Dave only has ONE TUBE LEFT! Dave had his appointment in Omaha today and Dr Grant took out his t-tube (the tube that was in his bile duct)!!! Everything went very well. They had Dave stay at the hospital for 2 hours afterward just to make sure he was able to tolerate the tube being out. He will need to carefully watch for negative side effects for the next couple of days (i.e. running a temperature, feeling poorly) He is feeling very tired and is running a low grade temperature right now. Dave does not have another appointment set up for Omaha at this time. He will have labs done in Lincoln on Monday.
Dr Grant said the g-tube (feeding tube from way back when) will stay in until sometime this spring. They will repair the 2 hernias and take out the g-tube at the same time. To take out the g-tube they will need to stitch up the lining of the stomach as well as the skin around the opening. Dave's liver will be evaluated prior to this spring procedure to make sure they don't have to remove any part of it.
Thanks for all your concern, support, and prayers over the past 6 months. We want to wish each of you a very blessed Christmas as we celebrate our Savior's birth!
Friday, December 19, 2008
Monday, December 15, 2008
Thursday, December 11th
Dave had his appointment in Omaha with Dr Grant today. She tied off his t-tube again! So far he is feeling really good, PTL! If all goes well Dr Grant will pull the t-tube out next Thursday, Dec 18th. She will literally pull the tube out of his abdomen, this will not take surgery or anesthetic. She said it should be painless! Please pray the bile duct is completely healed and there won't be any complications when they take the t-tube out. If there aren't any complications Dave won't have to have the surgery they have been talking about and promising since the first week he was in the hospital! That would be one more miracle in Dave's amazing story!!!
Dave is still going to work for 3 hours everyday. It is still tiring but he is building up stamina and doing great. His last day of PT was Monday, Dec 1st. He is still going to Madonna Pro Active 3 times a week to work out on his own! Dave got the okay last week from the doctor to drive!!! What a liberating feeling for him! Thank you for all your prayers, we will never be able to thank you enough!
Dave is still going to work for 3 hours everyday. It is still tiring but he is building up stamina and doing great. His last day of PT was Monday, Dec 1st. He is still going to Madonna Pro Active 3 times a week to work out on his own! Dave got the okay last week from the doctor to drive!!! What a liberating feeling for him! Thank you for all your prayers, we will never be able to thank you enough!
Friday, November 21st
Yesterday Dave had appointments in Omaha. Dave went to Interventional Radiology for a cholangiogram. The results of the cholangiogram showed the bile duct was not leaking, it is working properly, PTL!!!! Since the bile duct wasn't leaking Dr Grant tied off his t-tube. She took the bag off and literally tied a knot in the tube to see if his bile duct was working properly. After Dave got home from Omaha he started feeling sick. Diane untied the tube and put a makeshift bag on it. The tube started draining a significant amount of bile compared to what it had been draining previously. Dave was running a temperature and feeling pretty crummy. After talking with nurses in Omaha, Dr Grant wanted to see Dave immediately. So Diane drove Dave back up to Omaha and Dr Grant put the bag back on the tube. They put Dave on an antibiotic to take care of the infection.
Monday, November 10, 2008
Monday, November 10th
Dave just got home from Hy-Vee. He worked for 3 hours this afternoon! Being on his feet for 3 hours combined with a good workout during PT this morning has made him pretty tired. All in all Dave is thankful to be able to be back at work! Thanks for your continued prayers!
Thursday, November 6th
Dave had an appointment yesterday with his family doctor in Lincoln. Dr Bertolini gave him the okay to go back to work on Monday, with instructions only to work 2-3 hours a day! Dave is looking forward to getting back to his normal every day routine.
This morning when Dave woke up he noticed the stitch in his blake drain had come undone and the tube had migrated out of his abdomen about 3 inches. He went to the doctors' office in Lincoln to push the tube back in place and re-stitch it. When the doctor took the bag off the tube fell completely out of his abdomen. They called Dr Grant, liver doc in Omaha, and she said to go ahead and leave the tube out! Dave is now down to 2 tubes! PTL!!!
This morning when Dave woke up he noticed the stitch in his blake drain had come undone and the tube had migrated out of his abdomen about 3 inches. He went to the doctors' office in Lincoln to push the tube back in place and re-stitch it. When the doctor took the bag off the tube fell completely out of his abdomen. They called Dr Grant, liver doc in Omaha, and she said to go ahead and leave the tube out! Dave is now down to 2 tubes! PTL!!!
Thursday, October 23, 2008
Thursday, October 23
Dave's appointments today went well. His first appointment was with Dr Mormino the orthopedic surgeon. They took 3 x-rays of Dave's ankle. He said he couldn't tell where the break had been on the fibula (outside bone). The break in the tibia is healed. In the next 4-6 months the soft tissue in the ankle will be healed also and give Dave more range of motion. Dr Mormino has released Dave!!!
His second appointment was with Dr Stothert from trauma. Dave had labs run yesterday and Dr Stothert was pleased with the results. Dave's liver and kidney numbers have returned to the normal range! PTL!!! (They didn't do his WBC.) They are going to continue watching the 2 hernias and will repair them when he has his next surgery. Again, the trauma team was very pleased with Dave's progress!
His last appointment was with Dr Grant, liver specialist. She wants to continue monitoring Dave's bile output from his T-tube for 2 more weeks. Dave was really hoping to be able to go back to just one bag. There has been a lot of inconsistency in the output from both drains which is confusing to them. In 2 weeks Dave will go to interventional radiology for a cholangiogram rather than an x-ray cholangiogram. IR is able to do a more accurate placement of the dye, therefore, better able to view the bile duct's functioning at the injury site. The results of this cholangiogram will help determine what the next step will be for Dave. They are still talking possible surgery, but they have also said there is a chance Dave may not need surgery if the bile duct heals on its own and is not too constricted. Please continue to pray for healing of the bile duct.
Dave continues to do great at home! He is still doing PT 3 times a week. He continues to get stronger. Dave has gained 8 pounds since he has been home! Thank you for your prayers and support! The next update will be in about 2 weeks, we don't have the appointment set yet.
His second appointment was with Dr Stothert from trauma. Dave had labs run yesterday and Dr Stothert was pleased with the results. Dave's liver and kidney numbers have returned to the normal range! PTL!!! (They didn't do his WBC.) They are going to continue watching the 2 hernias and will repair them when he has his next surgery. Again, the trauma team was very pleased with Dave's progress!
His last appointment was with Dr Grant, liver specialist. She wants to continue monitoring Dave's bile output from his T-tube for 2 more weeks. Dave was really hoping to be able to go back to just one bag. There has been a lot of inconsistency in the output from both drains which is confusing to them. In 2 weeks Dave will go to interventional radiology for a cholangiogram rather than an x-ray cholangiogram. IR is able to do a more accurate placement of the dye, therefore, better able to view the bile duct's functioning at the injury site. The results of this cholangiogram will help determine what the next step will be for Dave. They are still talking possible surgery, but they have also said there is a chance Dave may not need surgery if the bile duct heals on its own and is not too constricted. Please continue to pray for healing of the bile duct.
Dave continues to do great at home! He is still doing PT 3 times a week. He continues to get stronger. Dave has gained 8 pounds since he has been home! Thank you for your prayers and support! The next update will be in about 2 weeks, we don't have the appointment set yet.
Friday, October 10, 2008
Wednesday, October 8
Dave's appointments went well today. He had the cholangiogram first and didn't get the results until late afternoon. The results showed a slight bile leak. However, the bile is not being picked up by Dave's blake drain, which poses the question where is the bile going. As yet one more diagnostic tool, Dr Grant decided to put a bag on the t-tube to measure any bile that may drain and to see if this makes a difference in the output of the blake drain. (Dave's blake drain is draining some fluid but it is not bile.) Dave's t-tube immediately started draining a significant amount of bile. They told Dave to start drinking more fluids so his body can replenish what it is losing. Dr Grant is going to discuss the results of the cholangiogram with her colleagues at a monthly meeting. By presenting Dave's case to the group she is hoping to get some feedback for what the next step should be. They are still talking surgery. Different time frames have been thrown out, some doctors have said 2 months down the road and some have said 6 months down the road. I think it is sufficient to say they want to give Dave's body time to heal before he has another surgery. At this point we still do not know what the extent of the surgery will be.
Dave now has a button G-tube. This replaced the 6 inches of tube that was sticking out from his stomach, taped to his body, and visible through his shirt. The button is flush with his skin and can't be seen through his clothes! They don't want to get rid of the G-tube because it would take another surgery to insert one in the event that he would need it. Since the tube is already there and isn't a cause for infection (the stomach/intestines have so much bacteria anyway the tube doesn't get infected) they have decided Dave will keep the G-tube until after his liver surgery. He isn't using the G-tube and hasn't since he has been home.
Dave has 2 hernias in his abdomen along his incision. Dr Young gave Dave an elastic belt to prevent the hernias from getting any worse. They will coordinate surgery to fix the hernias when Dave has his liver surgery. Dave's white blood count was 15,000. It has been holding pretty steady at 15,000 for about the last month. The doctors seem to have quit putting as much emphasis on the high WBC. Dave's physical therapy is going great. He is going to PT 3 times a week at Madonna ProActive. In the last week his PT, Darrin, has put Dave on the stationary bike and also on the elliptical machine. Dave was on the elliptical for 10 minutes and worked up a sweat! He thought it was great!!!! He is looking stronger and feeling stronger daily. On 3 of the days Dave doesn't have PT he works out on the Bowflex at home. Although he tires sooner than he once did, Dave is very determined to have a complete and quick recovery. Dave is enjoying being home and getting life back to normal. He is going to church, spending time with his family, going to Norris softball games, and getting together with friends. Dave had a birthday last week (56 years young!!!!) and is thankful the Lord has blessed him with another year! Dave's next appointment in Omaha is October 22. We will give you an update after the appointment! Thank you for your continued prayers, the body of Christ is amazing!
Dave now has a button G-tube. This replaced the 6 inches of tube that was sticking out from his stomach, taped to his body, and visible through his shirt. The button is flush with his skin and can't be seen through his clothes! They don't want to get rid of the G-tube because it would take another surgery to insert one in the event that he would need it. Since the tube is already there and isn't a cause for infection (the stomach/intestines have so much bacteria anyway the tube doesn't get infected) they have decided Dave will keep the G-tube until after his liver surgery. He isn't using the G-tube and hasn't since he has been home.
Dave has 2 hernias in his abdomen along his incision. Dr Young gave Dave an elastic belt to prevent the hernias from getting any worse. They will coordinate surgery to fix the hernias when Dave has his liver surgery. Dave's white blood count was 15,000. It has been holding pretty steady at 15,000 for about the last month. The doctors seem to have quit putting as much emphasis on the high WBC. Dave's physical therapy is going great. He is going to PT 3 times a week at Madonna ProActive. In the last week his PT, Darrin, has put Dave on the stationary bike and also on the elliptical machine. Dave was on the elliptical for 10 minutes and worked up a sweat! He thought it was great!!!! He is looking stronger and feeling stronger daily. On 3 of the days Dave doesn't have PT he works out on the Bowflex at home. Although he tires sooner than he once did, Dave is very determined to have a complete and quick recovery. Dave is enjoying being home and getting life back to normal. He is going to church, spending time with his family, going to Norris softball games, and getting together with friends. Dave had a birthday last week (56 years young!!!!) and is thankful the Lord has blessed him with another year! Dave's next appointment in Omaha is October 22. We will give you an update after the appointment! Thank you for your continued prayers, the body of Christ is amazing!
Thursday, September 25, 2008
Wednesday, September 24
Dave's 2 appointments went really well. His first appointment was with Dr Grant, the liver surgeon. She re-stitched his blake drain as it needed to be stabilized. She would still like to get Dave out 2 more months before doing a surgery. There is still a chance the bile duct could repair itself which would lessen the seriousness of the surgery. She would like to have a cholangiogram done on Dave's t-tube in a couple of weeks. This will show her if the T-tube is working properly. She may need to put a new t-tube in, this would probably be a one night hospital stay. Dave's next appointment was with Dr Young from the trauma team. Dr Young was very excited with how good Dave looks! Dave will have a button G-tube placed when he has the cholangiogram. Dr Young wants to leave the G-tube in until after the surgery. This type of G-tube isn't visible through clothing as it will be flush with the skin! Overall the appointments were very encouraging. Thank you for your continued prayers.
