Day 65 - New Year's Eve

Luke spend the last day of 2008 with therapy in the morning and taking a nap in the afternoon while Paula and I got some work done on line. Paula also made travel arrangements to fly back to Meadville tomorrow. I will be staying for a while to get Luke settled back in his house, work on some modifications that may be necessary, and take him to some doctor's appointments next week.

Paula and I made a trip to his house this evening taking things there in preparation for his return. His wheel chair, walker and bath bench arrived today as well. We spent the evening playing the Wii and going through things to pack up. Then we welcomed in the new year!

We extend to all of you our very best wishes for a very happy new year and may God richly bless you as you have blessed us with your prayers, cards and comments. The new year will no doubt be the most challenging ever for Luke, but with his strength, determination, and great sense of humor, it will be a good one.

---Bill

Day 64 - Discharge Date

As a result of our meeting this morning with the staff at Sharp Rehab Center, Luke is scheduled to be discharged this Friday. He will be going home to his house and adapting to life without continuous professional care for the first time in over two months. Paula and I haven't set any definite plans for returning home yet as Luke will be needing plenty of help initially in this adjustment. It will be several weeks yet before he will have a prosthetic leg to get around on.

It was therapy as usual today. This morning SCOPe Orthotics and Prosthetics came in and fitted Luke with compression sleeves that will shape his leg in preparation for his prosthetic. There are too many factors to predict a definite time frame, but he will most likely wear the sleeve for a couple of weeks before they will be able to make a cast for the prosthesis and then couple more weeks before it is ready.

This afternoon we took Luke for an EMG (electromyogram) on his left arm. This measures the electrical activity in the muscles at rest and during contraction. The doctor tested all the areas controlled by the brachial plexus. The results are inconclusive and he is going to study the results further, but basically there was no activity in the fingers, hand or arm. This is the baseline test and further testing down the road will be able to show whether there is any improvement. We remain confident that Luke will regain the use of his left arm. Pray that God will bring swift healing here as He has in other areas of injury and astounded doctors with his recovery.

Following the EMG we had another enjoyable meal out, this time at Applebee's.

---Bill

Day 63 - Back To Work

It was a return to therapy sessions for Luke this morning. An hour of occupational therapy, an hour of physical therapy and an hour of exercise class where he works out on exercise machines with therapists overseeing. His physical therapist was so impressed how well Luke could stand and balance himself, he asked how soon he would be going home. There is a lot to be prepared before we're ready for that, but Luke is physically getting closer and closer every day.

We have our biweekly meeting with Luke's doctor, his therapists and the rehab center management to discuss Luke's progress and status. Possibly we will have a better idea of a timetable from that. Luke also has a doctor's appointment tomorrow afternoon.

This afternoon we took Luke out to take care of a couple of things and then a little shopping with some gift cards he received. Then it was to Outback for a dinner out which we thoroughly enjoyed.

---Bill

Day 62 - Another Rest Day

Luke had a pretty restful day gearing up for another week of therapy. In fact, he got to sleep in until late morning! After lunch he got up in a chair for most of the afternoon, working on improving his skills on the Wii, so at least his right arm got a good workout! This evening we watched a movie.

As of now he is scheduled for all his therapies in the morning tomorrow. Unless that changes, we are planning getting him out with us and taking care of some of his personal business around town. Schedules do change quite frequently based on patient needs, so we'll have to play it by ear.

---Bill

Day 61 - Kicking Back

Luke had a relaxing day today with no therapies scheduled. So we hung out together watching college bowl games, playing games on the Wii and video visiting with family back home on the computer.

Luke continues to get stronger and adapting to his modified mobility. Soon he will be starting on the compression sleeve on his leg to get it prepared for a prosthesis. His left arm still has no mobility. He may be getting some sensation to touch in the upper part of his arm, but that is negligible. He is getting pain sensations in his finger tips and elbow, which could be a good sign, but could also be phantom pain. We won't know for sure what the extent of the damage to the brachial plexis is for two more weeks when we see the neuro surgeons.

Luke remains in great spirits and continues to whoop up on me on the Wii.

---Bill

Day 60 - A Typical Day

Today was a typical day of therapy for Luke. Three hours of strengthening, endurance and range of motion of his left arm kept him busy for half of his day. The rest of the day was spent getting lots of Wii therapy with Dad. This evening his neighbors brought in pizza and movies for the evening entertainment.

At the present Luke is planning on staying in San Diego when he is released from the rehab center and continuing his out-patient therapy. He's got some things to work out yet so nothing at this time is definite.

---Bill

Day 59 - A Very Different Christmas

Although Luke spent Christmas 2007 in warm and sunny San Diego apart from the rest of us, this was a first for Paula and I. While the rest of our family gathered at our home in Meadville, we spent the day at the rehab center with Luke, except for an hour and a half when we were able to get away to the Zamora household to once again visit Luke's dog, Boston, and to be treated to a delicious traditional Christmas turkey dinner. Since Luke didn't have any therapy on Tuesday because of travelling to doctor appointments, he had a full day of therapy today. This morning was occupational therapy. When it was done at 11:30, we booked to Zamora's for a brief visit and to enjoy the meal. We just made it back in time for Luke's physical therapy at 1.

Later we hooked up on line with our family and were able to see our grandkids showing off their Christmas presents and chat with the family. They got to see Luke open his gifts. While in the hospital we rigged up his X-Box for him, but he found that he wasn't able to effectively play the games he had for that with one hand. After seeing what he could do with the Wii systems that they use here for therapy, we felt that this would be a good gift for him. We spent the rest of the afternoon and evening playing it. He thoroughly enjoyed it and the day as well.

---Bill

Day 58 - Christmas Eve

Luke spent Christmas Eve working on his therapy. First up this morning was another session with the neuropsych therapist who had him work through various tasks testing his thought and reasoning capabilities. One test had him form a pattern of colored blocks from a picture that she showed him. When he finished she told him she had never had anyone complete the task in so short a time.

