Dave had an x-ray of his stomach and lungs and a CAT scan has been ordered for later today. They are wanting to monitor his infection and are concerned a pseudo-cyst is forming around his pancreas. His pancreas enzymes have increased since he started eating, which means his pancreas is not reacting well. Dave is a little down this morning. The trauma team said the food intake is not going as well as they had hoped. He is not nauseous, but he is not able to consume as much food as he needs to sustain his infected body and will most likely have to have another PICC line. The food is making his already distended belly even more taut. This morning he ate about 2/3 cup of cream of wheat and 4 ounces of grape juice. Dave continues to have the breathing episodes and they are increasing in frequency. His white blood count is holding around 30,000, the doctors are pleased it is not increasing (normal is 4,000-11,000). Thank you for your prayers and kind words. It is so encouraging to our family, especially Dave and Diane as they wait on the Lord's timing.

Prayer Requests:

• Dave will be able to eat enough calories orally to not require another PICC line.


• Dave's breathing episodes will diminish.


• Dave will have good results from the tests today.


• Wisdom for the doctors as they determine the best plan of treatment for Dave.


• Strength for Diane as she faithfully stays by Dave's side.


• Strength, healing, and a positive attitude for Dave.

Morning... Last night at 12:30 Dave called Diane to let her know they were moving him. He now has a private room because they cultured C. diff (bacterial infection). He has a nice big room with a great view! It looks over one of the pretty gardens! Once diagnosed with C. diff the rest of your hospital stay is in a private room, not too shabby! Dave also had this diagnosis 3 years ago. The restrictions with this diagnosis mostly affect the hospital staff. They must wear a yellow gown when in Dave's room and Dave has to wear a yellow gown when outside of his room. He is still allowed to go on walks and it doesn't affect visitors. Thanks for your continued prayers!

Dave got approved for a liquid diet today. He ate 1 1/2 Cups of broth and 2 bites of jello. He was able to keep it all down!!! The first food in over a week! If Dave can tolerate enough food to sustain himself he will not need another PICC line. Please pray Dave's body will tolerate food by mouth. Dave continues to have the hiccups and has started having the "breathing episodes" that he had 3 years ago. These "breathing episodes" are family named. They only occur when Dave has the hiccups and the spasms from the hiccups are strong enough to knock the wind out of him making him unable to breath for a short time. As you can imagine this is very scary. They checked for blood clots in Dave's legs, we will get the results from the ultrasound tomorrow.

Please pray that:

• Dave's body will tolerate food.
• Dave will not have the hiccups or breathing episodes. Dave's pancreas will heal.

Praise:

• Dave was able to keep food down today!

Thank you so much for your continued prayers. Dave is feeling better and he looks good, despite his bloated belly. Last night his temp was 101.2, so they ran the 2nd chect x-ray of the day. The lower left lobe of his lung is still partially collapsed. The best treatment at this point is still walking. Dave goes on walks a couple of times a day. They also did blood draws and urine analysis. We found out late last night that the blood culture from a few days ago did finally show a bacterial infection in the blood. They switched Dave's antibiotic (again). They are going to take out Dave's PICC line today and put in a peripheral IV. Due to the procedure, Dave will be without TPN (liquid nutrition) for 24 hours. Please pray that the PICC line is the source of the infection and that the new antibiotic will take care of it quickly. If the PICC line is not the culprit of the bacterial infection in the blood, we will have to look into more complicated solutions. Please continue to pray for Dave's pancreatitis. Dave's temperature was down to 100.3 this morning and his white blood count, liver, and pancreas numbers remain basically unchanged from yesterday.

Once again, Dave has the doctors puzzled. His white blood count has increased again. It is now at 55,500 and normal is 4,000-11,000. Dave's liver and pancreas numbers are continuing to improve. The CT scan that was done yesterday shows that Dave's pancreas is 'impressive' as Dr Nelson stated today. They are puzzled as to why the pancreas looks so horrible, yet the numbers are improving. Two options they have come up with: 1) He is on the tail end of pancreatitis, so his numbers are better, but the pancreas still needs to settle down or 2) Necrotizing pancreatitis, which could mean various things - sloughing off, psudocyst, or that the pancreas is shutting down. The doctors don't seem terribly concerned at this point, they are going to keep monitoring the situation. They are changing Dave's antibiotic in hopes to decrease any possible infection. They increased Dave's insulin and also increased the amount of water he could drink. Dave was excited! Dave is still struggling with the hiccups. Please pray for healing for Dave's pancreas. Although the doctors don't have all the answers now, we rest in the fact that our Great Physician has Dave in His hand.

Thanks for your continued care, concern, and prayers. Dave has gained 25 pounds since arriving here. It is mostly in his abdomen, but his legs are also swollen. His stomach is stretched tight, but we are thankful that he is not in pain. Dave's white blood count had increased to 45,000 and is running a temperature again so the doctors decided to do a CT scan of his liver and abdomen to make sure there are not any pockets of infection. They did not see any today, but will run another CT scan in a day or so. They did note that his pancreas is still 'angry' and that Dave has pancreatitis, which is most likely the culprit of the high white blood count and fever. In an attempt to control the pancreatitis, he is back to 8 ounces of water (no green tea) per day and still no food just TPN solution through the IV. Dave is thirsty, so this was disappointing. They did increase his IV fluid so hopefully that will help with the thirst. Since the pancreas is not fully functional, it is unable to completely process the TPN, so Dave is receiving insulin four times a day. Dave has had the hiccups numerous times in the last 24 hours.