The next blog entry will be with the results of Dave's cholangiogram that will take place on October 8th.
The next blog entry will be with the results of Dave's cholangiogram that will take place on October 8th.
Thursday, September 18, 2008
Wednesday, September 17
After:
93 days in the hospital
93 x-rays
WBC as high as 86 thousand
29 days of dialysis
24 CT scans
13 1/2 hours of surgeries and procedures
10 ultrasounds
10 days unconscious
9 tubes in the tummy and back
6 EKGs
5 trips to Interventional Radiology
and One Great Big GOD...
DAVE IS HOME!!!!!!!
The next blog update will be after Dave's follow up appointment at UNMC on Sept 24. Next Wednesday the doctors will most likely decide how extensive Dave's future surgery will be. The trauma team did tell us there is a very slight chance that Dave's bile duct will heal on it's own. A small portion of the left side of his liver has died and they will need to remove this, however, if the bile duct does not heal they will remove the entire left side of his liver. Please continue to pray that Dave does not have to have the left side of his liver removed.
We want to extend a heartfelt thanks to all of you prayer warriors!! We know your prayers are the reason Dave is at home today. It was awesome to experience the way the Body of Christ works together! During the most difficult days it was the faithful prayers of our brothers and sisters in Christ that encouraged us and helped us through. A big thanks to all those who came to the hospital, thank you for the meals, gifts, cards, and especially your prayers. It has been most humbling to be the recipients of such generosity. We praise God that Dave is home and for your faithful prayers. We have truly been blessed! Thank you!
93 days in the hospital
93 x-rays
WBC as high as 86 thousand
29 days of dialysis
24 CT scans
13 1/2 hours of surgeries and procedures
10 ultrasounds
10 days unconscious
9 tubes in the tummy and back
6 EKGs
5 trips to Interventional Radiology
and One Great Big GOD...
DAVE IS HOME!!!!!!!
The next blog update will be after Dave's follow up appointment at UNMC on Sept 24. Next Wednesday the doctors will most likely decide how extensive Dave's future surgery will be. The trauma team did tell us there is a very slight chance that Dave's bile duct will heal on it's own. A small portion of the left side of his liver has died and they will need to remove this, however, if the bile duct does not heal they will remove the entire left side of his liver. Please continue to pray that Dave does not have to have the left side of his liver removed.
We want to extend a heartfelt thanks to all of you prayer warriors!! We know your prayers are the reason Dave is at home today. It was awesome to experience the way the Body of Christ works together! During the most difficult days it was the faithful prayers of our brothers and sisters in Christ that encouraged us and helped us through. A big thanks to all those who came to the hospital, thank you for the meals, gifts, cards, and especially your prayers. It has been most humbling to be the recipients of such generosity. We praise God that Dave is home and for your faithful prayers. We have truly been blessed! Thank you!
Tuesday, September 16, 2008
Tuesday, September 16
For those of you keeping track today is month 3 since Dave's accident. The plan is still to come home tomorrow, PTL! Dave has had some discomfort in his abdominal region for the last 3 days. He had mentioned it to the doctors and nurses but they didn't know what would be causing the pain and sensations. This morning during breakfast Dave discovered his gastric tube was leaking. He lifted his shirt up and his tube literally fell out of his stomach. That was the answer to his discomfort! The tube, which by the way has a bulb on the end of it, had worked its way out of Dave's stomach and through his skin, OUCH!!!! The nurse quickly reinserted another gastric tube, with a larger bulb this time. This was done bedside and was painless for Dave. The tube was inserted through the preexisting tunnel and then the bulb was inflated after the tube was properly placed in his stomach. Last night was the last time Dave will receive tube feedings at night, PTL!!!! Dave had discharge evaluations in both PT & OT today. As you can imagine he has improved since the initial evaluations 11 days ago. As always thank you for your prayers.
Monday, September 15
Dave had a great day today! For one of his PT sessions he walked around outside, it was so beautiful out! The doctor took a look at Dave's CT scan from Friday and said there isn't any pockets of fluid in his abdomen. He said he didn't know quite what to make of the situation and called the Trauma team at UNMC to get their opinion, we don't know what Trauma had to say yet. The confusion stems from the blake drain suddenly not draining much of anything (and what it is draining is different than before), the t-tube still not draining very much, and now per the CT scan there aren't any pockets of fluid sitting in Dave's abdomen. The pesky hiccups still seem to show there ugly head through out Dave's days. However, the hiccups aren't causing as many breathing episodes, though the episodes do still take place randomly. Dave has gained 15 pounds! He is eating great, no nausea or lack of appetite, and he is still getting tube feedings at night. Dave is looking at discharge from Madonna on Wednesday, yes, 2 days from today!!! PTL! He will only need outpatient PT, they said he won't be needing OT after discharge! Thank you for your faithful prayers!
Monday, September 15, 2008
Saturday & Sunday, September 13 & 14
Dave continues to gain weight, PTL! He has an appetite and is still getting tube feedings every night. Dave didn't have PT or OT this weekend, just the walking he did on his own. He really enjoyed watching the Husker game on Saturday night! Thank you for you continued prayers!
Friday, September 12, 2008
Friday, September 12
Today using the groceries they bought on Wednesday, Dave helped make lunch for Diane, a therapist and another patient. Diane said she loved it! Dave is having a CT scan at 5:30 tonight at Bryan. They are concerned about his leaking bile duct because the amount of fluid draining from the blake drain dropped significantly in the last few days.
Thursday, September 11
For Dave's outing today he went to Barnes and Noble with Madonna therapists. In order to transition from Madonna, Dave was allowed to leave Madonna for 3 hours with Diane! In physical therapy Dave worked on the Bowflex and stairs. He did have hiccups today but no breathing episodes. Overall, he had a very good day.
Thursday, September 11, 2008
Wednesday, September 10
Dave's WBC came down a little, 16,600! He went on an "outing" with PT & OT to the grocery store. Nope, it wasn't Hy-Vee, Dave didn't have a choice in the matter! :) Being on his feet that long was a challenge but he did well. Dave has started walking to PT & OT without the cane, another step in the right direction! During therapy Dave went outside and walked on grass and other uneven ground without the cane. Some have inquired if Dave is up to visitors... he definitely is and would be encouraged by your visit. Stop by, Dave is in room 210.
Wednesday, September 10, 2008
Tuesday, September 9
In Recreational Therapy Dave bowled on the Nintendo Wii. What a neat way to do rehab! He said the therapist beat him easily, oh well, maybe next time! He should probably challenge her to a game of softball or baseball! He did stairs and some balancing exercises in PT, which he informed me he dominated! It was so good to see that confidence again! He is using the cane less often, PTL!
Monday, September 8
Dave's WBC went up, 17,000. He had lots of PT & OT today. It was difficult, but he enjoyed the challenge. He keeps getting stronger! We are so thankful he is in Lincoln. Thank you all for your prayers and support.
Sunday, September 7, 2008
Saturday & Sunday, September 6 & 7
Dave is now in room 210 at Madonna and the room even has a window! Dave is now taking all oral medications (no more IV's). Dave had PT, OT, and speech evaluations on Saturday. They determined that he doesn't need speech therapy so he will just start PT and OT on Monday. Dave is still getting tube feedings at night so that he can get in enough calories. Thanks to the medication to increase his appetite, Dave is eating more and gaining weight. PTL!
Friday, September 5, 2008
Friday, September 5
Dave is packed up and moving to Madonna! Praise God!
As soon as the paperwork is finished, Diane will be driving Dave to Madonna. Hopefully they will be arriving in Lincoln by 2:00 today! Today Dave's WBC is down to 15,000, other than that we don't have any other news to report. Dave is doing very well and is anxious to start rehab at Madonna. Again, thank you for your continued prayers.
As soon as the paperwork is finished, Diane will be driving Dave to Madonna. Hopefully they will be arriving in Lincoln by 2:00 today! Today Dave's WBC is down to 15,000, other than that we don't have any other news to report. Dave is doing very well and is anxious to start rehab at Madonna. Again, thank you for your continued prayers.
Friday, September 5
Happy Anniversary Dad and Mom!!!!
Dave and Diane are celebrating their 32nd wedding anniversary today, PTL! Update to follow...
Dave and Diane are celebrating their 32nd wedding anniversary today, PTL! Update to follow...
Thursday, September 4
Dave had a really good day today! He walked with the cane, he is even walking short distances without the cane and without assistance!!!! The doctors have told us as long as Dave's WBC does not go up he will be able to move to Madonna tomorrow or the next day, PTL! They took him off telemetry today as well! Dave did have a couple of breathing episodes today, but they don't seem to be as severe as they once were. Thank you for your faithful prayers, we truly appreciate each one.
Wednesday, September 3, 2008
Wednesday, September 3
Dave's WBC is 17,000!!! Dave had hiccups on and off last night and all day today, he did have 3 breathing episodes yesterday and 2 today. The PT decided to have Dave try a cane instead of the walker. He was walking all over 5th floor today with that cane (he barely puts weight on it)! The results of the cholangiogram show that the T tube is in the proper place, however, the bile is leaking from around it. The JP tube (Blake drain) they have been advancing slowly totally fell out of Dave's stomach today. So for a short time he was down to 2 tubes, but because the Blake drain continues to drain bile the doctors put the tube back in place. They were able to do this at the bedside and without anesthetic! In the last 5 days Dave has taken in an average of 2,200 calories per day! Dave is only getting 1/3 of those calories from the tube feedings! The nutritionist was very pleased with his progress, PTL! Thanks for your prayers for Harvey, he went home tonight, PTL!
Tuesday, September 2, 2008
Tuesday, September 2
Last night Dave tolerated tube feedings at 50 cc/hr, this was the goal they have been working towards!! Dave went down to IR around noon for the cholangiogram, test to see if the bile duct is working properly. They told Dave in IR that he is leaking bile from the bile duct but we haven't talked with the doctor yet. Dave's JP drain is still draining a significant amount, probably the bile the cholangiogram showed he was leaking. He wasn't able to have breakfast because of his trip to IR, but he had a big lunch that he has kept down! In PT today Dave did stairs and he walked on a slope (both without the walker)!! Diane's dad was admitted to ICU in Lincoln today because of some internal bleeding. They found his esophagus was ripped in 2 places and they have already clamped those via a scope. He will stay tonight so they can monitor his blood pressure. Please keep Harvey in your prayers also.
Monday, September 1
Dave's white blood count is 21,100 today! Dave had an abdominal x-ray, looking at his digestive tract. Dave threw up last night so the nurse pulled some food out through Dave's gastric tube. Dave is having a test run tomorrow to see if the t-tube is working properly. This is the tube in his bile duct that acts as a stint and also drains bile. The doctors' fear is that a portion has pulled out and isn't in proper position. Please pray for wisdom for the doctors and that this test goes well.
Sunday, August 31
Today has been a good day! Dave had 3 meals that he was able to keep down, PTL! Dave finished up with his IV antibiotics and is now back to oral antibiotics. He continues to get stronger everyday.
Monday, September 1, 2008
Saturday, August 30
Dave's white blood count went up a little today, 22,000. His temperature is hanging around 99.1. This morning Dave's JP tube started draining fluid again, they won't be pulling the tube out until this stops draining. Dave was able to keep 2 good meals down! However, the gastric tube started leaking from around the tube because his stomach was so full. The nurse removed 1 cup from Dave's stomach to help with the bloated feeling. They have been giving Dave an appetite stimulant and today was the first day it actually worked! Dave felt hungry for the first time since his accident! Dave has had the hiccups all day and they have progressively gotten worse. He has had one breathing episode. As many of you know Dave is a big Husker fan, he was able to listen to the game, the hospital wouldn't pay for pay-per-view, darn!
Friday, August 29
Dave's WBC is 20,700, down again!!!! Today was another great day for Dave! He was able to eat all 3 meals and keep them down, PTL! The doctors advanced his JP tube another 2 cm. He hasn't had any hiccups and consequently no breathing episodes either!
Thursday, August 28, 2008
Thursday, August 28
Dave's WBC went down today, 22,600! Dave had 3 big meals (big for him anyway) and was able to keep it all down, PTL!!!! He hasn't even had any times when he has felt nauseous, this is a huge improvement. They pulled his JP tube out another 2 cm tonight and will continue to do so every other day. Dave was hiccup free until this evening around 9:30, but these hiccups aren't the deep kind that cause breathing episodes. Today has been a great day, we pray Dave will be blessed with many more days like it! Thank you for all your prayers.