Then it was on to occupational and physical therapy. They continued to work on range of motion in his left arm as well as various exercises to strengthen all his muscles. During his therapy, he was paid a visit from Odele, the rehab center's therapy dog, who got quite comfortable with him.



Following his therapy he had an hour of exercise therapy where he could work out on his own. He pushed himself pretty hard and took a much needed nap after lunch. He also had several well-wishing visitors today.

I neglected to post the picture we took of Luke at his Border Patrol station running the scope when we visited on Monday. Here he is getting into it.


Luke, Paula and I extend to all of you our sincerest wishes for a wonderfully Merry Christmas! Among all the presents, feasting, fellowship and merriment, may we all be blessed by the greatest wonder of them all, that God demonstrated His great love for us, that our Saviour came as a baby in a manger, the event heralded by angels and witnessed by shepherds and kings!

---Bill

Day 57 - Checkups

We took Luke back to UCSD Medical Center today for two more checkups with his doctors. The first appointment was with the vascular specialists that placed the stent in his aorta to repair the tear. They want CT scans, with and without contrast (dye in the blood to light it up on the scan) to make sure it is in place and doing its job of sealing the tear. That will be done on January 9th. He will require follow up CT scans in a couple more months, then six months later, and then once a year after that.

Luke's second appointment was with the orthopaedic doctor that worked on his left leg. She said everything is looking good and he has the 'go ahead' to start with the compression on his leg to get it ready for the prosthesis. She was elated to see how well he has recovered and told us that only one out of ten patients that come in with the severity of injuries that he had survive. What gave him an edge is his age and his physical condition, but most importantly the grace of a loving God who answered thousands of prayers.

Between appointments we took Luke to Subway for his favorite sub. Before we left this morning Luke had a session with the neuropsych therapist working with him on various types of tasks just to check and make sure everything is OK upstairs. He completed everything with ease.

---Bill

Day 56 - Back to the Station

Luke made his first visit back to the Imperial Beach Border Patrol Station this morning. We went down early so that he would be there for when the midnight shift agents, the shift that Luke worked, came in from their duties. There were a lot of smiles and warm greetings as they were all very happy to see him back. It didn't take Luke long to take control of the scope and survey the areas of the border that he had worked.

We stayed for the first half of the benefit barbecue held on his behalf. It was more time of chatting and laughing with his fellow agents. Then Luke needed to get back to get his occupational and physical therapy workouts. During his workout he received a phone call greeting from Chief Aguilar, head of the national Border Patrol. Chief Aguilar had honored us with a visit while Luke was the ICU but under sedation and pain medication. This time Luke was able to talk with the Chief.

---Bill

Day 55 - A Visit To Boston

Luke rested most of the day today except for a trip this afternoon to visit with his dog, Boston. Boston has been staying at the home of a fellow Border Patrol agent. We took Luke to his house this afternoon for a few hours. As soon as Boston saw us park out front in Luke's jeep, he came running out all excited. They had a good time together as we did visiting with the Zamora family.

---Bill

Day 54 - Saturday Workouts

Today was Luke's makeup day for the therapies that he missed yesterday taking his 'road trip.' He pushed himself pretty hard with his arm and leg workouts. But after some rest he was able to get in some fun therapy on the Wii system with another patient. Later it was back to work with, what is probably the toughest for him, walking with the use of a walker. After his workouts he relishes a good nap!

---Bill

Day 53 - Doctor Visits

Luke paid visits to doctors today for checkups. With a little help from pop Luke got into the van and we took him back to UCSD Medical Center for a checkup with the trauma team doctor. He had the last staples removed from his left leg. Everything looked good. They talked to him about a couple of things he will need to keep up with. He will have to have periodic CT scans to make sure the stent in his aorta stays put. He will also have to be sensitive to the fact that now any fevers or other illnesses he gets will need doctors attention because of his splenectomy.

After the doctor visit we took him down to the SICU to say hello to all the nurses that cared for him during his five and a half weeks there. They were very happy to see him looking so good as you can see.



Between visits Luke got to eat out at a restaurant for lunch. He enjoyed that very much. Then it was off to the orthopaedic doctor. They removed the cast from the surgery on his elbow and then took x-rays of his elbow and hand. They also removed the stitches from the surgery and the last of the stitches in his hand and fingers. Physical therapy will be adding range of motion with his left arm to his daily exercises.

Since we were gone all day he didn't have his regular therapies but they're not letting him off the hook that easy. He will make it up by having his full three hours of therapy tomorrow. Monday is the day his Border Patrol station is having the Christmas Benefit BBQ for Luke in lieu of their regular Christmas party. We hope to be able to take Luke to the BBQ.

---Bill

Day 52 - Progress in Therapy

Luke is improving with each day of therapy. He is able to do more exercises and to work longer and with more weight on the devices. The workouts do tire him out and he likes to get as many naps in between sessions and meals as possible. Paula and I participated today, working on helping him in and out of a vehicle. We are taking him back to UCSD tomorrow morning for an appointment with the trauma team and then to another appointment up the road in La Jolla for an appointment with the doctor that repaired his elbow last week.

---Bill

Day 51 - Rain Outside, Therapy Inside

Today was another rainy day in the "It never rains in San Diego" area so it didn't seem so bad spending the day inside in therapy. Between all his therapies Luke spent about four hours in therapy. It wasn't all sweat and strain, though, as part of his occupational therapy was playing ping pong and I got to play with him for a while. After finishing up his last physical therapy for the day, we went across the hall and were able to get in some recreational therapy on their Wii system.

Luke has been working hard this week on getting his old appetite back and this evening was no different. His neighbor brought in home made chicken parmesan, pasta and cookies. A very delicious meal was enjoyed by all!

