difficult for the Wound Care Team at Drake to control his wound. In an effort to slow the drainage, the weekend doctor turned off the tube feed. There is an order to start it again at a lower level sometime this afternoon, which may help to calm Dave's stomach.

Because of the nausea, the day as been rather exhausting, but Dave's spirits still seem to be fairly good.

On the positive side, at the risk of speaking too soon, it looks like the Wound Care Team may have found a method for dressing Dave's wound that will help control the drainage and possibly assist in getting the skin flap to readhere. Over the past three days, they have tried three or four different dressing methods, all involving vacuums, all of which exploded or leaked not too long after they were completed. The method that they used this morning has been holding since 8:00 a.m. or so...we'll see if it continues.

We also had a chance to speak to Dave's doctor, Dr. Weintz (there is an n in his name), again, and we got some further explanation on what will hopefully be Dave's final surgery. According to Dr. Weintz, there is a very good chance that surgery will be necessary to fix the hole in Dave's colon. Generally, the surgeons like to wait at least six months after the last surgery to go back into a patient's abdomen, so we are about three months away from that mark. The positive side is that in the meantime, once the dressing situation is completely resolved (hopefully today did it), Dave has plenty of rehab and therapy to keep him busy until he is ready for the surgery.

Dave sat up on the edge of the bed again today, which he seemed to tolerate well in spite of the nausea. He also had a follow-up meeting with speech therapy (SIDENOTE: I never realized that speech therapy also included trach care, swallowing, and cognitive rehab), and Marilyn, the therapist, seems pleased with Dave's cognitive function. She mentioned that the therapist who met with Dave over the weekend expressed some concern about higher level memory and cognitive ability (mainly things that might impact his ability to go back to work at GE full force - I'm assuming remembering engineering code and processes, etc.), so she said she may have another therapist do a higher level evaluation to pinpoint what Dave may need to work on in order to prepare his mind for returning to work in the future.

Dave's roommate Chris just showed up for a visit, so I'll finish updating later, but overall, it has been a good start to our time in Cincinnati. Keep praying...

Update #93

2008-09-07T14:52:00.002-04:00

Note to self: never give dad the password to the blog. :-)

Sorry for the lack of updates. Dave did arrive safely in Cincinnati just after noon on Friday. He had about 45 minutes to get settled, then the fun began.

In the past two days, we have seen/met:

His attending physician, Dr. Weitz;
Five nurses;
Six nursing aides;
Two respiratory therapists;
Seven people from the Wound Care Team;
One speech therapist;
One occupational therapist; and
One physical therapist.

He has endured meetings with Dr. Weitz, his nurses and the Wound Care Team, evaluations by speech, occupational and physical therapy, two breathing treatments and three different kinds of dressing changes (they're having some difficulty figuring out the best way to control the drainage). We have discovered that he may not need a skin graft (his wound is healing itself well) but will likely need surgery to close the hole in his colon. On Friday, his room was not empty of Drake Center staff until almost 7:00 p.m., and yesterday, we saw doctors, nurses and therapists from 9:30 a.m. until after 2:00 p.m. without a break. Just after the craziness ended, Jen and Chris (Dave's sister and brother-in-law) arrived in Cincinnati for the weekend, and Dave got to see his two nieces and nephew for the first time since the accident.

All of that to say thank you all for being patient about the unreturned phone calls, lack of posts, and most importantly the request that you not visit for a few days. We have been very impressed with Drake so far, and it is clear that we made the right decision, but it has been an exhausting weekend.

Now that Dave is settled, he is very excited at being close to so many of his friends again, and as of tomorrow afternoon (Jen and her family are leaving after lunch), he will be ready for visitors. The next few days will still be a little bit crazy as he gets worked into a therapy schedule, so for anyone who wants to visit:

1. Please come during normal visiting hours (11:00 a.m. to 8:30 p.m.,, preferably more toward the evening);

2. Please call me, or call Dave's cell (which his parent are using), to let us know when you are planning to come (if you don't have the numbers, drop me an email at klund7atyahoo.com and I'll pass them along).

As things start to settle into a routine, the coordination will be less necessary, but at least for the first few weeks, Dave wants to make sure that he will actually be in his room when you come and that he won't have 50 people visiting all at the same time.

For anyone who wants to send mail, Dave's new address is:

Dave Heckel
c/o Drake Center
Room #420
151 W. Galbraith Ave.
Cincinnati, OH 45216-1096

We are so excited about this next step in Dave's recovery and can't wait to see the progress that God brings in his life next. Thanks again for all of your prayers and support, and for continuing to walk with us through this process! Hope to see many of you soon!

