Monday, June 30th

Morning update: Dave's white blood cell count is 73,000!!!! Wooohooo! The blood pressure and heart rate are good and his temperature is 99.9.
The doctors ran a fluorescent dye test this morning and determined the bile duct is leaking aside from the place where the t-tube was placed to drain the bile. They are going to talk with Dr Grant (liver specialist) and decide if they need to do the surgery soon to repair the bile duct of if they can continue to wait. (This was the surgery they were hoping to wait 2 months before performing.)
At this point the doctors' main concern is Dave's brain. During Dave's 3rd surgery there was an excessive amount of bleeding and this bleeding may have been the reason for the kidney failure. Dr Stothert explained to us that if the blood pressure was low enough to damage the kidneys it may have also damaged the brain at the same time. There is a possibility with time, that the kidney failure and the brain damage can be reversed, if there is brain damage. The concern is stemming from Dave's unconscious and unresponsive state as he has been off pain medication for 24 hours. Dr Stothert assured us that Dave is not feeling any pain in this state and if he would show any indication of feeling pain they will give him medication that can take effect within seconds. Dave has moved his arms, legs, head, and has opened his eyes half way. Occasionally he will move his head to the sound of a voice, but he has not moved on command.

Evening update: Dave continued to move his arms, legs and head more this afternoon and evening, but he has not moved on command yet. Keep praying! We haven't heard about the possible surgery to fix the bile duct leak. We are praying that if possible, the surgery can be postponed as long as possible to give Dave's body time to continue to heal. Currently, Dave is getting a break off of dialysis and will probably start tomorrow. Dave's vitals remain controlled by medication and with in normal range. He has however, spiked a temperature tonight. Dr Stothert did say that the bile leak may cause Dave's temperature to rise occasionally. It is now 101.5.

Sunday, June 29th

Morning update: Dave's white blood count is down to 81,000! Praise God! Baby steps! Dave's blood pressure was high enough today to start dialysis. Actually, his blood pressure is a little too high, hopefully dialysis will bring it back down. Dave's heart rate is a little high also, but within an acceptable range. Dave's temperature is 100.4. The doctors have been able to decrease his insulin. Dave is still not responding and is no longer under sedation. We so appreciate your prayers and words of encouragement. Thank you.

More updates to follow...

Evening update: Dave remained stable and on continuous dialysis throughout the afternoon and evening. The doctors took Dave completely off pain medication as they really want him to wake up. Dave has continued to move his limbs slightly, but hasn't opened his eyes and will not respond to commands yet. Dave remains on the ventilator. Dr Young, one of Dave's main doctors said today, "for an old guy, Dave isn't doing too bad". We laughed and said, Dave will appreciate that. :) Please pray that Dave's white blood count will continue to decrease. We get the next reading tomorrow morning.

Saturday, June 28th

Morning update: Dave's white blood count continues to rise and is now at 86,000. Please pray that this number will start to decrease. They plan to do another CT scan to try to find the source of the infection. The pancreas continues to be very irritated. Pray that a portion of it does not die as that would require another surgery. Dave's port for dialysis came out, so dialysis was stopped and Dr Vargas is putting in a new port right now. The doctors are still concerned about Dave's lungs and took an x-ray. Another update to follow this evening....

Around 5:00pm last night, the big storm blew through the Omaha area. Dave's room was not affected at all, but the emergency doors blew down, and all the pretty flowers are no longer blooming!

It is about 1:00pm and Dave's temperature continues to rise. It is about 102.7. His heart rate is also very high. Please pray.

Afternoon update: The x-ray of his lungs came back normal. Thank you for praying for Dave's rising temperature and heart rate. The nurse used a cooling blanket and his temperature is now down to 98.4. As his temperature decreased, so did his heart rate and his blood pressure increased. His vitals look pretty good now. Since his blood pressure was low, they put off the dialysis until tomorrow. Dr Stothert just stepped in the room and said that hopefully in 3-5 days, with dialysis, Dave's numbers will continue to improve. Dr Stothert believes all these problems are probably related to the pancreas. Please continue to pray for his pancreatitis. More updates to follow...