---Bill

Day 50 - From Wii to Polynesian Dancers

Luke got to enjoy his last morning with his friends from Crawford County by having them participate him in occupational therapy. His therapy was playing sports on the Wii entertainment system. It was most likely the most enjoyable therapy he will have.



We had a meeting this morning with his entire rehab team including his doctor, case worker and his therapists. Each discussed how Luke is progressing from each of their prospectives. The purpose is to make sure everyone is on the same page.

After saying goodbye to his visitors. Luke had lunch and his last visit from his speech therapist. He has progressed with his breathing and swallowing that therapy will no longer be necessary.

This afternoon Luke had an exhausting workout with physical therapy. He did several exercises with his leg. Then he used a walker and moved using his right leg and arm. Here he is with his physical therapist.



This evening the center had a Holiday Dinner Show. After a dinner of traditional Hawaiian food we were treated to a show by Heali'i's Polynesian Revue. I wish I had a picture to post of the dancers but they were so entrancing we didn't think to snap a photo!

Very special thanks to Jenna, Josh, Matt and Dustin for taking time away from family to spend time with Luke. We appreciate it and you can be assured it was a tremendous boost for Luke!

---Bill

Day 49 - Luke Aces the Test!

Luke had the swallow test this morning and passed with flying colors. As a result he was removed from all restrictions on his eating and drinking. I'd like to describe how much he enjoyed his 'normal' lunch, but I believe this says it all:

To celebrate this next step on his road to recovery, we had a special dinner for him. The weather was too nasty (wind and rain - typical weather for his old home town, Meadville!) to take him out so we we brought dinner to him from Red Lobster. Luke thoroughly enjoyed his shrimp alfredo but still has a long way to go before his appetite is back to the way it was before, when he was able to put down 110 shrimp scampi!

In between enjoying his meals he was able to squeeze in several hours of occupational and physical therapy. He is able to do a little more each day.

---Bill

Day 48 - Another Day of Rest

Luke spent the day pretty much resting. We did take him for a stroll out of the rehab center and over to the cafeteria in the adjacent hospital. Jenna and I needed a bite to eat and Luke wanted to be up and about. We also played some cards and watched a movie. By early evening, though, he was tired out and fell asleep.

Tomorrow he has the barium x-ray swallow test which will hopefully get him off having to thicken all his liquids. He will also have his first full day of therapy.

Luke is very concerned, as we are, about his left arm. He does sense sharp pains in his finger tips and this evening he sensed pain in his elbow. We hope this is real pain from the damage to his fingers and from the surgery last week on his elbow and not phantom pain like he has been feeling from his leg. They should begin soon to do testing on the nerves. Continue to pray particularly for healing of the nerves in his left shoulder.

-Bill

Day 47 - Picture Perfect Day

Luke started his second day of rehab with occupational therapy working his arm on a couple of workout machines. Then he had a session with speech therapy doing exercises to strengthen his swallowing muscles.

He was served up his cheeseburger for lunch as ordered, which he thoroughly enjoyed as you can see:

After lunch Luke had physical therapy and worked on his standing using parallel bars. After getting into the standing position he worked on raising up on the balls of his feet. After a short rest he then worked on lowering to a slightly squatted position. I was able to snap a photo while he was working out.

After therapy Luke got a very special visitor. Boston came to see him. It was a very happy reunion for both of them.

Since a picture is worth a thousand words, I guess enough has been said. Although today was cool and overcast with occasional showers, it really was a picture perfect day for Luke.

---Bill

Day 46 - Intro to Rehab

Luke's first day in rehab was pretty much an assessment of his condition and abilities. The first to see him this morning was his rehab doctor. He gave him an overall check-up and will be coordinating with the doctors at UCSD about his neck brace and left arm. Next was occupational therapy who got him in a wheel chair and took him to the therapy gym. While there they had him start working his arm on a couple of machines.

The speech therapist paid him a visit during lunch to check his swallowing. She scheduled him for a barium x-ray swallow exam Monday at 9:30 a.m. Luke is really hoping he will be able to get off the thickend liquids.

After lunch his physical therapist paid Luke a visit and took him to another therapy room and had him work on getting in and out of the wheelchair and sitting up on his own from laying down. He didn't spend very much time in therapy today. He will have a light therapy tomorrow, have Sunday off and then start full schedule on Monday which will be about 3 hours a day.

The representative from SCOPe stopped in today as well and took measurements of Luke's leg. She ordered the compression sleeve to start shaping his leg for the prosthesis and it should arrive Tuesday. She also gave us a brochure on the C-Leg, an advanced computerized prosthetic leg that she is submitting for approval from his insurance.

Luke spent the rest of the afternoon and evening watching movies and visiting with his friends. He is looking forward to tomorrow's meals. He ordered a cheeseburger for lunch and a chicken pot pie for dinner.

---Bill

Day 45 - The Big Move!

Luke moved from UCSD Medical Center to Sharp Rehabilitation Services this afternoon. Leading up to the great event he had several 'removals.' He had the stitches removed from his left leg, he had the PICC intravenous line removed from his right arm and he had the catheter removed. The only things that remain are the cast on his left arm from the elbow surgery the other day, a pin in his left thumb and the cervical collar that he is to wear for another almost six weeks. That time may possibly be shortened if they determine here at rehabilitation that it is no longer necessary.

After arriving here, he got settled in his room had dinner and, feeling pretty tired, went to sleep. Friends from Pennsylvania flew out to see him and were able to visit with him briefly before the ambulance crew arrived to take him to Sharp and then were there to help him get settled in.

Those of you that have been wondering about that first drink of orange juice, I apologize that I did not report the event when it happened. The funny thing was that the first time he was able to order his breakfast, he chose apple juice instead of orange! That really surprised me, but I guess his tastes changed over those few days. He did get his first orange juice the next morning, though.

