Thursday, October 23

Dave's appointments today went well. His first appointment was with Dr Mormino the orthopedic surgeon. They took 3 x-rays of Dave's ankle. He said he couldn't tell where the break had been on the fibula (outside bone). The break in the tibia is healed. In the next 4-6 months the soft tissue in the ankle will be healed also and give Dave more range of motion. Dr Mormino has released Dave!!!

His second appointment was with Dr Stothert from trauma. Dave had labs run yesterday and Dr Stothert was pleased with the results. Dave's liver and kidney numbers have returned to the normal range! PTL!!! (They didn't do his WBC.) They are going to continue watching the 2 hernias and will repair them when he has his next surgery. Again, the trauma team was very pleased with Dave's progress!

His last appointment was with Dr Grant, liver specialist. She wants to continue monitoring Dave's bile output from his T-tube for 2 more weeks. Dave was really hoping to be able to go back to just one bag. There has been a lot of inconsistency in the output from both drains which is confusing to them. In 2 weeks Dave will go to interventional radiology for a cholangiogram rather than an x-ray cholangiogram. IR is able to do a more accurate placement of the dye, therefore, better able to view the bile duct's functioning at the injury site. The results of this cholangiogram will help determine what the next step will be for Dave. They are still talking possible surgery, but they have also said there is a chance Dave may not need surgery if the bile duct heals on its own and is not too constricted. Please continue to pray for healing of the bile duct.

Dave continues to do great at home! He is still doing PT 3 times a week. He continues to get stronger. Dave has gained 8 pounds since he has been home! Thank you for your prayers and support! The next update will be in about 2 weeks, we don't have the appointment set yet.

Wednesday, October 8

Dave's appointments went well today. He had the cholangiogram first and didn't get the results until late afternoon. The results showed a slight bile leak. However, the bile is not being picked up by Dave's blake drain, which poses the question where is the bile going. As yet one more diagnostic tool, Dr Grant decided to put a bag on the t-tube to measure any bile that may drain and to see if this makes a difference in the output of the blake drain. (Dave's blake drain is draining some fluid but it is not bile.) Dave's t-tube immediately started draining a significant amount of bile. They told Dave to start drinking more fluids so his body can replenish what it is losing. Dr Grant is going to discuss the results of the cholangiogram with her colleagues at a monthly meeting. By presenting Dave's case to the group she is hoping to get some feedback for what the next step should be. They are still talking surgery. Different time frames have been thrown out, some doctors have said 2 months down the road and some have said 6 months down the road. I think it is sufficient to say they want to give Dave's body time to heal before he has another surgery. At this point we still do not know what the extent of the surgery will be.

Dave now has a button G-tube. This replaced the 6 inches of tube that was sticking out from his stomach, taped to his body, and visible through his shirt. The button is flush with his skin and can't be seen through his clothes! They don't want to get rid of the G-tube because it would take another surgery to insert one in the event that he would need it. Since the tube is already there and isn't a cause for infection (the stomach/intestines have so much bacteria anyway the tube doesn't get infected) they have decided Dave will keep the G-tube until after his liver surgery. He isn't using the G-tube and hasn't since he has been home.

Dave has 2 hernias in his abdomen along his incision. Dr Young gave Dave an elastic belt to prevent the hernias from getting any worse. They will coordinate surgery to fix the hernias when Dave has his liver surgery. Dave's white blood count was 15,000. It has been holding pretty steady at 15,000 for about the last month. The doctors seem to have quit putting as much emphasis on the high WBC. Dave's physical therapy is going great. He is going to PT 3 times a week at Madonna ProActive. In the last week his PT, Darrin, has put Dave on the stationary bike and also on the elliptical machine. Dave was on the elliptical for 10 minutes and worked up a sweat! He thought it was great!!!! He is looking stronger and feeling stronger daily. On 3 of the days Dave doesn't have PT he works out on the Bowflex at home. Although he tires sooner than he once did, Dave is very determined to have a complete and quick recovery. Dave is enjoying being home and getting life back to normal. He is going to church, spending time with his family, going to Norris softball games, and getting together with friends. Dave had a birthday last week (56 years young!!!!) and is thankful the Lord has blessed him with another year! Dave's next appointment in Omaha is October 22. We will give you an update after the appointment! Thank you for your continued prayers, the body of Christ is amazing!

