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

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

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

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

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

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

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

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

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 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 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 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 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.

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!

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 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 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!

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 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 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 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 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.