First impressions of Sharp Rehabilitation Center have been overwhelmingly positive. The facility is very nice and the people have bent over backwards to take care of Luke's desires. I ran into Mike and Bonnie, a couple we met at UCSD Medical Center. Mike is an officer that was hit by an impatient driver while escorting a motorcade on a motorcycle shortly after Luke was hit. He was in the ICU with Luke and came to Sharp a couple of days ago. They commented on how great the therapists are here. It sure looks like Luke is in the right place. Luke's new address is on the right sidebar.

---Bill

Day 44 - Goodbye Trach, Hello Solid Food!

When I got in to see Luke this morning physical therapy already had him in a wheel chair. They had him wheel himself all the way to the end of the hall. They would have had him wheel himself back but speech therapy came to work with him as well. He stayed in the wheel chair for speech therapy and was able to sit for almost an hour, but was then ready to get back in bed with being tired and his back aching.

A representative from Sharp Rehabilitation Services came and spoke with us about the facility. Plans are still on track for him to move there tomorrow.

Speech therapy returned for another swallow study, where they put a video tube into his throat and watch as he swallows different food items. He did much better than he did a week ago and he was cleared to eat solid food. He isn't totally recovered yet, so for now he still needs thickener added to any fluids he consumes. This allows him to swallow it completely and prevents any residual fluid from trickling down the bronchial tubes into his lungs. After what they have been through the past six weeks, we certainly don't want to set them back.

Then the doctor came in and removed the trach tube. She simply pulled it out, the hole closed up and will seal on its own. She put a bandage over the site just to help it stay closed. While she had the top part of the cervical collar off, I took the opportunity to give Luke a shave. His beard was causing him a lot of itching under the collar.

So for lunch today Luke was able to have is first solid food in over six weeks. And did he ever enjoy it, and dinner as well!

Representatives for SCOPe Orthotics & Prosthetics came in this afternoon and talked to us about the process of working towards getting fit with a prosthetic leg. His stitches are still in his leg from his last surgery so nothing is starting yet, but the first step will be putting an elastic shrinker on the leg to decrease the swelling and help shape the leg for the prosthesis.

The Border Patrol union is donating $2,000 to Luke for his recovery expenses. They are also doing a fund raiser for him. Luke's own Imperial Beach Station is going to fore go their usual Christmas party this year and have a BBQ & Raffle to raise funds for Luke. Again, we are so very much appreciative of the moral and financial support Luke has and is receiving from his Border Patrol family.

---Bill

Day 43 - Final Surgery at Long Last

After several postponements, Luke went for surgery about 8:00 this morning to fix the end of his radius bone in his left arm. They removed the broken piece and replaced it with a metal piece. He got back to his room about 1:00 this afternoon, thinking of food. They brought up some soup and puddings which he cleaned right up. The surgeon reported tonight that everything with the surgery went fine. His left arm is in a cast, but that will only be for about a week. Then they will start working on moving the elbow. Not much has changed with his feeling in the arm.

This afternoon his trach doctor came in and was very pleased with how he is doing, being able to have the Passy-Muir on all day long. She thinks the tracheostomy tube may be able to come out entirely tomorrow! Great news from the same doctor that told him yesterday that his cervical collar would have to be on for 12 weeks instead of 6. I found out that my assumption, that it was something they saw in his MRI that extended the time, was incorrect. She said she doesn't know where the 6 weeks came from, because her records show that it was 12 from the beginning.

His case worker came in this afternoon also very pleased with his overall progress and told us that a representative from Sharp Rehabilitation Center will be in to see us tomorrow morning and that he may be released from the Medical Center to Rehabilitation as early as Thursday!

Even though neither of these giant steps is certain to happen this soon, we thank God and give Him the praise and glory for His goodness and answers to prayers, as well as for all the saints' prayers for Luke!

---Bill

Day 42 - Luke Goes Mobile

Luke continues to get stronger and stronger. His physical therapists were very much impressed with his ability to move himself to the edge of the bed with very little help and sit up on his own. They then assisted him into a wheel chair and I pushed him out into the hallway. From there he worked on wheeling himself using his right hand and leg. I snapped a picture of him so all could share in this great moment. You can click on the photo to view a larger image.

A doctor came in this morning and gave Luke some disappointing news. He has been wearing a cervical collar from the beginning and the original plan was that it was necessary for six weeks. Today makes six weeks and he has been looking forward to getting the collar removed. He learned today that now he has to wear it for three months. The MRI done on his head and neck last week must have shown that the fracture at the base of his skull and the damage to his vertebrae hasn't healed as fast as originally thought.

Luke said today that he has had some sharp pains in the tips of his fingers on his left hand. Hopefully this is another sign that he will recover from the paralysis in his left arm. He will be heading to surgery at 7:30 tomorrow morning to repair the end of the radius bone in his left elbow. This time it should be a go, barring an overnight emergency that would bump his surgery.

---Bill

Day 41 - Another Move

Luke was moved this morning up the hall to room 535. It is still a part of Intermediate Care but a lot less crowded and quieter room. Again today he had quite a few visitors which kept him busy all afternoon and evening. I went to his apartment today to get his X-Box and bring in for him. He was very happy to be able to pass the time with his games.

Luke took a couple more steps towards getting the trach tube removed. He went the whole day today without the trach collar that supplies oxygen enriched air over the trach tube, so he was breathing room air. He also was able to still speak without the Passy-Muir valve over the trach tube.

Luke's right fingers were also very happy to find out that they don't need to be pricked any more to check his blood sugar. Since he is off the feeding tube and eating meals on his own that is no longer necessary. He will be on pureed food for a couple more days until the speech therapists come back and use the scope for another swallow study. If everything looks good he will be able start on more solid food.

He said the sensations in his arm are the same as yesterday. I am hoping tomorrow we will get a visit from the neurosurgeon and find out their plan to treat his brachial plexus injury.