Wednesday, September 24

Dave's 2 appointments went really well. His first appointment was with Dr Grant, the liver surgeon. She re-stitched his blake drain as it needed to be stabilized. She would still like to get Dave out 2 more months before doing a surgery. There is still a chance the bile duct could repair itself which would lessen the seriousness of the surgery. She would like to have a cholangiogram done on Dave's t-tube in a couple of weeks. This will show her if the T-tube is working properly. She may need to put a new t-tube in, this would probably be a one night hospital stay. Dave's next appointment was with Dr Young from the trauma team. Dr Young was very excited with how good Dave looks! Dave will have a button G-tube placed when he has the cholangiogram. Dr Young wants to leave the G-tube in until after the surgery. This type of G-tube isn't visible through clothing as it will be flush with the skin! Overall the appointments were very encouraging. Thank you for your continued prayers.

The next blog entry will be with the results of Dave's cholangiogram that will take place on October 8th.

Wednesday, September 17

After:
93 days in the hospital
93 x-rays
WBC as high as 86 thousand
29 days of dialysis
24 CT scans
13 1/2 hours of surgeries and procedures
10 ultrasounds
10 days unconscious
9 tubes in the tummy and back
6 EKGs
5 trips to Interventional Radiology
and One Great Big GOD...

DAVE IS HOME!!!!!!!

The next blog update will be after Dave's follow up appointment at UNMC on Sept 24. Next Wednesday the doctors will most likely decide how extensive Dave's future surgery will be. The trauma team did tell us there is a very slight chance that Dave's bile duct will heal on it's own. A small portion of the left side of his liver has died and they will need to remove this, however, if the bile duct does not heal they will remove the entire left side of his liver. Please continue to pray that Dave does not have to have the left side of his liver removed.

We want to extend a heartfelt thanks to all of you prayer warriors!! We know your prayers are the reason Dave is at home today. It was awesome to experience the way the Body of Christ works together! During the most difficult days it was the faithful prayers of our brothers and sisters in Christ that encouraged us and helped us through. A big thanks to all those who came to the hospital, thank you for the meals, gifts, cards, and especially your prayers. It has been most humbling to be the recipients of such generosity. We praise God that Dave is home and for your faithful prayers. We have truly been blessed! Thank you!

Tuesday, September 16

For those of you keeping track today is month 3 since Dave's accident. The plan is still to come home tomorrow, PTL! Dave has had some discomfort in his abdominal region for the last 3 days. He had mentioned it to the doctors and nurses but they didn't know what would be causing the pain and sensations. This morning during breakfast Dave discovered his gastric tube was leaking. He lifted his shirt up and his tube literally fell out of his stomach. That was the answer to his discomfort! The tube, which by the way has a bulb on the end of it, had worked its way out of Dave's stomach and through his skin, OUCH!!!! The nurse quickly reinserted another gastric tube, with a larger bulb this time. This was done bedside and was painless for Dave. The tube was inserted through the preexisting tunnel and then the bulb was inflated after the tube was properly placed in his stomach. Last night was the last time Dave will receive tube feedings at night, PTL!!!! Dave had discharge evaluations in both PT & OT today. As you can imagine he has improved since the initial evaluations 11 days ago. As always thank you for your prayers.