Evening update: Dave has not woke up from his surgery one week ago. Tonight they took him completely off sedation, the doctors would like him to at least open his eyes. Because he is completely off sedation, Dave's heart rate and blood pressure have increased. Please pray that they will stay within an acceptable range. Dave is still on a ventilator. Dave needs to have dialysis tomorrow, please pray that he is stable enough to do so. Dave is also receiving two units of blood tonight.

Friday, June 27th

Morning update: Yesterday evening, they stopped the paralytic drip, Dave is still heavily sedated and on a ventilator. Yesterday Dave started on dialysis. He handled it well and they were able to take off some excess fluid. At some point the doctors hope to take Dave off dialysis, but for now, Dave will continue. Because of the dialysis, all of his numbers are better today. His white blood count continues to rise and puzzle the doctors. This morning it was 80,000 (a normal range is 4,000-11,000). He continues on high doses of antibiotics and anti-fungals. The doctors feel Dave's white blood count may be a result of the pancreatitis, which there is not a treatment for. Time hopefully will calm the angry pancreas. Dave's heart has remained strong, but they have ordered an EKG due to some irregularities.

Thank you for your prayers and support, we will give more updates later today.

Evening update: Today was fairly uneventful. The EKG came back okay. Dave is no longer under the paralytics and his sedatives have decreased, but he has not yet started to wake up. Last night, Brad and I got a MP3 player for dad and today Brad loaded some christian music and some of Dave's favorite oldies. Dr Young said that as Dave starts to wake up, it may be good if he has music to listen to so he doesn't have to listen to all the 'hospital noises'. Dave's vitals remain stabilized by medication.

Surgery #4, Thursday, June 26th

Dave was in Pre-Op for about 45 minutes and the surgery started at 11:15am. Finally, at 2:15pm, Dr Young came out to the waiting room and said Dave is doing well. Dr Young said that Dave remained stable throughout the surgery with the exception of increasing his oxygen to 100% (you and I only use 21%). Here's what they found:

• They did not find any serious infection. Dr Young said that this does not mean that Dave does not have an infection, only that it has not grown to the point they can culture it.
• Dr Hutchins removed the stint placed during surgery #2. The doctors believe this stint may have been irritating the pancreas, pray this is correct and its removal will ease Dave's pancreatitis.
• Dr Grant looked over his liver and said it doesn't look terrific, but it looks like it it healing.
• After an unplanned bronchoscopy (scope of the lungs), Dr Young found and removed large amounts of mucus they did not know was there. This may have been one of the causes of Dave's increased need for oxygen.
• The doctors now have a total of 8 tubes coming out of Dave's stomach. This will increase drainage and hopefully help with his pancreatitis.

Thank you for your continued prayers. Dave has a long road ahead of him and we really appreciate your support.

Surgery #4

Dave is going to have surgery tomorrow, Thursday, June 26th around 10:30am. The doctors are going to check everything over and wash out his stomach cavity. They are also going to remove the stint they put in during Surgery #2, ERCP, as it is not necessary anymore. Please pray for wisdom for the doctors, clarity of the results, and a quick recovery for Dave.

Wednesday, June 25th

Today is going okay. The doctors determined that Dave has acute kidney failure and has started dialysis. This is something they have talked about doing for a couple of days. Due to the kidneys not working properly, Dave is pretty swollen. Hopefully we see a change by tomorrow.
The fungal yeast infection has moved into his blood stream and Dave has been on anti-fungal medication for two days. The doctors also decided today that they would like to perform surgery, probably on Thursday. They plan to use the same incision, check everything out and 'wash out' the abdominal cavity. They have not found the source of the infection and hope this will provide some answers. His heart rate and blood pressure continue to be controlled by medication and look good. Dave is still completely sedated and under medical paralysis.