Wednesday, August 27, 2008
Wednesday, August 27
PTL, Dave's white blood count went down, 23,200!!!! He isn't running a temperature either! He ate 3 good sized meals and promptly threw up after each one. He was able to eat a little bit after breakfast and lunch, both of which he kept down. They are giving him 2 different kinds of medicine for nausea, a third medicine to increase his appetite, and a fourth to help with digestion. Dave's numbers for malnourishment are improving, PTL! Dave is getting tube feedings at 25 cc/hr for 8 hours during the night. He is no longer getting TPN. His IV failed and had to be moved yet again. They found a different vein in his forearm to place the IV, this time it took 4 attempts. During PT Dave walked 600 feet with a walker and then walked 250 feet without a walker! He held my hand and the PT's hand so we could steady him and mom walked behind him with the wheel chair. Dave continues to go outside everyday, he really enjoys the fresh air! Dave didn't have hiccups or breathing episodes today, PTL!!!!
Tuesday, August 26, 2008
Tuesday, August 26
The doctors wrote a new order and Dave will only have his WBC checked Monday, Wednesday, and Friday. Dave has not had hiccups or breathing episodes today! He hasn't been able to keep very much food down today. Please continue to pray for the doctors as they are still trying to determine the best times and dosage amounts of the nausea medication. The CT scan yesterday showed everything is looking the same. The fluid in the lung did not fill back up as expected! The liver looks good except the one part that has died, which they anticipated from the beginning. In therapy Dave did 5 sit to stands without a walker and then walked four feet forwards and backwards 3 times without a walker!
Monday, August 25, 2008
Monday, August 25
Last night was a difficult night for Dave. He woke up at 1:30 throwing up and was awake until 5:00 with breathing episodes and more nauseousness. When the doctors made their rounds they decided to give Dave medicine 4 times a day for the nausea. They talked about many options on how to handle Dave's malnourishment. Dave is going to have a CT scan of his abdomen this afternoon. His WBC went down to 32,300! They also talked about pulling out the JP tube another inch today. Dave isn't running a temperature, however, one doctor suggested the reason Dave isn't running a temp with the high WBC (which would indicate infection) is because his malnurished body isn't able to run a temp. Dave hasn't had hiccups since the middle of the night, therefore no breathing episodes, PTL!!!!!
Sunday, August 24
Dave's white blood count went up again, 33,300. It was a difficult day for Dave. He threw up multiple times and had many breathing episodes stemming from hiccups. Before his supper they gave him a one time dose of new medicine for the nausea. He was able to eat more than he has in a long time and he kept it down!! Dave had an x-ray of his chest and abdomen. He had a new peripheral IV put in his hand as the old one was no longer working, it only took one stick this time!
Saturday, August 23, 2008
Saturday, August 23
Dave's WBC went up again today, 32,300. They are still working to find the correct combination of medicine to help keep Dave from throwing up and having dry heaves. Dave was up and walked two different times today and is on his second trip outside. They pulled the JP tube out another inch this morning!
Friday, August 22, 2008
Friday, August 22
Dave's white blood count went up today. The first reading was 30,500, the doctors didn't believe it so they ordered another blood draw and another test. The second reading was 30,300. The trauma team is stumped. The hemo team seems to think this is to be expected for all the trauma his body has been through and again withdrew from Dave's case. Because of Dave's high WBC the doctors put Dave on an IV antibiotic and took him off the 2 oral antibiotics. He still is not running a temperature though, PTL! During Dave's trip to IR they removed the tube in his back! He is back down to 3 tubes again! Dave didn't throw up today, although he did feel nauseous at times. He had fewer breathing episodes today! They decided to start pulling out Dave's JP tube, one inch at a time. This is how they removed the majority of his other tubes. Please pray the tube will come out without incident.
Thursday, August 21
Dave's white blood count went down a little bit today, 30,000! No temperature either! The orthopedic team stopped in and said Dave's left ankle is completely healed, he can start walking without his boot, PTL! So, in PT he walked 300 feet with his boot and then 300 feet without his boot! No pain!!! PT and OT continue to praise Dave's hard work. Dave had 7 breathing episodes today. Five of the episodes happened when he was sitting, one when he was standing (very scary), and one when he was laying down. Until today, he never had breathing episodes while he was sitting, or standing for that matter! Kinda scary! Eating didn't go well as Dave threw up before breakfast and felt nauseous throughout the day. The doctors did up Dave's tube feedings to 20 cc/hr from 6 PM to 6 AM. Dave will go to IR tomorrow to see if they can remove the tube in Dave's back.
Wednesday, August 20, 2008
Wednesday, August 20
Dave's white blood count went down again today, 30,500! He doesn't have a temperature either! Dave had an x-ray done on his ankle this morning, we don't have the results back yet. Dave went down to IR this afternoon. The tube is still draining a little so they left it in. They will check on Friday to see if the tube is still draining. They started Dave on a second antibiotic in addition to the Cipro. Dave had one more breathing episode in the middle of the night last night. As for today, Dave hasn't had the hiccups, PTL! He just got his first food of the day as he couldn't eat anything prior to going to IR. Thank you for your faithful prayers.
Tuesday, August 19, 2008
Tuesday, August 19
Dave's white blood count went down today, 32,800! His temperature is still hanging in there around 100. Dave was able to tolerate a large supper tonight! And he didn't throw up today either! However, they started tube feedings tonight at 10 cc/hr. They are using a different product and he is getting a very small amount. Dave did have the hiccups before they started the tube feeding and they continued to worsen throughout the evening. He had 2 breathing episodes after 10:30pm. On Saturday when they drained Dave's abdomen they placed a tube in Dave's back, he has 4 tubes now. Tomorrow Dave will go to IR to see if they can remove the tube in his back. It hasn't been draining very much and again, they want to alleviate any possible modes for an infection. They will push dye through the tube to determine if there is still fluid collecting in Dave's abdomen. Dave doesn't have a set appointment time with IR and he won't be able to have any food or drink after midnight tonight. Please pray Dave's trip to IR will go well and will be in the morning so he doesn't have to be without nutrition for very long.
Monday, August 18, 2008
Monday, August 18
Dave's white blood count is up again, 34,500. He didn't have a temperature this morning but is now running a low grade temp. Dave threw up this morning. Despite all of the bumps in the road, today Dave walked the farthest that he has yet! And he doesn't have hiccups! Dr Stothert was in and talked about different options besides the tube feeding. He said Dave would be able to get the nutrients he needs from Ensure or some other things as well. They talked about putting the Ensure directly into the gastric tube. Dave is getting Cipro, an antibiotic. Please pray this will bring Dave's WBC down. Dave's kidney function continues to improve, PTL!
Sunday, August 17
The procedure yesterday went well. The fluid they were able to take out looked bloody and of course was sent to the lab. Nothing has cultured out of any of the fluid samples or from the catheters with the exception of a swab from around Dave's JP tube. They expected this to culture out bacteria as this is one of his drain tubes. Dave's white blood count is up again, 31,900. The lack of nutrition continues to be a problem for Dave. He has lost 36 pounds since the accident. The tube feedings through the gastric tube were started again on Saturday night. Dave also got the hiccups again after a week without them. He had 2 breathing episodes due to the hiccups. Diane is wondering if the tube feedings and hiccups aren't directly related. She has been taking notes since the accident and it seems the only time he has hiccups is when he is on the tube feedings. They requested no tube feeding for tonight and Dave hasn't had the hiccups!
Saturday, August 16, 2008
Saturday, August 16th
Thank you for your prayers, the procedures yesterday went well and we should get the results for the cultures in a couple of days. Some of the fluid in Dave's abdomen, however, that needed to be drained is very close to his bladder. The lady doing the procedure thought it was too risky, so she opted not to drain that portion. After talking with the trauma team, it was decided that Dave needs to go back down to IR today at 1:30 to get the fluid drained. Please be praying that the procedure would be successful, without any complications. During the entire procedure, Dave will be laying on his stomach, on a board (without any padding). As you can imagine this is very uncomfortable. Dave had a temperature again through the night, but didn't throw up this morning! Despite these setbacks, Dave continues to remain positive and in good spirits.
Friday, August 15, 2008
Friday, August 15th
Dave started the day off similar to yesterday, throwing up. They started the tube feedings again in order to give Dave the nutrition he requires. He is still able to order any and all the food he wants and the doctors are encouraging him to do so, but he just doesn't have much of an appetite. Dave's white blood count is the same as yesterday, 23,300. The renal (kidney) doctors were by today and said they will no longer be on Dave's case. His kidneys are working at a level that Dave can live without having dialysis, although they would ideally like to see drastic improvement in his kidney function. The x-rays of the chest and abdomen and the CT scan came back looking normal. Nothing has cultured out from the 2 catheters or all the samples they took yesterday. Dave is going down to Interventional Radiology when they can squeeze him in sometime today. IR is going to aspirate the fluid in his lower right lung and they are also going to remove the fluid that has been in his abdominal cavity for about a month. They are desperately trying to find the cause of the high WBC so they are draining these 2 areas of fluid even though they don't believe either to be the culprit. As you may remember Dave had the fluid in his lung aspirated a few weeks ago and this was extremely painful, one of two times since his hospitalization that he rated his pain at a 10. This is not supposed to be a painful procedure but they hit a nerve so he was in severe pain for 3 days. Please pray the doctors won't hit a nerve this time and that the Lord will calm Dave's fears. Dave did awesome in PT again today. Despite being tired he walked further than he did yesterday, 500 feet! He is definitely getting stronger daily, PTL!
Thursday, August 14, 2008
Thursday, August 14th
Dave wasn't able to transfer to Madonna because his white blood count jumped up again, 23,300. He also had a temperature around 100 last night, but today it has been back down in the normal range. Dave had an upset stomach this morning and vomited. As for anyone, it's hard to want to eat after you throw up. They ran many labs today in an attempt to figure out why his WBC is rising. They x-rayed his lungs and abdomen and also did a CT scan of the abdomen. Please pray they will be able to find the reason for the rising WBC. Dave has felt very tired today, he didn't sleep very well last night. He still worked hard in PT though, and recorded his longest walk yet! Thank you for your constant prayers.
Wednesday, August 13, 2008
Wednesday, August 13th
There has been a change of plans... Dave is no longer moving to Madonna today. Last night Dave had a temperature and his white blood count jumped up to 17,600. The doctors want to keep Dave at UNMC to monitor his temp and WBC. More updates to follow...
Dave hasn't had a temperature today and they will check his white blood count in the morning. In order to reduce possible infection sites they took out Dave's central line and also his dialysis port. The news of not moving to Madonna today was disappointing for Dave but he didn't let it get him down. He walked 250 feet with his walker! He also did some exercises standing! Until today all of his exercises were done when he was in bed or sitting in a chair. Dave also went outside, which has become part of the daily routine. :) Provided Dave's white blood count looks good he will be moving to Madonna tomorrow. Thank you for your continued prayers and your many words of encouragement.
Dave hasn't had a temperature today and they will check his white blood count in the morning. In order to reduce possible infection sites they took out Dave's central line and also his dialysis port. The news of not moving to Madonna today was disappointing for Dave but he didn't let it get him down. He walked 250 feet with his walker! He also did some exercises standing! Until today all of his exercises were done when he was in bed or sitting in a chair. Dave also went outside, which has become part of the daily routine. :) Provided Dave's white blood count looks good he will be moving to Madonna tomorrow. Thank you for your continued prayers and your many words of encouragement.
Tuesday, August 12, 2008
Tuesday, August 12th
Can I have a drum roll please.......................
DAVE IS MOVING TO MADONNA REHABILITATION TOMORROW!!!!!!
Thank you Lord Jesus! We have been waiting for this huge step and here it is! We are rejoicing! Dave definitely isn't out of the woods but what a step in the right direction! We truly appreciate your prayers! God is so good!
DAVE IS MOVING TO MADONNA REHABILITATION TOMORROW!!!!!!
Thank you Lord Jesus! We have been waiting for this huge step and here it is! We are rejoicing! Dave definitely isn't out of the woods but what a step in the right direction! We truly appreciate your prayers! God is so good!