Praise:

• Dave's liver numbers continue to improve.
• Dave's rash is gone.
• Dave's eyes are almost white again!

Please pray that:

• Dave's pancreas will settle down.
• Dave's temperature will return to normal.
• Dave's hiccups will just be hiccups and not turn into not being able to breath as happened in 2008.

Friday, March 25

It snowed a couple inches last night, CRAZY!!! Dave continues to feel pretty good, but his stomach is still bloated. He has a little bit of a temperature, they are culturing his blood to determine the culprit, and he is on 3 different antibiotics to get rid of the infection. He has permission to drink 16 oz of fluids in 24 hours, not a lot but better than nothing! Dr. Grant stopped by and told Dave after he gets rid of the infection they will do some tests prior to him being discharged that will help determine what the next step will be. If possible they would like to balloon the bile duct opposed to performing surgery. Dave had a hernia repair surgery 2 years ago when they placed a large sheet of goretex in his abdomen, cutting through the goretex would increase the chance of his hernias reoccurring. Thank you for your prayers!

Thursday, March 24

Dave's white blood count is still high, but has not changed since yesterday. One lobe of Dave's lung is slightly collapsed or has some fluid in it. They have told him the best thing to do is walk. His rash is getting a little better and is less itchy. Dave's stomach is still bloated, but the nurse said his intestines are starting to function. Dave has permission to drink 8 oz of water in 24 hours, baby steps, but we'll take it. Dave has gone on two short walks this morning.

Wednesday, March 23

Evening Update...............Dave continues to run a fever, but has been able to get some rest. They ran a chest x-ray, they are concerned about pneumonia because of his fever spike, white blood count and elevated heart rate. Thank you for your continued prayers.

Afternoon Update...............Dave had a pretty good afternoon. They still have not cleared him to have any water or ice chips yet, which makes for an uncomfortable dry mouth. Because Dave's pancreas is still 'angry' it can not fully break down the nutrition being fed through the PICC line, so Dave as been receiving a little bit of insulin. Dave's white blood count is elevated and he is running a fever of about 101 degrees. He is still on antibiotics, and the doctors are keeping a close eye on him so they can catch any possible infection early. Dave went on a walk this afternoon or as the nurses called it a 'sprint'. The sprint raised his heart rate quite a bit, so they only let him do one lap and then they did an EKG to make sure everything was ok. Later on, when he wanted to go again, they thought it would be best to use a wheel chair. :) They are keeping a close watch on his heart rate, but are not too concerned at this time.

Please pray for:

• the rash to diminish, it is pretty uncomfortable
• continued peace and healing

Morning Update................Huge praise, although Dave wasn't able to get much sleep, he did have a good night! His pain is manageable now, his liver numbers are better as well as his pancreas numbers; indicating that pancreatitis is improving. They took his NG tube out this morning. He hasn't had any actual food or water yet, just liquid nutrition from the PICC line. Dave is looking forward to ice chips. They are waiting to make sure he tolerates not having an NG tube first. Dave is taking medication for his heart rate and blood pressure, but they look are looking good. Thank you for your prayers.

Tuesday, March 22

Evening update....................................Dave's pain continued to stabilize this afternoon. This evening Dave started the nutrition drink through his PICC line. Dave is running a low grade fever. Tomorrow we hope to discuss the long-term solutions with the doctors. Thank you for your continued prayers.

Afternoon update....................................Thank you for your faithful prayers! Dave has been more comfortable this afternoon. Right now, his pain is at a 3 out of 10, and that is with no pain medication! We have not heard anything back on the x-rays, in this situation, we figure no news is good news. He has been able to catch a few naps here and there. Mom was also able to get a little rest. Doctors have stopped by, but no plans have been discussed for long-term solutions. Dave was able to walk around the halls and take a shower. Please pray for relief from the rash.

Morning update....................................To be completely honest, Dave had an absolutely horrible night last night. He rated his pain at a 10 out of 10 and if you know Dave, he is a pretty tough guy. He wasn't able to sleep at all as the abdominal pressure and pain was unbearable. At 3:15am Dave's blood pressure was 209/102! At 4:35am Dave was given pain medication and felt immediate relief (7 out of 10). We tried to explain to the doctors and nurses that this is NOT Dave and that he has never been in this much pain, but for some reason, they didn't really 'get it'. I guess they are not used to having such tough patients. :) Dave's pancreatic enzymes are elevated, indicating he does have pancreatitis. We are unsure at this point how much of the pain is caused by the pancreatitis and how much is caused by air being trapped in the abdomen from the ERCP. Dave did have an abdominal x-ray around 5am and then again at 9:30am because the 5am one was not clear. Dave is currently getting a PICC line since he hasn't had a meal since Thursday.