---Bill

Day 40 - One More Tube Gone

Luke was able to get the feeding tube, that ran up through his nose and down into his stomach, removed today. He's getting his old appetite back even though he's still getting pureed food to eat. We were told he is supposed to start getting some solid food to eat tomorrow but his menu choices were all pureed food.

Talk about answer to prayer! I asked yesterday for prayer for feeling to return to Luke's left arm and today he told me that he feels a little pain in his upper arm and has a slight tingling feeling in his lower arm. I still have not received the official report as to the nature or extent of the damage to the brachial plexus but am cautiously optimistic that the sensations he is feeling is the first step towards full use of his left arm and hand.

He did have his first experience with phantom pain last night when he was sure something was squeezing the big toe of his left foot but then realized that it wasn't there. Luke continues to be upbeat about his situation, even occasionally making an joke about it. There have been a couple times when it has got him down and no doubt there will be more, but I'm sure that his faith and strength of character will overcome.

Luke had a steady stream of visitors today which was good in that he was doing a lot of talking (great therapy for him!). It made him pretty tired after he ate his dinner and slept most of the evening.

---Bill

Day 39 - Up and Out of Bed

Physical therapy is having Luke do more and more each day. In fact, when we got in to see him this morning he was sitting in a chair beside his bed. He told us that they had him stand up beside his bed when they were working with him earlier.

He continues to improve on his eating as well and will probably be starting to eat some real food (before it hits the blender!) on Sunday.

The MRI he had done yesterday shows some problems with his brachial plexus. This is a network of nerves that conducts signals from the spine to the shoulder, arm, and hand. There is swelling and bruising around it. We don't yet know how serious the damage is or what the long term prognosis is. Please pray that when the swelling and bruising abates, feeling and muscle control will return.

Luke will be heading to a rehab center in the near future, possibly as soon as the end of next week. He has a lot of decisions to make concerning the what's and where's. We are supporting his decisions and are here to help out in any way we can.

---Bill

Special News Flash!

Luke has a new nephew! Ian Kenneth Miller was born to Becki and Eric at 7:15 a.m. Eastern Time. He weighed in at 7 lbs. 11 ozs. and is 21 in. in length. All are doing fine.

Day 38 - Out of the ICU

This morning Luke made the first of what will probably be several location changes along the road to recovery by moving from the ICU to the IMU or for those of you that don't like acronyms from the Intensive Care Unit to the Intermediate Care Unit. This is the step between intensive care and a regular hospital room. It is a ward with six patients and nurses always in the room. It's a little more crowded from where he was, but it's moving in the right direction. The room number is 533.

He still has the trach tube in his throat but has been breathing on his own since being taken off the respirator last Friday morning. He was able to keep the one way valve on all day again today allowing him to talk freely. He did much better eating his meals today. He fed himself and was able to eat larger portions of his pureed food. He had an easier time swallowing. We continue to thank God for Luke's progress.

Luke had the MRI on his shoulder this afternoon to see if there is any structural damage that may be causing the numbness and paralysis in his left arm. Hopefully we will learn of any results tomorrow.

---Bill

Day 37 - First Meal

Luke had step two of his swallow test today. They put a scope in his throat just above his voice box and watched as he swallowed different types of food. He did good enough that an hour or so later they brought him lunch - mashed potatoes, squash, bean soup and vanilla pudding. Well, it's how he has to start before working up to cheeseburgers, shrimp and burritos! For dinner he had pureed meat, pureed peas, mashed potatoes and applesauce. He was able to take a bite or two of each but got tired out easily from working on swallowing.

Physical therapy and occupational therapy gave Luke a visit today and put him through a number of exercises and sat him up on the side of the bed. He has lots of exercises to do with these in addition to the ones given by the speech therapist.

Luke was scheduled for an MRI of his left shoulder area this afternoon, but ended up getting bumped to tomorrow morning because of an emergency. This is the one drawback to being in the ICU and needing procedures that are not critical.

Luke's current status is he still has the feeding tube in until he can eat enough. He has the trach tube in until there is no doubt that he will be fine without it. He has the pic line in his right arm for the IV antibiotics and occasional pain medication and he still has the catheter. His left leg is healing very well after the last surgery and the swelling has gone down considerably. He is weak from spending the past 5 weeks laying on his back, but his exercises will help him overcome that.

---Bill

Day 36 - Bumped Again

Luke's elbow surgery was postponed again today after a couple of emergencies took precedence for the operating room. This isn't really a problem as the fixing of his elbow can be done at any time and is not affecting his recovery.

Luke had the first step of the swallow tests today. They are evaluating how well he can swallow with the trach tube in. First he was given some small pieces of ice to chew on and swallow. Then he was given some spoonfuls of water. Next he was given water with material in it to make it thicker. Since he did well with all that he was allowed a couple of spoonfuls of applesauce! His first food in 5 weeks! Tomorrow will be the next step where they will run a scope down to make sure food won't go into the lungs. He has exercises to do with his mouth and tongue to aid the process of getting back to eating.

A neurologist came in today and examined Luke's left arm. He doesn't have sensation in it and no reflex action. They are going to do an MRI on his shoulder area in the near future. Pray for healing that he will regain the use of his arm.

---Bill

Day 35 - MRI

Luke had the MRI done today on his head and neck this afternoon. Hopefully tomorrow we will learn the results. Also tomorrow Luke is scheduled to go back to surgery to repair the end of the radius bone in his left elbow.

Luke did very good today with his breathing. When we went in to see him this morning they put a cap on the trach tube which is a one way valve that opens when he inhales and closes when he exhales so that he pushes the air up through his throat and vocal cords. This allows him to talk. He was able to go most of the day with the cap although it does tickle his throat more. He did quite a bit more coughing expelling material from his lungs.

Things that should be happening within the next few days are a swallowing test working towards allowing him to eat and drink and moving him from the ICU to regular room. All steps of progress in his recovery.

