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.