Dialysis Machine

Tuesday, June 24th

Today was a rough day, but it started out well and so far the evening is going well also. This morning, Dave had a CT scan to check to see if there was any extra air in his abdominal cavity and if they could locate the area of infection. The doctors were pleased with the results as there were no signs of air and they could not locate the infection.
Doctors are still talking about putting Dave on dialysis. The kidney doctor said that "Dave was fighting for his life" and he would like to put Dave on dialysis tomorrow. The doctor hopes dialysis would be temporary. That was really hard to hear. Later on in the day, Brad asked Dr Vargas for his opinion on that comment. Dr Vargas said that looking at Dave's chart, his condition does look very, very bad, but he said that he has worked with Dave the last week and Dave is doing better than the picture that is painted in his chart. Dr Vargas said that for Dave's age, Dave is in very good shape. He said that most men Dave's age would be on twice the medication Dave is on but would be only doing half as good. Dr Vargas said that Dave is very sick and had a lot of trauma, but all things considered is very fortunate and we just need to keep praying.
Dr Grant, (the liver doctor), said that the blood flow to Dave's liver is okay. They may end up having to take out just a part of the liver. But if blood flow continues as it is and there are no clots, then the majority of Dave's liver should live. Dr Grant also reminded us that due to all the trauma, Dave was probably going to get worse before he got better. As the day progressed, Dave continued to have problems with extreme pressure on the bladder and abdomen. The doctors were concerned that the pressure was so severe that it would damage the surrounding organs. They gave Dave medication, increased the sedation, and temporarily paralyzed Dave again hoping his stomach muscles and bladder would relax. The doctors were going to do surgery today to fix this issue, but thankfully they did not have to because the next test results were much better. Because of the infection, Dave's temperature as right around 101.9. The doctors are hoping that this will soon come down as soon as the infection is cleared up. Dave's blood pressure and heart rate increased throughout the day. The doctors and nurses wanted to get this under control before Dave was at significant risk of a heart attack. They decided to give Dave a beta block. Literally within seconds, Dave's heart rate dropped from 133 to 115. Because we didn't know how Dave's body would react to the medication, we were so happy. The nurse said she was going to do cartwheels down the hall! The plan at this point is to give Dave a beta block every 6 hours or as needed. The doctors also plan to keep Dave under sedation for the next few days, allowing his body time to heal.
Brad and mom are the visitors tonight, I just got off the phone with Brad and he said Dave is doing well. Please continue to pray for Dave. Hopefully tomorrow will be a little better. Today it seemed like every time we would switch out visitors, there was more bad news. What a roller coaster! Thank you again for the prayers.

Monday, June 23rd

Dave had another ultrasound of the liver and the results continued to be positive. Dr Grant said that as far as she was concerned, there was no need to do surgery today! She said that as long as his liver continues to be strong, they could wait for up to 2 months until the next surgery.
Dave was sedated the majority of the day. At some points he responded to people's voices. His vitals remained good, but he continued to develop a fever. His white blood cell count, a chemical in his kidney, and his liver enzymes were all much higher than they should be. The doctors still felt this could be a normal reaction to such an invasive surgery.
Dave's kidneys were not functioning as they should and doctors began to discuss the possibility of temporary dialysis.
In the evening, Dave become more agitated and an ultrasound of the liver showed that one half was doing better than the other. The nurses gave Dave more medication to further sedate him.

Sunday, June 22nd

Dave's family and friends were still pretty shaken up over the results of the surgery the day before. But, it was again so comforting to know that literally hundreds of people were praying for Dave.
Around 9:00am they took the first ultrasound of the liver to check on the blood flow and any possible clots. This was the first test to see if the surgery yesterday was successful. We prayed diligently as we waited for the results! A couple of hours later, we received word that the tests showed good blood flow to and from the liver. Praise God!
Dave was still under complete sedation and was resting from the surgery. We took turns reading Psalms to Dave. Dave's vitals remained stable throughout the day as he rested. By mid afternoon, Dave had started to move his limbs again. We did our best to keep him calm during these times by praying with and for him.
Dave had 37 visitors today! We are so grateful for the support of family and friends. It is encouraging to know how many people are praying for Dave.
At 8:30pm, Dave's liver enzymes had doubled what they were earlier in the day. This is a sign that the liver is not functioning as it should. Immediately, they took an ultra sound of the liver. We waited and prayed and finally 4 hours later, the doctors came in the room and said that the liver function was the same as this morning. Another answered prayer! The doctors said that the liver enzymes increase after surgery and it just took about 24 hours for that to happen. As long as the enzymes did not continue to increase, Dave was not in immediate danger. Dave continued to rest peacefully, his vitals were stable. It appeared as he would make it until Monday for another surgery.