Monday, September 15

Dave had a great day today! For one of his PT sessions he walked around outside, it was so beautiful out! The doctor took a look at Dave's CT scan from Friday and said there isn't any pockets of fluid in his abdomen. He said he didn't know quite what to make of the situation and called the Trauma team at UNMC to get their opinion, we don't know what Trauma had to say yet. The confusion stems from the blake drain suddenly not draining much of anything (and what it is draining is different than before), the t-tube still not draining very much, and now per the CT scan there aren't any pockets of fluid sitting in Dave's abdomen. The pesky hiccups still seem to show there ugly head through out Dave's days. However, the hiccups aren't causing as many breathing episodes, though the episodes do still take place randomly. Dave has gained 15 pounds! He is eating great, no nausea or lack of appetite, and he is still getting tube feedings at night. Dave is looking at discharge from Madonna on Wednesday, yes, 2 days from today!!! PTL! He will only need outpatient PT, they said he won't be needing OT after discharge! Thank you for your faithful prayers!

Saturday & Sunday, September 13 & 14

Dave continues to gain weight, PTL! He has an appetite and is still getting tube feedings every night. Dave didn't have PT or OT this weekend, just the walking he did on his own. He really enjoyed watching the Husker game on Saturday night! Thank you for you continued prayers!

Friday, September 12

Today using the groceries they bought on Wednesday, Dave helped make lunch for Diane, a therapist and another patient. Diane said she loved it! Dave is having a CT scan at 5:30 tonight at Bryan. They are concerned about his leaking bile duct because the amount of fluid draining from the blake drain dropped significantly in the last few days.

Thursday, September 11

For Dave's outing today he went to Barnes and Noble with Madonna therapists. In order to transition from Madonna, Dave was allowed to leave Madonna for 3 hours with Diane! In physical therapy Dave worked on the Bowflex and stairs. He did have hiccups today but no breathing episodes. Overall, he had a very good day.

Wednesday, September 10

Dave's WBC came down a little, 16,600! He went on an "outing" with PT & OT to the grocery store. Nope, it wasn't Hy-Vee, Dave didn't have a choice in the matter! :) Being on his feet that long was a challenge but he did well. Dave has started walking to PT & OT without the cane, another step in the right direction! During therapy Dave went outside and walked on grass and other uneven ground without the cane. Some have inquired if Dave is up to visitors... he definitely is and would be encouraged by your visit. Stop by, Dave is in room 210.

Tuesday, September 9

In Recreational Therapy Dave bowled on the Nintendo Wii. What a neat way to do rehab! He said the therapist beat him easily, oh well, maybe next time! He should probably challenge her to a game of softball or baseball! He did stairs and some balancing exercises in PT, which he informed me he dominated! It was so good to see that confidence again! He is using the cane less often, PTL!

Monday, September 8

Dave's WBC went up, 17,000. He had lots of PT & OT today. It was difficult, but he enjoyed the challenge. He keeps getting stronger! We are so thankful he is in Lincoln. Thank you all for your prayers and support.

Saturday & Sunday, September 6 & 7

Dave is now in room 210 at Madonna and the room even has a window! Dave is now taking all oral medications (no more IV's). Dave had PT, OT, and speech evaluations on Saturday. They determined that he doesn't need speech therapy so he will just start PT and OT on Monday. Dave is still getting tube feedings at night so that he can get in enough calories. Thanks to the medication to increase his appetite, Dave is eating more and gaining weight. PTL!

Friday, September 5

Dave is packed up and moving to Madonna! Praise God!

As soon as the paperwork is finished, Diane will be driving Dave to Madonna. Hopefully they will be arriving in Lincoln by 2:00 today! Today Dave's WBC is down to 15,000, other than that we don't have any other news to report. Dave is doing very well and is anxious to start rehab at Madonna. Again, thank you for your continued prayers.

Friday, September 5

Happy Anniversary Dad and Mom!!!!
Dave and Diane are celebrating their 32nd wedding anniversary today, PTL! Update to follow...