Praise:

• Dave's temperature is normal which indicates the infection caused by the constricted bile duct is clearing up. It appears that the stint is working properly.
• Dave no longer has a headache.
• Dave's blood pressure is now down to 173/84.

Please pray for:

• Wisdom for the doctors as they assess the best treatment for Dave now and long-term.
• Comfort for Dave.
• Pancreatitis to subside.
• Rest and strength for mom, she was up all night with dad.

Monday, March 21

Evening update.............................11:30pm Thank you for your prayers. A member of the trauma team came to visit Dave around 9:30pm. He said that often with an ERCP air is introduced into the stomach and can be very, very uncomfortable. Thankfully, Dave did not experience this on his two previous ERCPs in 2008. Dave was able to get some medication. Eventually the burning sensation subsided as well as the nausea; however, it was replaced with a feeling of extreme pressure and bloating. Dave is still very uncomfortable. He is not vomiting as frequently. Also, we are thankful that his headache is gone. Dave now has a NG tube, which should eliminate the vomiting and release some stomach pressure.

Please pray for:

• Comfort for Dave
• That Dave will not develop pancreatitis (he developed a very severe case in 2008 following an ERCP)
• Wisdom for the doctors in deciding on a long-term solution for the repair of the bile duct
• Strength and rest for our family

Evening update.............................9:00pm Please pray for Dave. After the surgery he was feeling fairly good, but very recently he has become nauseous and has a burning sensation in his stomach. He has thrown up and is VERY uncomfortable. Please pray that he feels relief very soon and that the pain he is feeling is a result of switching to a liquid diet and that this is not a complication from the surgery.

Afternoon update.........................Thank you for your prayers. Unfortunately the procedure didn't go as we had hoped. The best case scenario would have been a stone or sediment blocking the bile duct but this was not the case, Dave's bile duct is very constricted due to external pressure cause by the scar tissue that resulted from his pancreatitis 2008. This is not where the bile duct was severed in 2008, that area looks great, Praise the Lord! The constricted portion of his bile duct is approximately 9 cm. This area is very infected and will be closely monitored the next couple of days. The stint is only a short term solution and we'll have to discuss long-term solutions with Dr. Grant over the next couple days. Please continue to pray for Dave's healing and wisdom as we make decisions about the best solutions for Dave long-term.

Morning update...................It has been a busy morning. The ERCP was originally scheduled for today, then it was cancelled and on the agenda for tomorrow. 30minutes ago we were told that it is back on schedule for today. All 3 teams are in agreement that the ERCP is the best choice to remove the stone or sludge causing the blockage. Today Dave seems to be doing a little better. He does seem to be having a slight allergic reaction (rash) to the antibiotic, but is otherwise responding well. His fever is down, white blood count is down, and headache is at times a little more manageable. Please pray that the procedure is successful.

Sunday, March 20

Sunday Evening.......... The nurse just informed us Dave is scheduled for the ERCP tomorrow at 1:15pm. This was the first we had heard about a decision being made, so imagine our surprise! She assured us we would get to talk with the doctors before they take him for the ERCP, that made us feel much better. Dave continues to fight a fever, but seems to be fairly comfortable at the moment, PTL! Please continue to pray for Dave's headache, which has been persistent since yesterday. The doctors had pity on him and allowed him 2 Extra Strength Tylenol, this seemed to help! Thank you for your continued prayers for Dave, our family, and the doctors.

Sunday Afternoon.......... Thank you so much for all your prayers. The results of the MRI show that there is a blockage of some sort in the bile duct. They think it may be a stone or sediment. The trauma team is working with a few other teams to make a decision on the best way to address the blocked duct. They will come to a conclusion in the next day or so and the procedure will take place shortly after. The options discussed at this time are an ERCP (scope) or surgery. Pray for wisdom for the doctors as the different teams have varying opinions on the best course of action.
Because the liver is not working properly, Dave has an infection resulting in a fever of 102 degrees, a severe headache, and nausea. The nausea is mostly being controlled by medication. However, he is unable to take Tylenol (because of his liver) and can not take Ibuprofen (because of his kidneys). Please pray for relief from the headache.
The doctors are encouraging Dave to get up and walk around when he is able. The highlight of his day was walking to the elevator to see his grandson Titus. Dave and the family are in fairly good spirits. Although the thought of another surgery or procedure isn't too exciting, we know our almighty God is in control and we are trusting in Him.

Saturday, March 19

Thankfully, it has been awhile since we have updated the blog! Earlier this week Dave came down with a cold and then on Thursday he had flu like symptoms. We didn't think too much of it until early Saturday morning when he appeared jaundiced. His family doctor sent him on to his old stomping grounds; UNMC in Omaha. After testing at UNMC, they have found that Dave's white blood count is high, indicating an infection and his liver counts are elevated as well. An ultrasound indicates that the bile duct is probably at least partially blocked. It is difficult to determine as the bile duct is already compromised from his previous injuries. Dave is going to start on antibiotics and will have an MRI tonight. The MRI will be read tomorrow and a decision will be made at that time as to what the next step will be. They have said surgery may be a possibility. Please pray for wisdom for the doctors, peace for our family, and comfort for Dave.