Surgery #3 - Saturday, June 21st

Taking advice from doctors and nurses, Dave and his family decided to proceed with the exploratory surgery. Dave was taken down to Pre-Op and prepped for surgery slightly before 4:00pm. Dave's family prayerfully waited in the waiting room. We received a call at 5:10pm saying they had started surgery. We had many, many people praying for Dave. That was encouraging. Thank you!
Throughout the evening, we received two other phone calls, saying that Dave was doing well, but it would be a while longer. Finally, 5 hours later at 10:15pm, two doctors came out of the operating room. Their faces were red, and it was very evident it had been a stressful surgery.
The doctors, explained what they had found:

• A severed bile duct. Solution: they placed a T stint and another drain tube on Dave's left side to catch the leaking bile. Another surgery will be necessary to permanently fix the problem.
  
  
• A significant tear in the portal vein. Solution: they placed a semi-synthetic patch over the tear to stop any further internal bleeding.



• A blood clot in the hepatic artery. Solution: they snipped the hepatic artery so the blood clot would not be pushed into the liver.

The doctors had not expected to find so many problems and it was quite a shock to our family. Because of the trauma, Dave had developed a very severe case of pancreatitis. It was a very, very difficult surgery. During the surgery, Dave received 10 pints of blood. The doctors were not too optimistic. They said Dave's vitals were good, but he had a very long road ahead of him. Dr Grant, a top liver transplant surgeon, said that because of the injuries to the hepatic artery and portal vein, Dave runs the risk of losing one or both sides of his liver. Dr Grant said she was concerned about more blood clots forming and also insufficient blood flow to and from the liver. If his liver does die, he would be put on a liver transplant waiting list. The positive news is that the liver regenerates itself so, it would be okay if one side of Dave's liver did die. And, if Dave would need a liver transplant, he could receive half of a relatives. The doctors said that because of the seriousness of the surgery and the extent of his injuries, another surgery on Sunday or Monday would be necessary to check everything and make adjustments.
Dave returned to his room in ICU and rested for the night. Dave was completely sedated and the doctors also gave him medicine to paralyze his limbs so he could rest and his body could heal. It was difficult to see him hooked up to a ventilator and so many more tubes and monitors, but comforting to know he was actually resting for the first time in days and his body was hopefully starting to heal. It was a short night for the family and many friends as they spent much time in prayer. Thank you to all the prayer warriors!

Saturday, June 21st

Dave continued to have a lot of bile in his drain tubes; a sign that the ERCP wasn't as successful as we hoped. Dave also continued to be in intense pain. Dave's doctors continued to talk about the possibility of surgery. Some doctors said Dave could wait until Monday for the surgery and others suggested surgery that day. The doctors didn't know what was causing all the pain and why Dave was not getting better. The surgery would be very invasive. Ultimately they left the decision up to Dave and his family. Dave was not improving and although his vitals were stable, they were getting progressively worse. After much prayer, Dave decided to proceed with surgery. Within an hour, he was taken to Pre-Op.

Friday, June 20th

Dave was recovering well from the ERCP. However, the surgery caused gas and air buildup in his abdomen, which was very painful. A room with a window became available, and the nurses thought Dave could use some sunshine, so he moved rooms. It was a lot of extra work for the nurses, but very sweet on their part.
As the day progressed, the doctors were not seeing the results they wanted from the ERCP. They started talking about an exploratory surgery to find any unknown injuries. Dave remained in good spirits, and even occasionally cracked a joke.

Surgery #2 - Thursday, June 19th

Dave had the ERCP at 2:00pm on Thursday, June 19th. Dr Hutchins was able to place a stint in the bile duct and was hopeful this would prevent any more bile from leaking. Dave was in recovery until 10:00pm because they had given his ICU room to another patient and a nursing shift change prolonged the preparation of a new room. Once settled in for the night, Dave's vitals remained steady, but he continued to experience intense pain. It was a restless night.