Thursday, September 4

Dave had a really good day today! He walked with the cane, he is even walking short distances without the cane and without assistance!!!! The doctors have told us as long as Dave's WBC does not go up he will be able to move to Madonna tomorrow or the next day, PTL! They took him off telemetry today as well! Dave did have a couple of breathing episodes today, but they don't seem to be as severe as they once were. Thank you for your faithful prayers, we truly appreciate each one.

Wednesday, September 3

Dave's WBC is 17,000!!! Dave had hiccups on and off last night and all day today, he did have 3 breathing episodes yesterday and 2 today. The PT decided to have Dave try a cane instead of the walker. He was walking all over 5th floor today with that cane (he barely puts weight on it)! The results of the cholangiogram show that the T tube is in the proper place, however, the bile is leaking from around it. The JP tube (Blake drain) they have been advancing slowly totally fell out of Dave's stomach today. So for a short time he was down to 2 tubes, but because the Blake drain continues to drain bile the doctors put the tube back in place. They were able to do this at the bedside and without anesthetic! In the last 5 days Dave has taken in an average of 2,200 calories per day! Dave is only getting 1/3 of those calories from the tube feedings! The nutritionist was very pleased with his progress, PTL! Thanks for your prayers for Harvey, he went home tonight, PTL!

Tuesday, September 2

Last night Dave tolerated tube feedings at 50 cc/hr, this was the goal they have been working towards!! Dave went down to IR around noon for the cholangiogram, test to see if the bile duct is working properly. They told Dave in IR that he is leaking bile from the bile duct but we haven't talked with the doctor yet. Dave's JP drain is still draining a significant amount, probably the bile the cholangiogram showed he was leaking. He wasn't able to have breakfast because of his trip to IR, but he had a big lunch that he has kept down! In PT today Dave did stairs and he walked on a slope (both without the walker)!! Diane's dad was admitted to ICU in Lincoln today because of some internal bleeding. They found his esophagus was ripped in 2 places and they have already clamped those via a scope. He will stay tonight so they can monitor his blood pressure. Please keep Harvey in your prayers also.

Monday, September 1

Dave's white blood count is 21,100 today! Dave had an abdominal x-ray, looking at his digestive tract. Dave threw up last night so the nurse pulled some food out through Dave's gastric tube. Dave is having a test run tomorrow to see if the t-tube is working properly. This is the tube in his bile duct that acts as a stint and also drains bile. The doctors' fear is that a portion has pulled out and isn't in proper position. Please pray for wisdom for the doctors and that this test goes well.

Sunday, August 31

Today has been a good day! Dave had 3 meals that he was able to keep down, PTL! Dave finished up with his IV antibiotics and is now back to oral antibiotics. He continues to get stronger everyday.

Saturday, August 30

Dave's white blood count went up a little today, 22,000. His temperature is hanging around 99.1. This morning Dave's JP tube started draining fluid again, they won't be pulling the tube out until this stops draining. Dave was able to keep 2 good meals down! However, the gastric tube started leaking from around the tube because his stomach was so full. The nurse removed 1 cup from Dave's stomach to help with the bloated feeling. They have been giving Dave an appetite stimulant and today was the first day it actually worked! Dave felt hungry for the first time since his accident! Dave has had the hiccups all day and they have progressively gotten worse. He has had one breathing episode. As many of you know Dave is a big Husker fan, he was able to listen to the game, the hospital wouldn't pay for pay-per-view, darn!

Friday, August 29

Dave's WBC is 20,700, down again!!!! Today was another great day for Dave! He was able to eat all 3 meals and keep them down, PTL! The doctors advanced his JP tube another 2 cm. He hasn't had any hiccups and consequently no breathing episodes either!

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.