Monday, August 11, 2008
Monday, August 11th
Today is week 8 since Dave's accident. We are so thankful our Lord has been by Dave's side through all of this and brought him this far! Dave's white blood count is 14,600, up from Saturday. Dave still doesn't have a temperature, PTL!!! Dave walked 200 feet this morning and 50 feet this afternoon (both with the walker)! Dave has hardly had the hiccups today, PTL, and no breathing episodes!!!!!!!! Still no talk of dialysis! It's been a week since his last dialysis treatment. Dave went outside again this afternoon and enjoyed the great outdoors, what a beautiful August day, not too hot or humid! Please pray for Dave's malnutrition as this continues to be a problem.
Sunday, August 10th
We don't have Dave's white blood count for today, but yesterday's count was 12,600. Dave still doesn't have a temperature, PTL! Yesterday Dave walked 100 feet, he is feeling a bit sore today though! Dave was able to go outside today with PT (in a wheelchair)! On Saturday they stopped the gastric tube feedings completely and they reduced the TPN to 1/2 the amount he was receiving. Dave's digestive system continues to be a problem. He always feels very full and therefore doesn't want to eat much. Dave only had 2 breathing episodes today!
Saturday, August 9, 2008
Saturday, August 9th
Today Dave walked 40 feet! We also went outside for a few minutes. He had one session of PT today and will have a session of OT later. We received the results from the CT scan and everything looks about the same. Please continue to pray for the hiccups, they seem to be getting a little better. Dave only had 2 breathing episodes last night and he hasn't had any yet today! Dave had a lime slush from Sonic and a chicken strip for lunch. He really enjoyed the lime slush, but still doesn't have too much of an appetite. Thank you for your continued prayers.
Friday, August 8, 2008
Friday, August 8th
THERE ARE MANY THINGS TO BE THANKFUL FOR TODAY!!!!!!!
Dave walked for the first time with his walker, he was able to walk 40 feet! Yesterday the renal docs told Dave he would need dialysis today and then today his kidney numbers looked so good he didn't have dialysis! The Infectious Disease docs were in and said Dave hasn't had a high temperature for an entire week. They were happy to announce they won't be needed on Dave's case any more!!! Dave's white blood count is down again today! He had 4 breathing episodes yesterday, but hasn't had any yet today and has only had the hiccups a few times today! Dave is having a CT scan to look at his abdomen and an ultrasound done to look at the bile flow in his liver. The x-ray on Tuesday of Dave's right lung shows the same amount of fluid on the lower lobe. The only way to get rid of the fluid in Dave's circumstance is to place a large uncomfortable tube in his chest. This tube would be a fairly long term fix due to Dave's malnutrition, as the malnutrition would cause the fluid to continue gathering in his lung. The tube would also be a potential source of infection so they have decided not to place the drainage tube in his chest. Thank you for your faithful prayers!
Dave walked for the first time with his walker, he was able to walk 40 feet! Yesterday the renal docs told Dave he would need dialysis today and then today his kidney numbers looked so good he didn't have dialysis! The Infectious Disease docs were in and said Dave hasn't had a high temperature for an entire week. They were happy to announce they won't be needed on Dave's case any more!!! Dave's white blood count is down again today! He had 4 breathing episodes yesterday, but hasn't had any yet today and has only had the hiccups a few times today! Dave is having a CT scan to look at his abdomen and an ultrasound done to look at the bile flow in his liver. The x-ray on Tuesday of Dave's right lung shows the same amount of fluid on the lower lobe. The only way to get rid of the fluid in Dave's circumstance is to place a large uncomfortable tube in his chest. This tube would be a fairly long term fix due to Dave's malnutrition, as the malnutrition would cause the fluid to continue gathering in his lung. The tube would also be a potential source of infection so they have decided not to place the drainage tube in his chest. Thank you for your faithful prayers!
Thursday, August 7, 2008
Thursday, August 7th
Dave had a lot of activity this morning. Some how his IV line was pulled out so they had to place 2 peripheral IVs in his right hand. These 2 IVs took 6 attempts before they were all said and done! Then this afternoon they decided to put in a central line by his clavicle, like what was pulled out. The 2 IVs in Dave's hand were going to inhibit him from being able to do PT and consequently get out of bed. They are still planning on the CT scan tomorrow to check the bile drainage situation. Dave did start draining more bile today than was draining yesterday. Dave has had the hiccups today but he has not had any breathing episodes yet, PTL! Thank you for your prayers.
Wednesday, August 6th
Dave's white blood count is 15,600, coming down again, PTL! Dave only had 5 breathing episodes today, another improvement from yesterday. :) Dave went outside for the second time! It sprinkled a little on him, but I think he appreciated the opportunity to be outside enjoying God's creation. He was out of bed, sitting in the wheelchair and also the recliner, for a total of 6 hours today, another big step! The bile draining into Dave's 2 tubes has slowed down a lot. Dr Jawa said theoretically this is a good thing, however, it has probably slowed too fast for it to have healed so they are going to do a CT scan on Friday to take a look at his abdomen again. Although, we know that we serve a mighty God and Dave's bile duct may well have healed that quickly.
Tuesday, August 5, 2008
Tuesday, August 5th
Dave's white blood count for today is 16,700. He sat up for 2 hours this morning and again for 2 hours tonight! This evening Dave did his bed to chair transfer basically by himself!!!! He is getting stronger daily! They gave Dave the green light to put his full weight on his left leg! Dave only had 4 breathing episodes today, still very scary but at least he didn't have as many episodes as yesterday. For supper Dave had turkey, mashed potatoes, and gravy! He still isn't eating very much, but they allow him to have anything on the menu, another thing to be thankful for! They did an x-ray of Dave's lungs today, hopefully we will get the results tomorrow. We are rejoicing, Dave is making many steps in the right direction! Thank you all for your prayers and many forms of encouragement, we truly appreciate it!
Monday, August 4, 2008
Monday, August 4th
Dave is not running a temperature and his nurse hasn't told us his daily white blood count number. Dave is still having the hiccups and still on medication for this. Consequently he is still having the episodes when he isn't able to breathe. Dave only had to be on dialysis for 2 hours today, instead of the normal 4 hours, because his kidneys started functioning better over the weekend, PTL!!!!!! The renal doctors said hopefully Dave won't have to have dialysis ever again. We pray this is the case! What a pleasant surprise, the Lord is definitely capable of anything! Dave's lower right lung is still full of fluid. They have told us there is about .5 liters of fluid, the same amount as last time. At this point they are not going to act on this fluid, hoping it will take care of itself. A nutritionist came by to help figure out which foods would be easy for Dave to digest but also have a lot of nutrition. Thanks for your continued prayer support, we can see God working!
Sunday, August 3rd
Dave had another pretty relaxing day. His white blood count is still slightly above normal at 12,300 and he did not run a temperature. Dave sat up for an hour in the "cadillac chair". Dave's hiccups were better today with the help of medication. There were 6 times when he wasn't able to breathe because of the hiccups. The doctors still don't have any explanation for these episodes.
Saturday, August 2, 2008
Saturday, August 2nd
Dave did not have a temperature today and his white blood count was just a little over 10,000. Dave have PT today, but not dialysis. It was a fairly relaxing day for Dave, except he still has hiccups and had a couple more episodes of difficulty breathing. Basically, Dave's diaphragm just freezes and he can't breathe in or out. As you can imagine, this is very scary for Dave and for everyone in the room. This has happened two times today, both this evening, and each lasted for 10-15 seconds. The nurses assured us that he is still getting oxygen when this happens. Dave's heart rate dropped to 60 during the last episode. They said that it is vagal reponse, which is when your heart rate drops due to holding your breath. The doctors have been made aware of his breathing problem and are going to stop by tonight. Please pray for wisdom for the doctors as last night they had no idea as to what could be causing this. We have noticed that it happens when Dave is having a particularly difficult time with hiccups and afterward he doesn't have hiccups (for about 5 minutes). Dave enjoyed mashed potatoes and pureed pears today! Dave remains in good spirits, gaining more strength every day.
Friday, August 1, 2008
Friday, August 1st
We don't have Dave's labs from this morning, as they took Dave to dialysis early this morning and he isn't back yet. Dave is also scheduled for a CT scan after dialysis. They ordered the CT scan to take a look at Dave's liver, pancreas, kidneys, digestive tract, basically his entire abdomen. They are also looking for any possible infection and any possible blood leaks since he keeps needing blood transfusions. The results from Dave's trip to IR yesterday showed that the left side of his liver is functioning ok. PTL! After the test they told us the real reason for going to IR was because they were afraid the left side of the liver was blocked, therefore dead or dying, and they were going to have to remove it.
Diane was able to catch Dr Jawa outside of Dave's room last night and ask a few questions, hoping to get some specific and honest answers. Basically what she found out is that the doctors are concerned that Dave is not progressing as they hoped he would and they are perplexed as to the reason or reasons for the lack of progression. Naturally this news was very discouraging. Please pray for Diane as this news was so hard to hear. Please pray she will be comforted by the Lord and in turn will be an encouragement to Dave.
Here is a head to toe analysis, it's been almost 3 weeks since the last one.
Head: The doctors are NO longer concerned that Dave may have brain damage! His speech is much improved and he still entertains us with his sense of humor!
Heart: Dave's blood pressure is tolerating HD, fast dialysis, very well. Dave has been getting blood transfusions on a regular basis during HD. This is a concern to the doctors because they aren't sure where the blood is going or why his body isn't replenishing it's own blood supply. They check for blood clots weekly and Dave hasn't had any since the clot in his left arm.
Lungs: Dave had .5 liters of fluid aspirated from his right lung on Monday of this week. This caused him much pain as they think they must have hit a nerve with the needle. The fluid was cultured and showed no infection last we knew, although they have to culture specimens for a few days. Dave's initial x-ray on Tuesday showed no more fluid, however, his latest x-ray showed there is fluid in the right lung again. This would mean that this part of the lung is considered collapsed again. And of course it's never good to have fluid on the lungs. Dave is no longer on the BiPAP machine.
Diaphragm: Dave is having hiccups often when he is awake. PTL, they are no longer painful! However, they are very annoying. Today the hiccups have taken on a new twist and seem to knock the wind out of him, not being able to breathe is upsetting! Sleeping, eating, and a drug with bad side effects seem to stop the hiccups temporarily. As you can imagine it's hard to fall asleep with the hiccups, it's hard to eat when you feel bloated, and Dave doesn't like to hallucinate or have bad dreams so he doesn't take the drug. Basically, it's pretty difficult to get rid of the pesky things!
Abdomen: Dave is down to 3 tubes! The t-tube is placed in the bile duct. One tube is in his lower abdomen to drain anything that may be leaking, mostly bile. The gastric tube is for Dave's liquid food because he is not able to consume an adequate diet orally. The incision and the holes from the other tubes are healing nicely.
Liver: Both the left and right sides of the liver are functioning ok. The CT scan today will give the doctors another look at the liver. Dave is still leaking bile which the doctors are hoping will be able to heal itself to a certain extent, but they will also have to do surgery sometime. The liver enzymes are slowly improving, a sign of a healing liver!
Pancreas: Dave still has pancreatitis but we haven't heard much from the doctors about this lately. They have mentioned a pancreatic pseudo cyst behind the pancreas. From my research a pancreatic pseudo cyst is the collection of fluid around the pancreas, usually consisting of pancreatic fluid that has leaked out of a damaged duct. The CT scan will give the doctors an update on the pancreas and the pseudo cyst.
Stomach: Dave has been upgraded to a "soft diet", although, milk, grape juice, and water are easier to get down and taste better than most food. He is still only eating a few tablespoons of food at a meal, he just gets full quickly. Dave vomited last night after he ate barely anything. Dave's stomach was so full he was leaking from the opening for the gastric tube. Dr Jawa came in and removed the remainder of the food in his stomach. He also stopped the liquid food for the night and used the gastric tube as a drain to prevent Dave's stomach from becoming too full again.
Digestive tract: The dye used in previous CT scans has shown that the dye works its way through the digestive tract, however, the doctors are wondering why the food doesn't pass through the digestive tract quicker.
Kidneys: Dave is still on dialysis about every other day. His kidneys seem to be producing more urine daily, however, not at a normal rate.
Bladder: Dave's bladder is functioning now, PTL!
Urinary tract: Dr Smith said Dave still has a low grade infection.