Wednesday, June 18th

The orthopedic doctor put a plaster splint on Dave’s ankle. His ankle will remain in this splint for at least a week and then they will take another x-ray to evaluate the fractures at that time. One of the fractures is on the border of needing surgery. The orthopedic surgeon will make that decision next week.
The nurse came in at 10:00am and said they had an opening and they would be taking Dave for the ERCP immediately. Five minutes later the nurse came back in Dave’s room and stated the ERCP would be done on Thursday at 1:00pm as the entire trauma team would be available at that time. Dave continued to experience a great deal of pain from the trauma and surgery but doctors believed his injuries could be treated with the scope.

Arrival at UNMC - Tuesday, June 17th

Dave arrived at UNMC by ambulance on Tuesday, June 17th at 4:00pm. He was admitted into the Intensive Care Unit and was evaluated by the UNMC doctors. They found the NG (nasal gastric) tube was misplaced in his lung so they painfully corrected the situation. Dave was evaluated to a greater extent and another x-ray done on his left ankle. This x-ray, like the one done in North Platte, revealed a fracture on both the inside and the outside of his ankle. The trauma team decided to hold off on the ERCP (scope to evaluate and fix the leaking bile) due to Dave’s previous trauma and his stable condition. The ERCP was scheduled for Wednesday at 3:00pm.

Surgery #1 - Tuesday, June 17th

Dave arrived at Great Plains Regional Medical Center in North Platte at about 2am on Tuesday, June 17th. The trauma team was ready and waiting, they checked Dave over and decided the best approach was to perform surgery. Once inside, they found a lot of internal bleeding, taking out nearly a liter of blood. They also noticed some bile leaking so Dr Seip removed Dave's gallbladder, which was not the source of the leak. He also placed two drainage tubes to help drain the blood and bile that was leaking into Dave's stomach cavity. At this time, Dr Seip knew that there was bile leaking but felt the situation was under control and sent Dave to the University of Nebraska Medical Center in Omaha to be evaluated by specialists. We are very thankful that Dr Seip was able to get the situation under control and was humble enough to admit Dave's injuries required a specialist.

The Rescue

The accident happened approximately 9 miles from camp and could only be reached by four wheelers due to the width and terrain of the trails. The rescue process was slowed due to no cell phone reception. Brad stayed with Dave while Bryce rode back to camp to get his wife Christine (a nurse!) and tell Diane. Diane and Christine arrived on the scene at about 9:45pm. By this time, Dave was having an extremely difficult time breathing due to the internal bleeding. Christine monitored his vitals, which remained stable the entire night. Dave was also in a tremendous amount of pain. Brandon stationed himself at a trail head in order to point people in the correct direction. Chad was able to find the Park Ranger who called surrounding towns that had helicopters, but the helicopters were unable to respond due to the weather in those towns. The Thedford volunteer EMTs responded to the accident, drove their truck as close as possible, and started the .9 mile hike to reach Dave. By the grace of God, Mike and Ryan 'happened' to meet the EMTs at a crossroad and were able to give them a ride to Dave. The EMTs strapped Dave to a board and with the help of 6 friends, 1 Park Ranger, and 1 Sheriff, carried Dave nearly one mile through the sandy, uneven terrain to the EMTs truck. Dave was loaded into the back of the truck and then traveled 20 minutes and hit almost every bump in Nebraska! They then transferred Dave to an ambulance and started the 30 minute drive out of the park. Once out of the park, the North Platte paramedics relieved the Thedford EMTs and traveled 60 minutes to Great Plains Regional Medical Center in North Platte.

The Accident - Monday June 16th

On Monday, June 16th 2008, Dave was in Halsey National Forest on a camping/four wheeling vacation. Dave and five other guys went out for an after dinner ride. Around 8:30pm Dave hit a stump, lost control of his four wheeler and went off the trail. Dave was then thrown from his four wheeler and was impaled on a tree. The branch was 1 1/4 inches in diameter and went into Dave's side about 4-5 inches. The four wheeler pinned him against the tree. Dave then pushed the four wheeler off of himself and took himself off the tree. Dave walked about 8 feet and then sat down. About 2 minutes later, Mike Cheney, (Traci's father-in-law) found Dave sitting on the trail. Mike made sure Dave was stable and then went to get the other guys. Mike quickly caught up with everyone. Brad (Traci's husband) stayed with Dave and the others went to get help.