Thursday, July 31st

Dave's white blood count is at 6,200! His temperature is 99.7. Dave went down to interventional radiology this morning so they could take a look at the left side of his liver. Apparently they weren't able to see the left side last week in IR for some reason. They said the left side of his liver is looking okay. Dave had PT this morning and they had him stand twice. He also had wheelchair 101 during PT. Dave wheeled himself down the hallway and then had assistance in getting back to his room. He is definitely gaining strength daily! PTL. Dave asked for cottage cheese on Tuesday, which isn't part of the fluid diet. After Dr Stothert asked, "who even likes cottage cheese?" he wrote an order for a soft diet and specified on the order that that would include cottage cheese as well. Yesterday Dave had his cottage cheese! Since Tuesday they have upped Dave's liquid food intake to 20 cc/hr through the gastric tube. Dave has tolerated this well. Dave is pretty comfortable again today with continued bouts of random hiccup episodes. Dave continues to make progress, small steps at a time! We appreciate all the prayers.

Wednesday, July 30th

Dave's white blood count is up to 3,600!!!! His temperature is 99.7. Dr Smith, ID team, said Dave didn't have to worry about the bone marrow biopsy! PTL. He also said Dave has bile leaking in his abdomen. The bile is coming out both drain tubes, the t-tube designed to drain the bile and also the tube that drains from his abdomen. He said the trauma team is taking a "wait and see" approach, hoping the leak will heal itself. Dave was not in as much pain today and had fewer hiccup episodes! Dave had dialysis this morning for 4 hours. He can only have HD now that he is no longer in ICU. Dave had PT this afternoon and stood 3 times! The therapist said she can tell Dave is getting stronger and she is having to help support him less and less! Thank you for your continued prayers.

Tuesday, July 29th

Dave's white blood count is 3.2 today. His temperature is 101.5. Dr Smith, with the ID team, came in today and stated Dave may need to have a bone marrow biopsy because of his low white blood count, high temperatures, and history of cancer. Dave didn't like the idea of a bone marrow biopsy so Dr Smith said he would talk with the hemo team. The hemo team came in and said they will have to do a biopsy if the white blood count goes down or if there is a fever that they can't explain. The biopsy will be able to tell if there is actually an infection. It would also be able to tell if there was a tumor. The blood tests they ran a couple of weeks ago for cancer were negative, however, the white blood count pattern and high temperatures are still concerning and they must get to the bottom of the problem. Dave is still in a lot of pain from the injection site where the fluid was aspirated from his lung yesterday. Please continue to pray for Dave's comfort. Dave was able to have oatmeal (pureed) this morning, better than broth for breakfast!

Monday, July 28th

Dave had dialysis this morning for 4 hours. During dialysis they gave him 3 units of blood! This is the most blood he has received at one time since his huge surgery about 5 weeks ago. From dialysis they took him to Interventional Radiology to aspirate the fluid from his right lung. He finally got back to his room a little before 5:00. When he got back from IR he was in a tremendous amount of pain from the injection site. Dave rated his pain at a 10. They were able to give him a pain medication that made him more comfortable within 10 minutes. They aspirated .5 liters of fluid from his right lung. Radiology came in and x-rayed his lungs to see if they had removed all of the fluid, we don't know the results of the x-ray yet. Please pray that Dave's lungs will be fluid free.

Sunday, July 27th

Dave's white blood count is down to 3.1 (normal is 4-11). His highest temperature of the day was 101.4. Dr Stothert said the temperature may be due to the fluid in his right lung. He stated the fluid must be aspirated on Monday. Because of the fluid the right lung is considered collapsed. Dave had hiccups this morning for 3.5 hours until they gave him thorsene, which stopped the hiccups.

Saturday, July 26

Dave started dialysis this morning at 7:45am. Since Dave is not in ICU anymore, they can not do bedside dialysis. Dave returned to the room around 1:00pm. The results for the CT scan yesterday show that bile is now moving into the intestine, this is good news! The Orthopedic team said that the x-ray of Dave's ankle showed that there is still a fracture, but Dave can begin to put some weight on his ankle. This will make physical therapy much easier for Dave. Dave is adjusting well to his new room, it is much quieter and much smaller! Dave and Diane have not made a decision yet about aspirating the lung. Please pray for Dave as he is not sleeping well, the nights are lonely for him as he just 'watches the clock and prays'. Praise God, He will never leave us nor forsake us. What a wonderful promise!