Left ankle: His ankle x-ray still showed a fracture line but he is able to put a little weight on it. This helps during PT when they have him stand. They haven't said anything more about surgery! He is still in his walking cast.
Right leg: Dave's right leg is still doing the brunt of the work when he stands in PT. Standing is less of a balancing act since he can now use his left leg to stabilize himself.
Isolation: Dave is still in isolation, gowns and gloves for all hospital staff. Most likely he will remain in isolation until he gets out of the hospital as a precaution for the other patients. Like one of the techs told us, this isn't all bad as Dave will always have a private room!
Discharge from UNMC: No time frames have been given for an anticipated discharge date. In fact, the doctors have not even brought up the subject.
Rehab: Dave will need to go to a rehab facility once he gets out of UNMC, hopefully Madonna in Lincoln. Dave understands the rehabilitation from this ordeal will be an ongoing uphill climb but he is ready to take on the challenge!
Future surgery: Dave will require another surgery to remove the t tube and/or repair the bile duct. We pray the surgery will only be to remove the t tube as the doctors have seen bile ducts repair themselves. Dr Jawa said last night that they would like to have Dave stable before doing another surgery, right now he is far from stable due to the many issues the doctors can't explain. Ideally they would like to wait until Dave is discharged from Madonna to perform the surgery.
Diane was able to catch Dr Jawa outside of Dave's room last night and ask a few questions, hoping to get some specific and honest answers. Basically what she found out is that the doctors are concerned that Dave is not progressing as they hoped he would and they are perplexed as to the reason or reasons for the lack of progression. Naturally this news was very discouraging. Please pray for Diane as this news was so hard to hear. Please pray she will be comforted by the Lord and in turn will be an encouragement to Dave.
Here is a head to toe analysis, it's been almost 3 weeks since the last one.
Head: The doctors are NO longer concerned that Dave may have brain damage! His speech is much improved and he still entertains us with his sense of humor!
Heart: Dave's blood pressure is tolerating HD, fast dialysis, very well. Dave has been getting blood transfusions on a regular basis during HD. This is a concern to the doctors because they aren't sure where the blood is going or why his body isn't replenishing it's own blood supply. They check for blood clots weekly and Dave hasn't had any since the clot in his left arm.
Lungs: Dave had .5 liters of fluid aspirated from his right lung on Monday of this week. This caused him much pain as they think they must have hit a nerve with the needle. The fluid was cultured and showed no infection last we knew, although they have to culture specimens for a few days. Dave's initial x-ray on Tuesday showed no more fluid, however, his latest x-ray showed there is fluid in the right lung again. This would mean that this part of the lung is considered collapsed again. And of course it's never good to have fluid on the lungs. Dave is no longer on the BiPAP machine.
Diaphragm: Dave is having hiccups often when he is awake. PTL, they are no longer painful! However, they are very annoying. Today the hiccups have taken on a new twist and seem to knock the wind out of him, not being able to breathe is upsetting! Sleeping, eating, and a drug with bad side effects seem to stop the hiccups temporarily. As you can imagine it's hard to fall asleep with the hiccups, it's hard to eat when you feel bloated, and Dave doesn't like to hallucinate or have bad dreams so he doesn't take the drug. Basically, it's pretty difficult to get rid of the pesky things!
Abdomen: Dave is down to 3 tubes! The t-tube is placed in the bile duct. One tube is in his lower abdomen to drain anything that may be leaking, mostly bile. The gastric tube is for Dave's liquid food because he is not able to consume an adequate diet orally. The incision and the holes from the other tubes are healing nicely.
Liver: Both the left and right sides of the liver are functioning ok. The CT scan today will give the doctors another look at the liver. Dave is still leaking bile which the doctors are hoping will be able to heal itself to a certain extent, but they will also have to do surgery sometime. The liver enzymes are slowly improving, a sign of a healing liver!
Pancreas: Dave still has pancreatitis but we haven't heard much from the doctors about this lately. They have mentioned a pancreatic pseudo cyst behind the pancreas. From my research a pancreatic pseudo cyst is the collection of fluid around the pancreas, usually consisting of pancreatic fluid that has leaked out of a damaged duct. The CT scan will give the doctors an update on the pancreas and the pseudo cyst.
Stomach: Dave has been upgraded to a "soft diet", although, milk, grape juice, and water are easier to get down and taste better than most food. He is still only eating a few tablespoons of food at a meal, he just gets full quickly. Dave vomited last night after he ate barely anything. Dave's stomach was so full he was leaking from the opening for the gastric tube. Dr Jawa came in and removed the remainder of the food in his stomach. He also stopped the liquid food for the night and used the gastric tube as a drain to prevent Dave's stomach from becoming too full again.
Digestive tract: The dye used in previous CT scans has shown that the dye works its way through the digestive tract, however, the doctors are wondering why the food doesn't pass through the digestive tract quicker.
Kidneys: Dave is still on dialysis about every other day. His kidneys seem to be producing more urine daily, however, not at a normal rate.
Bladder: Dave's bladder is functioning now, PTL!
Urinary tract: Dr Smith said Dave still has a low grade infection.
Left ankle: His ankle x-ray still showed a fracture line but he is able to put a little weight on it. This helps during PT when they have him stand. They haven't said anything more about surgery! He is still in his walking cast.
Right leg: Dave's right leg is still doing the brunt of the work when he stands in PT. Standing is less of a balancing act since he can now use his left leg to stabilize himself.
Isolation: Dave is still in isolation, gowns and gloves for all hospital staff. Most likely he will remain in isolation until he gets out of the hospital as a precaution for the other patients. Like one of the techs told us, this isn't all bad as Dave will always have a private room!
Discharge from UNMC: No time frames have been given for an anticipated discharge date. In fact, the doctors have not even brought up the subject.
Rehab: Dave will need to go to a rehab facility once he gets out of UNMC, hopefully Madonna in Lincoln. Dave understands the rehabilitation from this ordeal will be an ongoing uphill climb but he is ready to take on the challenge!
Future surgery: Dave will require another surgery to remove the t tube and/or repair the bile duct. We pray the surgery will only be to remove the t tube as the doctors have seen bile ducts repair themselves. Dr Jawa said last night that they would like to have Dave stable before doing another surgery, right now he is far from stable due to the many issues the doctors can't explain. Ideally they would like to wait until Dave is discharged from Madonna to perform the surgery.
Thursday, July 31, 2008
Thursday, July 31st
Dave's white blood count is at 6,200! His temperature is 99.7. Dave went down to interventional radiology this morning so they could take a look at the left side of his liver. Apparently they weren't able to see the left side last week in IR for some reason. They said the left side of his liver is looking okay. Dave had PT this morning and they had him stand twice. He also had wheelchair 101 during PT. Dave wheeled himself down the hallway and then had assistance in getting back to his room. He is definitely gaining strength daily! PTL. Dave asked for cottage cheese on Tuesday, which isn't part of the fluid diet. After Dr Stothert asked, "who even likes cottage cheese?" he wrote an order for a soft diet and specified on the order that that would include cottage cheese as well. Yesterday Dave had his cottage cheese! Since Tuesday they have upped Dave's liquid food intake to 20 cc/hr through the gastric tube. Dave has tolerated this well. Dave is pretty comfortable again today with continued bouts of random hiccup episodes. Dave continues to make progress, small steps at a time! We appreciate all the prayers.
Wednesday, July 30, 2008
Wednesday, July 30th
Dave's white blood count is up to 3,600!!!! His temperature is 99.7. Dr Smith, ID team, said Dave didn't have to worry about the bone marrow biopsy! PTL. He also said Dave has bile leaking in his abdomen. The bile is coming out both drain tubes, the t-tube designed to drain the bile and also the tube that drains from his abdomen. He said the trauma team is taking a "wait and see" approach, hoping the leak will heal itself. Dave was not in as much pain today and had fewer hiccup episodes! Dave had dialysis this morning for 4 hours. He can only have HD now that he is no longer in ICU. Dave had PT this afternoon and stood 3 times! The therapist said she can tell Dave is getting stronger and she is having to help support him less and less! Thank you for your continued prayers.
Tuesday, July 29, 2008
Tuesday, July 29th
Dave's white blood count is 3.2 today. His temperature is 101.5. Dr Smith, with the ID team, came in today and stated Dave may need to have a bone marrow biopsy because of his low white blood count, high temperatures, and history of cancer. Dave didn't like the idea of a bone marrow biopsy so Dr Smith said he would talk with the hemo team. The hemo team came in and said they will have to do a biopsy if the white blood count goes down or if there is a fever that they can't explain. The biopsy will be able to tell if there is actually an infection. It would also be able to tell if there was a tumor. The blood tests they ran a couple of weeks ago for cancer were negative, however, the white blood count pattern and high temperatures are still concerning and they must get to the bottom of the problem. Dave is still in a lot of pain from the injection site where the fluid was aspirated from his lung yesterday. Please continue to pray for Dave's comfort. Dave was able to have oatmeal (pureed) this morning, better than broth for breakfast!
Monday, July 28, 2008
Monday, July 28th
Dave had dialysis this morning for 4 hours. During dialysis they gave him 3 units of blood! This is the most blood he has received at one time since his huge surgery about 5 weeks ago. From dialysis they took him to Interventional Radiology to aspirate the fluid from his right lung. He finally got back to his room a little before 5:00. When he got back from IR he was in a tremendous amount of pain from the injection site. Dave rated his pain at a 10. They were able to give him a pain medication that made him more comfortable within 10 minutes. They aspirated .5 liters of fluid from his right lung. Radiology came in and x-rayed his lungs to see if they had removed all of the fluid, we don't know the results of the x-ray yet. Please pray that Dave's lungs will be fluid free.
Sunday, July 27th
Dave's white blood count is down to 3.1 (normal is 4-11). His highest temperature of the day was 101.4. Dr Stothert said the temperature may be due to the fluid in his right lung. He stated the fluid must be aspirated on Monday. Because of the fluid the right lung is considered collapsed. Dave had hiccups this morning for 3.5 hours until they gave him thorsene, which stopped the hiccups.
Saturday, July 26, 2008
Saturday, July 26
Dave started dialysis this morning at 7:45am. Since Dave is not in ICU anymore, they can not do bedside dialysis. Dave returned to the room around 1:00pm. The results for the CT scan yesterday show that bile is now moving into the intestine, this is good news! The Orthopedic team said that the x-ray of Dave's ankle showed that there is still a fracture, but Dave can begin to put some weight on his ankle. This will make physical therapy much easier for Dave. Dave is adjusting well to his new room, it is much quieter and much smaller! Dave and Diane have not made a decision yet about aspirating the lung. Please pray for Dave as he is not sleeping well, the nights are lonely for him as he just 'watches the clock and prays'. Praise God, He will never leave us nor forsake us. What a wonderful promise!
Friday, July 25, 2008
Friday, July 25th
Dave has officially moved to the telemetry floor, room 5477! Dave slept good last night with fewer interruptions than when he was in ICU! Last night he was running a temperature so they ran all labs again to see if they could culture out something. Today he is not running a temperature. Right now Dave is at interventional radiology to take a look at his bile ducts and t-tube. From IR he will go to dialysis for 4 hours. Dialysis no longer comes to his room since he moved from ICU. This morning's lung x-ray still showed fluid in the lower right lung. If the fluid has infection it could be a reason for the occasional high temperatures. Dr Young said sometimes time will take care of the problem. He would prefer but not insist on aspirating the fluid. Dr Young has given the decision of aspirating the fluid over to Dave and Diane. Please pray for wisdom in their decision. Kidney output increased again today!!!!!!
Thursday, July 24, 2008
Thursday, July 24th
PRAISE! PRAISE! PRAISE! PRAISE! PRAISE! PRAISE! PRAISE! PRAISE! Dave is no longer in ICU!!!!!!!!! He is in a modified intensive care bed. Actually he is still in his same room because they don't have a room available, but the care he is receiving is equivalent to the step down. Dave's white blood count is at 8,400 today, within normal range!!!!!!!!!! Dave was actually given real food to be taken orally! He got broth, jello, a popsicle, tea, and juice. He can only have 2 tablespoons per hour but this is definitely a step in the right direction!! Yesterday he was on SLED for 6 hours before he clotted off a little after 7:00pm. They decided not to restart dialysis even though the goal was 24 hours. They will do HD tomorrow. The orthopedic team had a second x-ray done of Dave's ankle. (The first was done the day after the accident.) We don't have the results back yet but please be praying that the ankle is healing as Dave really doesn't want to have surgery. They x-rayed his lungs twice today because they saw some fluid on the lower lungs. They may need to aspirate the fluid with a needle through his back. Please pray the aspiration won't be necessary. They put one new stitch around each of the 3 tubes still remaining in his abdomen to make sure the tubes were staying secure. Dave's kidneys have started to produce small amounts of urine! Each day he seems to be producing more than the day before. The renal doctors were pleased with this, however, they are still not promising full kidney function. Please continue to pray for Dave's kidneys to regain full function.