Update #92

2008-09-05T15:13:00.003-04:00

Just spoke to Kendahl at 3:10 p.m. (this is her dad). Dave is successfully settled in his room in Cincinnati. She asked me to post the blog because she can't take all the phone calls/messages she's getting.... Yet she wants to let everyone know what's going on.

The trip went well. Dave slept most of the way. Kendahl couldn't ride with him in the ambulance (she learned at the last minute) because the ambulance insurance wouldn't cover her. So she followed in her car. She says they made very good time.

Dave is now resting comfortably. He has a view of the courtyard. They have met his doctor and some of the nurses, and don't expect physical therapy to start until Monday, so he'll have a couple days to rest and get acclimated.

Dave's parents should be arriving within a "few minutes" and his sister is coming down from Michigan tomorrow.

Knowing that everyone in the Cincinnati area will be wanting to see him, Kendahl said that she will post a blog when he is ready to have visitors. He probably couldn't handle the onslought of everyone who has been supporting and praying for him for the past 13 weeks visiting at the same time. But I'm sure he's looking forward to seeing you all.

Now, a personal note to Dave (I'm taking advantage of having access to the blog). Now that you have come this far in your recovery, you and I have some unfinished business to discuss...something about my daughter's hand...? Her three brothers also want in on that conversation...:)

Update #91

2008-09-04T12:48:00.002-04:00

Dave's moving to Cinci! Just 38 hours shy of three months after his accident, Dave will be transported by ground ambulance from UT in Knoxville to Drake Center in Cincinnati tomorrow morning at 8:00 a.m. After much discussion, Dave chose to go by ground in order to avoid having to be transferred from his hospital bed to an ambulance stretcher, from the ambulance stretcher to the plane stretcher, from the plane stretcher to the ambulance stretcher, and from the ambulance stretcher to a bed at Drake. The doctors here will be giving him meds for pain and nausea before he leaves, which will hopefully be enough to knock him out for the duration of the five hour trip.

Please be praying tomorrow that the weather will be fair, the traffic will be flowing, and the transfer will be completely uneventful. We should be arriving in Cincinnati around 1:00 p.m. - I'll get a post up as soon as he is settled.

God is awesome, I am giddy, and Dave is one step closer to home. Love you all!

Update #90

2008-09-04T08:18:00.002-04:00

Really quick - we have to make a decision on if and how Dave will be transported to Cincinnati by 10:00 a.m. today if he is going to be moved before the weekend (the goal is to leave at 8:00 a.m. tomorrow). Right now, the options seem to be:

1. Just under $3,800 for air transport through a company called Air Compassion (ground transport from UT to Knoxville's airport and from Cincinnati's airport to Drake Center are a separate expense, but it should be covered);

2. $2,000 for ground transport in a normal ambulance.

Either way, from the sounds of it, Dave's insurance company will only pay to have him transported to the nearest facility (i.e. he has to stay here in Knoxville), so all expenses are out of pocket.

Be praying...

Update #89

2008-09-02T21:45:00.003-04:00

I talked to Dave and his parents tonight, and it was kind of a rough day today. Nothing serious, but the drain slipped out of his wound while the nurse was changing his dressings, and it took a while to figure out who would (and how to) get it back in under the skin flap. Dave has also thrown up for the past two days, coming not so much from nausea as from a pressure in his abdomen that seems to be pretty constant recently.

In spite of both of those issues, however, Dave still seems to be doing okay. He sat up on the edge of his bed for 10 minutes today (still supported by two physical therapists and his dad - all of his back muscles are really weak - completely normal considering how long he has been in bed, but I just want to make sure I'm being clear about where he is so you'll be able to see the progress as it happens in the future), and he said that he slept okay last night. He sounded tired on the phone but overall said he was feeling okay.

Sherri, the Case Manager, found a surgeon at Drake Center that has agreed to take on Dave as a patient, so as soon as the surgeon talks with Dr. Taylor, most of the medical logistics of the transfer should be complete. As for the insurance aspect, no word yet. If the cost of the air ambulance is approved by Dave's insurance, it sounds like he will be moving at 8:00 a.m. on Friday or early next week. Either way, we may not hear a definite go or no-go until as late as 3:00 p.m. on Thursday.

Thank you so much for the continued prayers and for everyone who has asked for Dave's email address to send him a word of encouragement. In the midst of questions about insurance and transportation, please be praying for Dave's overall state of mind as well. Although I know he is happy about the possibility of being back in Cincinnati, he also sounds pretty apprehensive about the move and how hard it will be on him. Be praying that the transfer will not only happen but that it will be uneventful and gentle on Dave and his injuries.

More tomorrow...