Friday, July 25th

Dave has officially moved to the telemetry floor, room 5477! Dave slept good last night with fewer interruptions than when he was in ICU! Last night he was running a temperature so they ran all labs again to see if they could culture out something. Today he is not running a temperature. Right now Dave is at interventional radiology to take a look at his bile ducts and t-tube. From IR he will go to dialysis for 4 hours. Dialysis no longer comes to his room since he moved from ICU. This morning's lung x-ray still showed fluid in the lower right lung. If the fluid has infection it could be a reason for the occasional high temperatures. Dr Young said sometimes time will take care of the problem. He would prefer but not insist on aspirating the fluid. Dr Young has given the decision of aspirating the fluid over to Dave and Diane. Please pray for wisdom in their decision. Kidney output increased again today!!!!!!

Thursday, July 24th

PRAISE! PRAISE! PRAISE! PRAISE! PRAISE! PRAISE! PRAISE! PRAISE! Dave is no longer in ICU!!!!!!!!! He is in a modified intensive care bed. Actually he is still in his same room because they don't have a room available, but the care he is receiving is equivalent to the step down. Dave's white blood count is at 8,400 today, within normal range!!!!!!!!!! Dave was actually given real food to be taken orally! He got broth, jello, a popsicle, tea, and juice. He can only have 2 tablespoons per hour but this is definitely a step in the right direction!! Yesterday he was on SLED for 6 hours before he clotted off a little after 7:00pm. They decided not to restart dialysis even though the goal was 24 hours. They will do HD tomorrow. The orthopedic team had a second x-ray done of Dave's ankle. (The first was done the day after the accident.) We don't have the results back yet but please be praying that the ankle is healing as Dave really doesn't want to have surgery. They x-rayed his lungs twice today because they saw some fluid on the lower lungs. They may need to aspirate the fluid with a needle through his back. Please pray the aspiration won't be necessary. They put one new stitch around each of the 3 tubes still remaining in his abdomen to make sure the tubes were staying secure. Dave's kidneys have started to produce small amounts of urine! Each day he seems to be producing more than the day before. The renal doctors were pleased with this, however, they are still not promising full kidney function. Please continue to pray for Dave's kidneys to regain full function.

Wednesday, July 23rd

Dave's white blood count is down again, 12,300 (yesterday was 15,400)!!!! He does have a little bit of a temperature, 99.7. Dave was just put on SLED. They are wanting to leave him on dialysis for 24 hours as they didn't pull off enough fluid yesterday during HD. Dave already had PT and ST this morning. He stood up (with assistance) twice during PT! The infectious disease team decided to take Dave off Cipro, antibiotic for the mutant bacteria in his urine. The ID team said the Cipro killed all the bacteria (including the good) in Dave's stomach which allowed the C. difficile to become a problem. They haven't cultured anything out of his urine but he is still in "isolation" because of the C. difficile. Thanks for your continued prayers!!!!!

Tuesday, July 22nd

Dave had HD (fast dialysis) today and his blood pressure remained stable!! Doctors have told us as soon as he can tolerate HD they will be able to move him from ICU to a regular bed. Dave had 2 units of blood and was also given iron during dialysis. We have not yet received the results of the CT scan from Monday. They did culture out the bacteria Clostridium difficile from Dave's stool. They are treating this with Flagyl, a very strong antibiotic. Dave is getting 6 cc of "food" through his feeding tube, however, the "food" is no longer being diluted! Dave has been really tired today, dialysis always wears him out. PT and ST are to come in later this afternoon. Dave's temperature is looking good at 97.7!