Wednesday, July 23, 2008
Wednesday, July 23rd
Dave's white blood count is down again, 12,300 (yesterday was 15,400)!!!! He does have a little bit of a temperature, 99.7. Dave was just put on SLED. They are wanting to leave him on dialysis for 24 hours as they didn't pull off enough fluid yesterday during HD. Dave already had PT and ST this morning. He stood up (with assistance) twice during PT! The infectious disease team decided to take Dave off Cipro, antibiotic for the mutant bacteria in his urine. The ID team said the Cipro killed all the bacteria (including the good) in Dave's stomach which allowed the C. difficile to become a problem. They haven't cultured anything out of his urine but he is still in "isolation" because of the C. difficile. Thanks for your continued prayers!!!!!
Tuesday, July 22, 2008
Tuesday, July 22nd
Dave had HD (fast dialysis) today and his blood pressure remained stable!! Doctors have told us as soon as he can tolerate HD they will be able to move him from ICU to a regular bed. Dave had 2 units of blood and was also given iron during dialysis. We have not yet received the results of the CT scan from Monday. They did culture out the bacteria Clostridium difficile from Dave's stool. They are treating this with Flagyl, a very strong antibiotic. Dave is getting 6 cc of "food" through his feeding tube, however, the "food" is no longer being diluted! Dave has been really tired today, dialysis always wears him out. PT and ST are to come in later this afternoon. Dave's temperature is looking good at 97.7!
Monday, July 21, 2008
Monday, July 21st
We hope you all had a great weekend. Dave had a couple days off of dialysis, which I think he enjoyed. Dave is uncomfortable right now, he just had a CT scan this morning and taking in all the contrast always makes him feel 'full'. Dave is about to get another unit of blood as well. The CT scan was done because the doctors can't determine why Dave is requiring blood transfusions on almost a daily basis. Previous scans haven't shown internal bleeding. Please pray that the doctors again 'have the eyes of God'. At 12:30 he will go down to intervention radiology and have a tunnel catheter put in. Dave had a kind of 'temporary' catheter for dialysis before, but they are prone to be an entry point for bacteria, so his was removed and he will get his new one today. The tunnel catheter is a more permanent type and should be more comfortable as well as safer. After the procedure to place the catheter, they will try to put Dave on dialysis, but his blood pressure and clotting off has prevented any long run of dialysis lately. Thank you for your continued prayers.
Sunday, July 20, 2008
Sunday, July 20th
Morning update: This morning, Dave's WBC is 20,000. Getting closer to normal range, PTL! Dave's hemoglobin is down this morning. It is 7.6, the lowest it has been. The doctors are a little baffled as to why Dave's hemoglobin is low. Dave will receive more blood today. Dave will have PT today. Please continue to pray for Dave's physical strength. He often gets discouraged during PT due to his lack of strength. Dave was nauseous this morning and threw up. Please continue to pray for his upset stomach. On a side note, since I went back to work, Jiree has been updating the blog during the week. Thanks sis!
Saturday, July 19, 2008
Saturday, July 19th
Yesterday, Dave was on dialysis for a full 12 hours. That was great, thank you for you prayers. Dave's WBC is 23,700. Today was a pretty good day. Dave was fairly comfortable throughout the day. The blood clot in Dave's arm has improved and is not as hard and red as it was before. Dr Stothert put in a new PICC line and removed Dave's dialysis catheter. On Monday, they plan to put in a tunnel catheter, which has a lesser chance of becoming infected. This is a more permanent solution for dialysis. The doctors are still confident that Dave's kidneys will begin normal function.
Friday, July 18, 2008
Friday, July 18th
Morning update: Dave's white blood count went up a little to 28,100. His temperature is 99.0. Dave clotted off during the night so SLED was stopped. They are going to start SLED again today and are wanting to get 12 hours so they can remove the dialysis port and give him a break over the weekend. Dave is pretty miserable right now. His stomach is feeling very full. Yesterday his digestive tract wasn't moving very much. They have decided to do a CT scan to check his stomach and digestive tract around 11:30ish. In order to do the CT scan they have to give Dave contrast which always makes him feel uncomfortably full. Please pray Dave will be able to tolerate the contrast and that his digestive system would start working.
Evening update: The results from Dave's CT scan showed that the contrast had made it's way through the digestive tract! Which was great news, but Dave wasn't feeling any better. He had a coughing spell which initiated the gag reflex and he ended up throwing up. So they decided they would drain what was left in Dave's stomach through the gastric tube. Needless to say Dave started feeling better. The ultrasound Dave had on Wednesday showed that his portal vein (going into the liver) was functioning at what the doctors would consider a normal level!!! PTL! The right side of his liver is doing better than the left side and there is still a portion of the liver the doctors say is dying and will have to be removed in a future surgery. Overall, great news on the liver! The pancreatitis is getting better but still existing. Please continue to pray the pancreatitis will calm down. We haven't updated you on the number of tubes Dave has coming out of his abdomen lately...he is down to 3! They consist of one of the original JP tubes (from North Platte), the gastric tube, and the T tube (draining the bile from his liver). Dave was on SLED for the afternoon and then clotted off. Because he wasn't on for 12 hours they started SLED again tonight. Please pray Dave will be able to tolerate SLED in order to reach the desired 12 hours on dialysis.
Evening update: The results from Dave's CT scan showed that the contrast had made it's way through the digestive tract! Which was great news, but Dave wasn't feeling any better. He had a coughing spell which initiated the gag reflex and he ended up throwing up. So they decided they would drain what was left in Dave's stomach through the gastric tube. Needless to say Dave started feeling better. The ultrasound Dave had on Wednesday showed that his portal vein (going into the liver) was functioning at what the doctors would consider a normal level!!! PTL! The right side of his liver is doing better than the left side and there is still a portion of the liver the doctors say is dying and will have to be removed in a future surgery. Overall, great news on the liver! The pancreatitis is getting better but still existing. Please continue to pray the pancreatitis will calm down. We haven't updated you on the number of tubes Dave has coming out of his abdomen lately...he is down to 3! They consist of one of the original JP tubes (from North Platte), the gastric tube, and the T tube (draining the bile from his liver). Dave was on SLED for the afternoon and then clotted off. Because he wasn't on for 12 hours they started SLED again tonight. Please pray Dave will be able to tolerate SLED in order to reach the desired 12 hours on dialysis.
Thursday, July 17th
Sorry for the late entry, thank you for your faithfulness in checking the blog and keeping Dave in your prayers. We believe prayer changes things! :)
Dave's white blood count is down to 27,800! His temperature is 98.8!!! Dave was able to take a wheelchair ride outside today and enjoy God's creation for 15 minutes! He was refreshed and definitely worn out after the trip. No ST or OT today as Dave was tuckered out. Dave went down to Interventional Radiology (IR) to make sure his tubes are draining properly. They decided one more tube could come out! Dave started SLED again today, they are hoping they will be able to leave him on dialysis for 24 hours, taking him off sometime on Friday. They still have not put in a new catheter to replace the infected PICC line. They new plan is after dialysis on Friday they will take out the dialysis port, and thus the piggyback line Dave was getting his IV nutrition through. Dave will not have dialysis on Saturday or Sunday giving his body a chance to heal and get rid of any infections, especially the urine infection. On Monday they will place a new dialysis port and a separate new catheter for IV use. Dave didn't get any "food" all day until 8:30pm because he was feeling very full. He started getting 10 cc/hr and was able to tolerate this as of 1:00am. Please pray Dave will be able to digest the food put in his gastric tube.
Dave's white blood count is down to 27,800! His temperature is 98.8!!! Dave was able to take a wheelchair ride outside today and enjoy God's creation for 15 minutes! He was refreshed and definitely worn out after the trip. No ST or OT today as Dave was tuckered out. Dave went down to Interventional Radiology (IR) to make sure his tubes are draining properly. They decided one more tube could come out! Dave started SLED again today, they are hoping they will be able to leave him on dialysis for 24 hours, taking him off sometime on Friday. They still have not put in a new catheter to replace the infected PICC line. They new plan is after dialysis on Friday they will take out the dialysis port, and thus the piggyback line Dave was getting his IV nutrition through. Dave will not have dialysis on Saturday or Sunday giving his body a chance to heal and get rid of any infections, especially the urine infection. On Monday they will place a new dialysis port and a separate new catheter for IV use. Dave didn't get any "food" all day until 8:30pm because he was feeling very full. He started getting 10 cc/hr and was able to tolerate this as of 1:00am. Please pray Dave will be able to digest the food put in his gastric tube.
Wednesday, July 16, 2008
Wednesday, July 16th
Morning update: Dave's white blood count is down again, 38,800! His temperature is 99.9!
Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST) were all in to see Dave yesterday afternoon and again this morning.
- PT - They assisted Dave to a standing position and moved him to a chair. He sat for 1 1/2 hours yesterday and 2 hours today.
- OT - They did exercises to strengthen his arms and legs.
- ST - They did an evaluation yesterday and now know what to focus on for the days ahead. Dave was discouraged but is willing to work hard. All 3 forms of therapy back to back completely tucker Dave out! It is good to see him working so hard!
Dave was put in "isolation" yesterday as the culture from his urine sample is a mutant form of bacteria. Dave is already on Cipro (antibiotic) and they think this will take care of the problem. "Isolation" just means the hospital staff have to wear gloves and long sleeved gowns over their clothes whenever they are in his room for the safety of the other patients they treat.
They did find a blood clot in Dave's left arm where the PICC line had been. They are treating this by putting a heating pad around his arm. Because of this blood clot Dave needs a new IV line or port. The different teams of doctors put their heads together yesterday to come up with an acceptable place to put the line/port. We were told it was a "balancing act where all the choices are NOT optimal". After much discussion they decided yesterday to put in a femoral line (in his groin), this was not ideal because there is a high chance for infection and this would only be a temporary solution. Today they came in and said they are going to use the dialysis piggyback line that is already in as Dave has developed a rash. This piggyback line is also only a temporary solution. Please pray this dialysis port will be able to endure everything and the doctors will be able to come up with a line/port solution they are confident about.
Yesterday they gave Dave 5 cc per hour of food (fiber & nutrients in a semi-thick consistency) through his gastric tube. He was able to tolerate this so today they are giving him 10 cc per hour, again through the gastric tube. The only things Dave has taken orally are water, ice, and Diet Dr Pepper. Please pray Dave will be able to tolerate the "food" because the TPN, IV nutrition, is hard on the liver and also makes the new IV line/port dilemma more of an issue.
The hemo (blood) team was in yesterday and explained Dave's white blood count roller coaster ride. The initial skyrocket increase was due to Dave's horrific trauma. The decrease was because Dave was on 3 different antibiotics. A side effect of all 3 antibiotics is a decrease in white blood cells. The next increase was due to taking Dave off of the antibiotics because they thought he was allergic to one or more of the medications. The hemo team assured us all the increases and decreases in his white blood count are to be expected with trauma of this magnitude but it was abnormal that the count went as high as it did (86,000). All of that said, these increases and decreases look like a pattern in a cancer patient so they are running tests to rule out cancer. They assured us they are very confident Dave does NOT have cancer but they must rule that out in order to continue with his care.
Dave started SLED dialysis again today. Please pray that Dave's blood pressure will not drop.
The infectious disease (ID) docs were in today and stated the rash on Dave's abdomen has returned. It may be due to an allergic reaction. They had changed their minds on the initial thought of an allergic reaction but because the rash is back they will look into it further. Dave also has a red area on his left (broken) ankle that ID said they would keep an eye on.
Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST) were all in to see Dave yesterday afternoon and again this morning.
- PT - They assisted Dave to a standing position and moved him to a chair. He sat for 1 1/2 hours yesterday and 2 hours today.
- OT - They did exercises to strengthen his arms and legs.