---Bill

Day 34 - A Day of Rest

The past several days of giant leaps finally caught up with Luke today. He spent the day quietly resting and taking brief naps. In between we watched the Lord of the Rings trilogy.

Luke didn't get the MRI done today, most likely due to the fact that his is not an emergency and the medical center seems to have had more than their share of emergencies this weekend. Hopefully they will be able to do it tomorrow.

---Bill

Day 33 - 36 Hours and Counting!

Last night I reported that they would be putting Luke back on the respirator over night. When we got in to see him this morning we found out that he was doing so well without it that they left him off it. He has gone the day with just the trach collar so he has been breathing totally on his own for over 36 hours! In fact, when we got back in to see him tonight the respirator had been removed from his room. Praise be to God for the wonderful progress Luke has made the past couple of days!

Luke told us yesterday that he was seeing double when writing messages on the board and this afternoon an eye specialist came in and gave him a thorough checkup. He didn't find anything that would be causing the problem. Luke is scheduled for an MRI tomorrow to check for any problems that may be causing the inability to move his left arm. They will also check his brain for anything that may be affecting his vision.

For his eye checkup it was necessary to cap his trach tube so he could speak. He was able to stay that way until we left at 6:30. What a tremendous blessing to talk with him! Luke was being the Luke we all know and love, making jokes and enjoying conversing. He said he would give anything for a glass of orange juice. He is so looking forward to being able to eat real food again. This evening when we came back in he tried again with the cap but had a little trouble with it so they took it back off.

The past two days they have been lowering his dosage of fentanyl (pain medication) until this evening when they shut it off! All he is receiving now is some antibiotics with fluids. They will now be administering pain medication for him whenever he needs it.

---Bill

Day 32 - Breathing On His Own

Luke started sprinting at 5:00 this morning and sprinted for three hours. Then they removed the respirator tubes from his trach and put a trach collar over it. This gives him air over the trach but he is breathing totally on his own. He stayed on the trach collar all afternoon until visiting hours were over at 6:30 this evening. Occasionally his breathing rate would rise above the 40 breaths per minute limit that they like to see, but all his vitals remained normal and he didn't show any signs of discomfort or anxiety. What a giant leap forward after several days of small steps!

He was also taken off the ativan so he was more awake than he has been. Another huge step forward! He didn't have the trach collar deflated to talk to us but could write messages on his dry erase board for us.

Now that he is able to effectively communicate we talked to a trauma team doctor today about his left arm that he has not been moving. He will be evaluated by neurological doctors. Pray that they will be able to determine the problem and that it is not a long term problem.

---Bill

Day 31 - More Sprints, More Words

Late update: This evening when we went in to see Luke he was still sprinting from when we left him at 6:30 and continued through our visit. After we left they were going to put him back on the respirator for the night to let him rest and sleep. They plan to start him sprinting again in the morning and see how long he can go. He sprinted this evening for over 4 hours! Thank you, Lord, for another answer to prayer!

This Thanksgiving Day we give thanks to God watching over Luke one month ago when he survived multiple serious injuries and for bringing him along in his recovery to where he is today. Luke spent the day continuing his breathing sprints and resting in between. His first sprint this morning lasted two hours at the 5 and 5 settings. This afternoon he sprinted again for 30 minutes and was sprinting for the third time when we left him at the end of visiting hours.

We were able to talk with him a couple of times again today. He made a joke to one of his fellow PAs (Patrol Agents) that he guessed he was out of the running for getting on the ATV team. We assured him not to count that out, because with God and what they are able to do with prosthetics today he may very well be able to get the 'scoots' assignment.

Luke was also able to exchange verbal Thanksgiving greetings with his Grandma, Ben, Jill, Isabelle, Natalia, Becki, Eric, Bradyn, Andy and Elwood in Meadville through an internet video hookup. Paula told them to freeze some of the deep fried turkey they had for dinner for her to bring back for Luke on her planned trip home the second week of December for the birth of Becki and Eric's son. When Luke heard her say that he gave a big thumbs up of approval!

---Bill

Day 30 - First Words!

Luke started his thirtieth day in intensive care by being challenged with breathing exercises. The respiratory therapist wanted to push Luke and had him breathe on his own with the respirator set at 5 and 5. Those of you that have been keeping up with the blog for a while will know that this is the lowest settings of breathing support for him. Not only did he sprint for the 30 minutes they usually do, he lasted 90 minutes! Praise the Lord!

This was done before we were able to get in to see him. The therapist told us when we did get in that she also had shrunk the bladder that surrounds the trach tube at the neck to seal it so that some air could enter and Luke could use it push up through his vocal cords and try to speak. She told us he had made some sounds but couldn't tell what he was trying to say. She said that if he was awake in the afternoon she would try it again.

Luke slept the whole time we were in to see him until about 5:00. The therapist came back early in the afternoon and had him sprint again at the 5 and 5 settings. This time he sprinted for 2 hours! Praise the Lord! He was asleep just about the whole time and when he did stir his breathing rate did rise to above the limits they like to see. He is still having a problem with keeping the rate down when awake. We don't know if it is anxiety or what, but he does great breathing on his own while sleeping. Please continue to pray that he will improve in this area.

When Luke woke up around 5, we told the therapist that he was awake and she came back and again shrunk the bladder. We were finally able to hear him speak! He first asked who the therapist was and when we asked if he knew what yesterday was he answered that it was his birthday. He was also able to tell us where to locate things at his house. He told us that things were foggy with him and he was having trouble putting his thoughts together. We explained to him that he is still on medication and that once he does better with the sprints he will be able to be free of the respirator. He asked how long that would be.

What a blessing! What joy filled our hearts! Although his words are difficult to understand the chance to communicate with him is priceless!

We have received such a multitude of best wishes from so many we would like to take this opportunity to wish all of you a wonderful Thanksgiving and most of all to cherish the blessings of family and friends and take nothing for granted. God bless you all.

