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.