- ST - They did an evaluation yesterday and now know what to focus on for the days ahead. Dave was discouraged but is willing to work hard. All 3 forms of therapy back to back completely tucker Dave out! It is good to see him working so hard!
Dave was put in "isolation" yesterday as the culture from his urine sample is a mutant form of bacteria. Dave is already on Cipro (antibiotic) and they think this will take care of the problem. "Isolation" just means the hospital staff have to wear gloves and long sleeved gowns over their clothes whenever they are in his room for the safety of the other patients they treat.
They did find a blood clot in Dave's left arm where the PICC line had been. They are treating this by putting a heating pad around his arm. Because of this blood clot Dave needs a new IV line or port. The different teams of doctors put their heads together yesterday to come up with an acceptable place to put the line/port. We were told it was a "balancing act where all the choices are NOT optimal". After much discussion they decided yesterday to put in a femoral line (in his groin), this was not ideal because there is a high chance for infection and this would only be a temporary solution. Today they came in and said they are going to use the dialysis piggyback line that is already in as Dave has developed a rash. This piggyback line is also only a temporary solution. Please pray this dialysis port will be able to endure everything and the doctors will be able to come up with a line/port solution they are confident about.
Yesterday they gave Dave 5 cc per hour of food (fiber & nutrients in a semi-thick consistency) through his gastric tube. He was able to tolerate this so today they are giving him 10 cc per hour, again through the gastric tube. The only things Dave has taken orally are water, ice, and Diet Dr Pepper. Please pray Dave will be able to tolerate the "food" because the TPN, IV nutrition, is hard on the liver and also makes the new IV line/port dilemma more of an issue.
The hemo (blood) team was in yesterday and explained Dave's white blood count roller coaster ride. The initial skyrocket increase was due to Dave's horrific trauma. The decrease was because Dave was on 3 different antibiotics. A side effect of all 3 antibiotics is a decrease in white blood cells. The next increase was due to taking Dave off of the antibiotics because they thought he was allergic to one or more of the medications. The hemo team assured us all the increases and decreases in his white blood count are to be expected with trauma of this magnitude but it was abnormal that the count went as high as it did (86,000). All of that said, these increases and decreases look like a pattern in a cancer patient so they are running tests to rule out cancer. They assured us they are very confident Dave does NOT have cancer but they must rule that out in order to continue with his care.
Dave started SLED dialysis again today. Please pray that Dave's blood pressure will not drop.
The infectious disease (ID) docs were in today and stated the rash on Dave's abdomen has returned. It may be due to an allergic reaction. They had changed their minds on the initial thought of an allergic reaction but because the rash is back they will look into it further. Dave also has a red area on his left (broken) ankle that ID said they would keep an eye on.
Tuesday, July 15, 2008
Tuesday, July 15th
Morning update: Dave's white blood count went down to 41,000!!! His temperature is at 99.3! Because Dave's hiccups lasted sooooo long they have not put in a central line yet. However, Dave doesn't have hiccups today! They put a temporary line in his right wrist, which they have already taken out and put back again. They are still wanting to do the central line. We don't have any word on the results from the possible blood clot in his left arm. We've asked, more than once :), and we still don't know. Dave is very tired this morning because of dialysis. They would like to be able to keep him on dialysis for 24 hours. Please pray the dialysis is effective.
Monday, July 14, 2008
Monday, July 14th
Morning update: Dave's white blood count is at 50,000. His temperature is 99.1!!!! Dave sat up for the first time in a chair! He was able to sit for 2 1/2 hours. This made him very tired but he said it was encouraging to him to be able to sit up. They are going to start SLED (slow dialysis) late this afternoon. Dr Jawa was in and said they need to remove the PICC line (for IV fluids) from Dave's left arm as it has been in too long. Dave has quit using his left arm because of the line, but hasn't complained of any pain in the arm. Dave has had the hiccups for over 2 hours now. Dr Jawa wants to put a central line in to replace the PICC line but due to Dave's hiccups putting a central line in is too dangerous. (Dave had a central line prior to the PICC line.) They discussed moving the PICC line from his left arm over to his right arm but they would like to save his veins for future dialysis needs. Please pray Dave's hiccups would stop so they can put in a central line. Thank you for your prayers!
Evening update: Over the course of the afternoon, the doctors determined that the PICC line was infected. They also think that Dave's left arm (the one with the PICC line) may have a blood clot. Dave had an ultrasound of his arm to determine if indeed he has a blood clot and the size and location of the clot. We have not received any results yet. The doctors said that regardless if he has a clot or not, the PICC line must come out. They removed the PICC line. They are temporarily using the same catheter that they use for dialysis to give Dave his IV. Please pray for wisdom for the doctors as they make decisions about the possible blood clot and also as they decide where to relocate the PICC line. Please continue to pray for Dave, it is 10:15pm and he still has the hiccups.
Evening update: Over the course of the afternoon, the doctors determined that the PICC line was infected. They also think that Dave's left arm (the one with the PICC line) may have a blood clot. Dave had an ultrasound of his arm to determine if indeed he has a blood clot and the size and location of the clot. We have not received any results yet. The doctors said that regardless if he has a clot or not, the PICC line must come out. They removed the PICC line. They are temporarily using the same catheter that they use for dialysis to give Dave his IV. Please pray for wisdom for the doctors as they make decisions about the possible blood clot and also as they decide where to relocate the PICC line. Please continue to pray for Dave, it is 10:15pm and he still has the hiccups.
Sunday, July 13, 2008
Sunday, July 13th
Morning update: Praise that Dave is more awake and less confused this morning. Dr Young said that the sleepiness could have been caused by the benadryl Dave had been taking for the rash (which is completely gone now!). Dave is now off benadryl and also off Fentanoyl, pain medication because it could make his mind a little 'foggy'. Dave's white blood count is up again, 39,000. Dr Young said that this is probably due to the liver and pancreas being inflamed. A doctor from the hemo (blood) team is going to come up and check on Dave today, just as a precaution due to the high WBC. Dr Young said that there is no change in Dave's liver, there is still a small part that will probably die. Dave will not be on dialysis today! Yesterday he was on for a little over eleven hours. The doctors were satisfied with the results and are giving Dave a much needed break from dialysis. He had been on for 14 days straight. We found out this morning that Dave has bacteria in his urine. The doctors started Dave on an antibiotic. Please pray that the antibiotic clears the infection with no side effects. Dave is on the BiPAP machine right now. He is tolerating it fairly well. Last night, they started to put the mask on and due to the nausea from the food and difficulty breathing, Dave threw up and was pretty uncomfortable for a while. Please continue to pray for peace for Dave.
Evening update: No changes to report tonight, except Dave's temperature is 101.7. Dave has a cooling blanket on right now. Please pray that his temp will go down.
Evening update: No changes to report tonight, except Dave's temperature is 101.7. Dave has a cooling blanket on right now. Please pray that his temp will go down.
Saturday, July 12, 2008
Saturday, July 12th
Morning update: Dave's white blood count is 39,000. The ID doctors said high (within reason) is better than extremely low. His temperature is 100.8. Dave didn't have any heart issues last night, praise God! He is going to have SLED dialysis again today. Dave's kidney readings did not improve from the last dialysis. Please pray Dave will be able to tolerate dialysis and that his kidney readings would improve. Dave's hemoglobin is still too low so they will be giving him a unit of blood today. In order to get better sleep last night they didn't put Dave on the by-pap machine, he was glad to be rid of that even for a little while. Dave stood 3 times (assisted) today in PT! Thank you for your prayers and support, you are such an encouragement to us!
Evening update: We are mixing it up tonight and using a different format. We will give an update starting from Dave's head, all the way to his toes...
'Head': Dave was very, very sleepy today, and has been the last few days. The doctors have took him off many medications, hoping to wake him up a little bit. Dave still responds to questions and occasionally asks a question, but he is more confused now then in the past. Please continue to pray for this.
Heart: Dave has not had any more irregular heart beats today. His heart rate and blood pressure have tolerated dialysis today. Thank you Lord!
Lungs: Dave's upper lungs are functioning very well! However, his lower lobes are not. Dave has been using a BIPAP machine 2 hours on, 2 hours off to strengthen his lungs. BIPAP (Bi-level Positive Airway Pressure) machine is a breathing assistance device which is worn over the mouth or nose, in Dave's case the nose. We have included a picture we found on google, it is basically exactly like Dave's.
Abdomen: Dave has 5 tubes in his abdomen. The doctors are slowly taking the tubes out one inch at a time. Eventually, as drainage continues to decrease, the doctors will completely pull the tubes out.
Liver: We don't have any updates at this time, but please continue to pray for the function of Dave's liver.
Pancreas: Dave still has pancreatitis, but it is slowly improving.
Stomach/Digestive tract: Dave received more 'food', through his gastric tube. He wasn't able to digest quickly enough, so they stopped for today and will continue again tomorrow.
Kidneys: PTL Dave has been on dialysis for 9 hours so far, without clotting off. The doctors would like him to stay on for three more hours tonight. Please pray that Dave's numbers would improve and that dialysis would be effective.
Left ankle: Dave still has a walking cast. The doctors will x-ray in a couple of weeks to see if the broken bones have healed or if it will require surgery.
Evening update: We are mixing it up tonight and using a different format. We will give an update starting from Dave's head, all the way to his toes...
'Head': Dave was very, very sleepy today, and has been the last few days. The doctors have took him off many medications, hoping to wake him up a little bit. Dave still responds to questions and occasionally asks a question, but he is more confused now then in the past. Please continue to pray for this.
Heart: Dave has not had any more irregular heart beats today. His heart rate and blood pressure have tolerated dialysis today. Thank you Lord!
Lungs: Dave's upper lungs are functioning very well! However, his lower lobes are not. Dave has been using a BIPAP machine 2 hours on, 2 hours off to strengthen his lungs. BIPAP (Bi-level Positive Airway Pressure) machine is a breathing assistance device which is worn over the mouth or nose, in Dave's case the nose. We have included a picture we found on google, it is basically exactly like Dave's.
Abdomen: Dave has 5 tubes in his abdomen. The doctors are slowly taking the tubes out one inch at a time. Eventually, as drainage continues to decrease, the doctors will completely pull the tubes out. Liver: We don't have any updates at this time, but please continue to pray for the function of Dave's liver.
Pancreas: Dave still has pancreatitis, but it is slowly improving.
Stomach/Digestive tract: Dave received more 'food', through his gastric tube. He wasn't able to digest quickly enough, so they stopped for today and will continue again tomorrow.
Kidneys: PTL Dave has been on dialysis for 9 hours so far, without clotting off. The doctors would like him to stay on for three more hours tonight. Please pray that Dave's numbers would improve and that dialysis would be effective.
Left ankle: Dave still has a walking cast. The doctors will x-ray in a couple of weeks to see if the broken bones have healed or if it will require surgery.
Right leg: We mentioned it this morning, but Dave stood 3 times today. What we didn't mention is that because Dave's left ankle is broken and in a cast, Dave can not put any weight on his left foot. So when he stands, he is actually balancing on one leg, (I can't even do that!)
Friday, July 11, 2008
Friday, July 11th
Morning update: Dave's white blood count is at 28,000, again with the help of medicine. They won't be giving him that medicine for a while to see if the white blood count will level itself out. His temperature is hanging in at 100.2. The kidney doctors were in today and said they were pleased Dave was still hooked up to dialysis (almost 24 hrs). They are happy they were able to remove fluid, but Dave's blood pressure continues to remain low while on dialysis. They look to do dialysis again tomorrow. The infectious disease (ID) doctors came in and said things are looking good. The ID doctors said they cultured an organism from one of Dave's tubes but they aren't too concerned. The organism is very resistant and they stated they are "not going to chase it", some organisms in the body are normal. The little bit of "food" given to Dave yesterday through his gastric tube upset his stomach causing distention and a couple hours of severe pain. Dr Stothert came in last night and said he was hoping Dave's liver would be functioning better by now. He was expecting some of the yellow in Dave's skin to be diminished by this time. The liver numbers are basically remaining the same and haven't improved for a couple of days. Please continue to pray for Dave's liver. I don't think we mentioned, Dave got his staples out a couple of days ago! Dave is still doing on 2 hours, off 2 hours with the by-pap machine. As much as he loathes this treatment he did admit yesterday (after being asked) that he can tell a difference, it makes his breathing off the machine easier. Thank you for your diligent prayers!