---Bill and Paula

Day 29 - Birthday in Bed

Luke spent his 25th birthday in his ICU hospital bed, but it certainly wasn't an uneventful day for him. He had a constant stream of visitors coming to see him and bring him cards, balloons and gifts. We can't get half of his get well cards up on his wall let alone all the birthday cards that came today! We read a few of them to him but there were far too many to try to read them all. We're all still struggling with the frustrations of not being able to communicate other than him nodding or shaking his head in response to questions and us trying to figure out the right questions to ask! In any event, it certainly is a blessing to see smiles!

As of 5:00 p.m. they still hadn't taken him for surgery, so we're doubtful that they will today. We aren't sure of the reason for the delay, but most likely it has to do with emergencies and repairing his elbow is not.

He did well on his sprint this morning going for 30 minutes on settings 5 and 5. The respiratory therapist was going to try to push him further this afternoon, but with all the visitors and activities, she decided to postpone it until 5:00. That's why we cleared out a little earlier than usual today. She wanted to be able to sprint him when all was quiet.

One of the trauma team doctors came in and talked to us about Luke's progress. Their main concerns now are getting him off the respirator and weaning him off the ativan and fentanyl. It is taking him longer than they expected, but when they stop and consider the many problems he had when he came in, it is understandable.

If I can find out any more about his scheduled surgery when we see him this evening, I'll post an update.

---Bill

Day 28 - A Little Better

Luke completed his fourth week in the ICU today. His ativan (sedative) level was down to 1 all day and he was more coherent than he has been. It is still awfully difficult to communicate with him since he is unable to talk with the trach tube in and he still doesn't quite have the dexterity in his right hand to write on the dry erase board. His fentanyl (pain medication) remains at 10. This is keeping him from being in much discomfort but does add to his grogginess (probably bad English, but you get my drift).

He had two sprints, or breathing exercises, today. This morning he went for 30 minutes and 45 minutes this afternoon. He still needed the respirator at 5 and 15. With the afternoon sprint, even though he was breathing fast, his heart rate didn't rise so they let him sprint longer.

His vitals remained the same and he continued with his low grade fever, although when we left at 6:30 his temperature was down to normal. But when we came back in at 8:30 it was back up a couple of degrees.

Tomorrow he will be heading back to surgery to repair the end of his left radius, essentially replacing part of his elbow. We don't know if they will do anything with his wrist, hand or fingers at the same time. That is a different team of surgeons. Luke still hasn't moved his left arm or hand and we don't know if this is due to all the bone damage or if there may be some nerve damage.

Luke's Border Patrol station, Imperial Beach, is having a dinner tomorrow of deep fried turkeys. We have been invited to the dinner, but it will depend on when Luke's surgery is, as to if and when we go there.

We continually are thankful to the Lord for Luke's progress, although not always in great measure, progress all the same.

---Bill

Day 27 - Holding His Own

Luke held steady today, resting for most of it. This morning he sprinted for 30 minutes at 5 and 15. This afternoon they let him sprint for 45 minutes but still at 5 and 15. He needs to get down to 5 and 5 and then they can let him sprint longer.

Everything else is holding pretty much the same. He still has congestion in his lungs and continues to run a slight temperature.

Paula is decorating his walls with a small portion of the multitude of cards that he has received.

---Bill

Day 26 - One of those small steps back

Luke didn't do quite as well on his sprints today. This morning they tried starting him out at 5 but then had to raise him up to 15 before he got his breathing rate down. They also did a short sprint this afternoon, but again he couldn't stay at 5 for very long. They plan to have him sprint againg this evening when all is quiet and see how he does. He has a bit more congestion and is coughing more frequently. He does have a strong cough and the nurses are glad to see that.

He was semi-awake most of the time we were with him today. Again he responds to commands and will most of the time answer questions with a nod or shake of the head. Late this afternoon he was pretty restless and nodded that he was feeling some pain so the nurse upped his medications a bit.

It seems we are always expecting him to be getting better each day, but realize there are going to be these days when he takes that small step backwards. The bright spot of the day was when he gave us a couple of big smiles. What a tremendous blessing to our hearts!

Pray for continued healing in his lungs and of course for his body in general.

---Bill

Day 25 - Final Leg Surgery

Luke went in this morning for what should be the last surgery on his left leg. We didn't get the chance to talk to the surgeons but the report that went in his notebook noted that everything went as expected. So they should have cleaned up the wounds and repositioned the muscles to get the femur centered and then closed the incisions. Down the road he will probably need some work to shape the leg for a prosthesis, but this should be it for now.

He slept until the middle of the afternoon. Then they had him sprint for another 30 minutes. They started him out at 10 and lowered him to 5 (the lowest setting) for about 5 minutes and then finished the sprint back at 10. This was the first time he did any breathing at 5. He is getting a little better each day. Once he can sprint at the 5 setting for 30 minutes, they will start extending the length of time. All steps to getting off the respirator.

He was in and out of sleep for the rest of the afternoon. His temperature rose a bit but then dropped back down by the time we left.

A package arrived for Luke today. It is the poster from the Applebee's benefit pancake breakfast, signed by the folks there. It is hanging on the wall in his room opposite his bed. Here's what it looks like:



Thanks to the great folks at Applebee's and all those that supported Luke.

Today we were presented a check from a barbeque fundraiser held at the Border Patrol Academy in Artesia, New Mexico. Thanks to all of you, also, for your support of Luke.

---Bill

Day 24 - Scopes and Sprints

Luke did well again on his sprinting exercises. This afternoon he went for 40 minutes with the residual pressure setting at 10. They had set it at 20 and 15 in the past. The lowest setting they will use is 5 and from there they will increase his time until eventually he will be able to come off the respirator.

He had an x-ray of his upper chest to check his lungs and we were told that they are looking better. They also did another brachioscope and were able to remove some deep seated material from his lungs.