Evening update: Dave had PT this afternoon and sat up for a few minutes. Lora, the PT, let him get past his dizziness and then had him stand. Dave stood, with assistance, for 30 seconds!!! Huge accomplishment for someone who's been in bed for so long. Then Lora had him sit up for about 45 minutes. He was tuckered out, sitting and standing is hard work! Dave gave us a scare this evening. He had some irregular heart beats, everything started beeping and his room was full of ICU staff. They x-rayed his chest, which came back normal. They did an EKG, which also came back normal. They aren't sure what caused the irregular beats but his heart is beating normal now. Thank the Lord!
Evening update: Dave had PT this afternoon and sat up for a few minutes. Lora, the PT, let him get past his dizziness and then had him stand. Dave stood, with assistance, for 30 seconds!!! Huge accomplishment for someone who's been in bed for so long. Then Lora had him sit up for about 45 minutes. He was tuckered out, sitting and standing is hard work! Dave gave us a scare this evening. He had some irregular heart beats, everything started beeping and his room was full of ICU staff. They x-rayed his chest, which came back normal. They did an EKG, which also came back normal. They aren't sure what caused the irregular beats but his heart is beating normal now. Thank the Lord!
Thursday, July 10, 2008
Thursday, July 10th
Morning update: Dave's white blood count is at 6,900 (with the help of medicine)!!!! His temperature is at 100.6, this is better than yesterday! Dave did SLED dialysis for 4 hours yesterday and then clotted so they hooked him up for another round and he clotted again after another 4 hours. So a total of 8 hours, the clotting is normal, this is how they determine when to stop the dialysis unless of course his body clots too soon then they hook him back up again. :) Dave started SLED today already. Please pray Dave will be able to tolerate the dialysis today. The doctors were concerned because his blood pressure is so low and dialysis tends to drop it further. Dave is going to be on the by-pap (breathing) machine today for 2 hours, have it off for 2 hours, and then back on for another 2 hours. They are doing this to hopefully prevent from putting him back on the ventilator. The by-pap makes Dave very anxious. Please pray he will be able to tolerate the discomfort. Last night they started Dave on a small dose of liquid food through his gastric tube. This did make him a little bit nauseous but he was able to keep it all down! They have decided to give Dave a little bit of ice and water each hour and then every couple of hours alternate with Diet Dr Pepper! He has been asking for pop, but obviously told absolutely not! They don't look for Dave to enjoy the pop, but at least he will get the small satisfaction of being able to do something he could before the accident. The nurse told us yesterday that Dave produced twice the amount of urine on Tuesday and Wednesday that he had been producing in previous days, PTL! Please keep praying his kidneys will begin to function as they should as they are still labeling the situation as acute renal failure. Dave had occupational therapy again yesterday. The OT asked Dave to do 10 of each exercise. You know Dave...he did 11 of each exercise, what a guy!!!! Thank you for your continued prayers. Dave is making baby steps with the Lord's help.
Wednesday, July 9, 2008
Wednesday, July 9th
Morning update: We will give you a more detailed update later, but for now... everything is about the same. Dave's white blood count is 1,800 and his temperature is 101.3. Today he had physical and occupational therapy, a ventilation treatment, and he will have dialysis later. Thanks for your continued prayers, Dave appears to be a little more comfortable today.
Evening update: Dave took a trip down to Intervention Radiology where they did a fluid draw on his abdomen. The doctors found significantly more fluid than they thought they would find, so they placed another drain tube and sent samples to the lab. We are still waiting for the results. Dave was in a lot of pain this afternoon after the procedure, but he seems more relaxed now. The doctors started Dave on medication to raise his white blood count. He has been on dialysis all afternoon and is extremely exhausted. Sorry we are slow getting this information out, but we are thankful that the Lord knows the specifics of our requests! What a mighty God we serve!
Evening update: Dave took a trip down to Intervention Radiology where they did a fluid draw on his abdomen. The doctors found significantly more fluid than they thought they would find, so they placed another drain tube and sent samples to the lab. We are still waiting for the results. Dave was in a lot of pain this afternoon after the procedure, but he seems more relaxed now. The doctors started Dave on medication to raise his white blood count. He has been on dialysis all afternoon and is extremely exhausted. Sorry we are slow getting this information out, but we are thankful that the Lord knows the specifics of our requests! What a mighty God we serve!
Tuesday, July 8, 2008
Tuesday, July 8th
Morning update: Sorry there wasn't an update posted last night. Today Dave's white blood count is 1,500 which is down from yesterday morning, but up from last night (1,100). His temperature this morning is 101.7, this is better than yesterday as well. On Monday Dave received 2 units of blood. He started dialysis in the morning but it was stopped due to his blood pressure dropping to 79/50. The doctors are wanting to due dialysis today, but haven't decided if they will do HD (fast) or SLED (slow). Dave has a CT scan this morning at 9:00. This is something that he has been worrying about since last night because of the discomfort the contrast they put in his stomach causes. Please pray the CT scan will go well and not cause Dave to be anxious. Dr Young would like to remove 2 tubes depending on the results of the CT scan. Sometimes Dave's speech is slow, as he searches for the correct words to use. We have noticed the slower speech comes when he is in pain and when he is running a high temperature. They have assured us the slow speech will improve as his body continues to heal. This morning Dave had a painful bout with the hiccups for 45 minutes. As you can imagine with all the trauma, even something as "small" as a hiccup is excruciating.
9:00 AM
One of the Infectious Disease doctors just came in and said the blood culture is growing something. They will have to wait for the culture to continue growing before they will be able to decipher what is actually growing. Dave will have to go back on antibiotics. The doctors don't know what he was allergic to (causing the rash). Please pray for wisdom for the doctors in choosing the correct antibiotic. Dave's CT scan has been pushed back to 9:30 AM.
Evening update: After a second look of the cultures, the Infectious Disease doctors determined that there is NOT anything growing out of the blood cultures. Dr Rupp still feels that the low white blood count, high temperature (it reached 103.8 today!), and rash may be a result of a bad reaction to an antibiotic. Dr Rupp will do a biopsy of the rash.
The results of the CT scan done this morning show that everything looks basically the same, except the areas of fluid may be larger. Tomorrow they plan to culture these areas, possibly drain them or place drain tubes. Dave was on dialysis today for four hours before the machine clotted off. They plan to start dialysis again tomorrow and hope to have a longer run. Tonight Dr Young removed one drain tube. I believe that brings the total down to 6 tubes in Dave's abdomen. Dave's vitals remain stable, he is no longer on oxygen, but is still requiring ventilation treatments two out of every six hours. Please pray continue to pray for wisdom for the doctors and healing for Dave.
9:00 AM
One of the Infectious Disease doctors just came in and said the blood culture is growing something. They will have to wait for the culture to continue growing before they will be able to decipher what is actually growing. Dave will have to go back on antibiotics. The doctors don't know what he was allergic to (causing the rash). Please pray for wisdom for the doctors in choosing the correct antibiotic. Dave's CT scan has been pushed back to 9:30 AM.
Evening update: After a second look of the cultures, the Infectious Disease doctors determined that there is NOT anything growing out of the blood cultures. Dr Rupp still feels that the low white blood count, high temperature (it reached 103.8 today!), and rash may be a result of a bad reaction to an antibiotic. Dr Rupp will do a biopsy of the rash.
The results of the CT scan done this morning show that everything looks basically the same, except the areas of fluid may be larger. Tomorrow they plan to culture these areas, possibly drain them or place drain tubes. Dave was on dialysis today for four hours before the machine clotted off. They plan to start dialysis again tomorrow and hope to have a longer run. Tonight Dr Young removed one drain tube. I believe that brings the total down to 6 tubes in Dave's abdomen. Dave's vitals remain stable, he is no longer on oxygen, but is still requiring ventilation treatments two out of every six hours. Please pray continue to pray for wisdom for the doctors and healing for Dave.
Monday, July 7, 2008
Monday, July 7th
Morning update: Dave's white blood cell count is up to 1,800, still below normal. His temperature is at 103.2. Dave is receiving dialysis for 4 hours today. The renal doctors came in today with the results of the URR (kidney function) test. They are concerned because Dave has been on dialysis for 6 days in a row and normal protocol is 2 days on and 1 day off. Their conclusion was that Dave is still very ill and they are hopeful that dialysis will not be a permanent need. The infectious disease doctors are still working on Dave's case but they haven't been able to pinpoint anything yet. Dave continues with the ventilation support for 2 hours at a time every 6 hours. The results from the ultrasound yesterday shows that the blood flow to the liver still looks good. Thank you for your continued prayers.
Sunday, July 6, 2008
Sunday, July 6th
Morning update: It has been a busy morning. Dave has already completed a two hour ventilation treatment. This is uncomfortable for Dave and very frustrating because he can't talk during this time. Dave also had physical therapy, he sat on the side of the bed. He said he didn't experience any more pain while sitting up, just a little light headed.
Dave's white blood count is now below normal, 2,900. Dave has also developed a rash on this stomach and arms. Combined with a continuous high temperature, the doctors have become concerned. Infectious disease doctors, Dr Dewitt and Dr Rupp came in separately and looked everything over. Dr Rupp double checked to make sure Dave was on the correct medication, they already took him off a couple antibiotics. Dr Rupp said that he believes that the white blood count will increase and the rash will fade in 1-2 days. Dr Rupp also confirmed that they didn't find anything too abnormal on the CT scan. Please continue to pray for wisdom for the doctors.
Dave's hemoglobin is not as high as the doctor would like it to be considering all the blood he received yesterday. Today Dave has started sled dialysis (the slow kind) and will be on for many hours. During this time, Dave will also receive several units of blood.
We have had several people ask about donating blood for Dave. We have talked to the doctors about this and they said the testing process is pretty long. So the best thing to do is to just go to your local blood bank and donate!
More updates to follow...
Evening update: Dave was on dialysis this afternoon for five hours but it was cut short due to some clots in the dialysis machine (this is very normal). Due to the internal bleeding episode yesterday, Dave is now off blood thinners. They plan to start dialysis again sometime tonight, but will give Dave a small dose of blood thinners to prevent clotting in the machine. Please pray that Dave will be able to continue on dialysis long enough to have some positive results. The doctors also took an ultrasound of the liver this afternoon to make sure it is still functioning properly. We hope to have the results later on tonight. Dave's white blood count is now 1,600. Please pray that this will increase. Dave is currently doing another ventilation treatment. The respiratory therapist gave Dave a different type of mask, it just goes over his nose so he is still
able to talk.
We are praying that we will be able to report a higher white blood count tomorrow morning...
Dave's white blood count is now below normal, 2,900. Dave has also developed a rash on this stomach and arms. Combined with a continuous high temperature, the doctors have become concerned. Infectious disease doctors, Dr Dewitt and Dr Rupp came in separately and looked everything over. Dr Rupp double checked to make sure Dave was on the correct medication, they already took him off a couple antibiotics. Dr Rupp said that he believes that the white blood count will increase and the rash will fade in 1-2 days. Dr Rupp also confirmed that they didn't find anything too abnormal on the CT scan. Please continue to pray for wisdom for the doctors.
Dave's hemoglobin is not as high as the doctor would like it to be considering all the blood he received yesterday. Today Dave has started sled dialysis (the slow kind) and will be on for many hours. During this time, Dave will also receive several units of blood.
We have had several people ask about donating blood for Dave. We have talked to the doctors about this and they said the testing process is pretty long. So the best thing to do is to just go to your local blood bank and donate!
More updates to follow...
Evening update: Dave was on dialysis this afternoon for five hours but it was cut short due to some clots in the dialysis machine (this is very normal). Due to the internal bleeding episode yesterday, Dave is now off blood thinners. They plan to start dialysis again sometime tonight, but will give Dave a small dose of blood thinners to prevent clotting in the machine. Please pray that Dave will be able to continue on dialysis long enough to have some positive results. The doctors also took an ultrasound of the liver this afternoon to make sure it is still functioning properly. We hope to have the results later on tonight. Dave's white blood count is now 1,600. Please pray that this will increase. Dave is currently doing another ventilation treatment. The respiratory therapist gave Dave a different type of mask, it just goes over his nose so he is still
able to talk.
We are praying that we will be able to report a higher white blood count tomorrow morning...
Subscribe to:
Posts (Atom)
.JPG)
.JPG)