His medication settings for the day were 1.5 on the sedative and 12.5 on the pain medication - not the lowest they have been but very close. He rested most of the day but did come around a few times that we were able to talk to him. He probably won't remember these sessions, but it still is great to be able to talk to him and get a nod or shake of the head and the occasional smile. This evening he pulled Paula's hand up to his lips and kissed it!

We received an update today on the total amount of paid leave that fellow Border Patrol agents and employees have donated to Luke. Are you ready for this? It is up to well over 4,000 hours!! For the mathematically challenged, that is over 2 years! Praise God and our deepest gratitude to all the donors. Hopefully he won't need to use it all, but in case he does, it is a huge load off our minds to know it is there.

Luke will be heading back to surgery tomorrow to what is hopefully the last one on his leg. They plan to do a final cleaning and close it up. They didn't have the scheduled time when we left tonight. Pray for a successful surgery and continue to pray for his lungs and his low grade fever. His temperature was still slightly elevated today but it didn't get as high as it has in the past. Little by little, better each day.

I apologize for getting this on so late tonight. I usually try to get it put together and uploaded during the no visiting hours between 6:30 and 8:30 pm. Tonight we used that time to get on Skype with our granddaughter Isabelle to wish her a happy 5th birthday.

---Bill

Day 23 - Small But Measurable Progress

Luke continues to make progress, although it's not so easy for us to see, spending all the time we can with him. His vitals are all good and even though he still has a low grade fever, his temperature didn't rise as high as it has the past few days - another answer to prayer! His sedative and pain medication were lowered to their lowest levels thus far. Praise God!

They had him sprint (breathe on his own) this morning, and again late morning, but this time he was restless and they didn't keep the respirator off for very long. Late this afternoon they tried again, when we were there to work with him, and he did really good. The respiratory therapist was very pleased and attributed it to our presence and coaching him. We actually saw him the most relaxed for a sprint exercise yet. Another praise God!

The physical therapist came in and exercised his arms and hands, although he still isn't moving the left arm voluntarily. Luke also had the stitches removed from his left arm. All that is left are the staples for the small incision made when they put the stent in to fix the tear in his aorta. Of course, he will have more stitches or staples when they do the final surgery on his left leg. We were informed today that this surgery has been postponed until Friday. This is only a change in scheduling. Also scheduled is the surgery to fix the end of radius bone in his left elbow for next Tuesday.

This afternoon Luke gave a couple of huge smiles when his good friend and fellow academy classmate, Rick, was talking to him . It was great to see, since mostly he has been restless when awake. Another blessing for all present!

---Bill

Day 22 - More Sprints

Luke had two more sprint (breathing on his own) sessions today. The first was this morning before we got back to see him. He was able to breathe on his own for about 40 minutes. The second session the started at noon and we were able to be there and able to coach him through again, encouraging him to breathe slowly and deeply. After 30 minutes of breathing, he was working hard with a forehead covered with sweat! Shortly after that session, he went to sleep and slept all afternoon until 5:00. When awake he is somewhat responsive, sometimes responding to us and sometimes not.

One of the trauma team doctors talked to us today about Luke's progress. He is still scheduled for surgery Thursday to close up his leg. The two areas they are concentrating on are working with his lungs to get him off the respirator and to try to find out why he continues to run a slight fever. After 24 hours the three cultures they took are all negative. They can't put their finger on a source. There is nothing scheduled as yet for working on his left arm and hand. We did talk to him about our observation that Luke doesn't seem to voluntarily move his left arm. There is the possibility of nerve damage but they can't evaluate him until he is fully awake. Please lift these areas to the Lord.

---Bill

Day 21 - Sprinting Again

The big news for today is Luke was able to begin back with his sprint exercises. That is where he breathes on his own for a while with little help with the respirator. Paula and I were able to be with Luke and coached him by encouraging him to take deep slow breaths. When he sprints he has a tendency to take quick shallow breaths. He was pretty well sedated all day with only brief periods of restlessness.

They took cultures of his urine, sputum and blood. Hopefully they won't grow anything! All his vitals held steady today with his temperature taking its daily rise in the afternoon.

---Bill

Day 20 - Clean Up and Day of Rest

Luke had his clean up surgery this morning at 7:30 a.m. They also replaced the vacuum bandage on the wound. We were not told of any new findings and things are still on track for the final surgery on Thursday. A culture they took last time they operated showed a slight infection. Something else to treat.

The respiratory technicians continue to work with Luke to wean him of the respirator. His lungs still are not absorbing enough oxygen into the blood. If he were taken off the ventilator now he would essentially have to hyperventilate to get enough oxygen. Please continue to pray for healing in his lungs.

Luke was asleep and resting until late this afternoon. He then drifted in and out of sleep but could understand us talking to him and follow instructions. He also had periods of agitation and restlessness. The staff are grateful that we are there with him so he can see us and to talk to and work with him.

We have been told that in most cases when patients come out of sedation for a while and are told things, they don't remember them the next time they wake up. We've seen that with Luke as different times we have asked him if he knew where he was and he shook his head "no." We explain to him that he is in the hospital, was hit by a car while riding his motorcycle, has several injuries and needs time and rest to heal. We haven't yet said anything about losing his leg but plan to include that soon. Pray also for him to have understanding and acceptance of what has happened to him.

I wrote on here the other day about Department of Homeland Security employees being able to donate leave time to Luke. We were told yesterday that there is now 11 months leave credited to Luke. Praise the Lord! Heartfelt thanks to all the generous agents out there!

---Bill

Day 19 - One Small Step - One Giant Leap!

Luke was able to get his the left chest tube out today. Good news, but it gets even better. His sedative level is reduced from 5 to 1 and his pain medication level is reduced from 20 to 15.

They switched his respirator mode from pressure to volume because Luke was breathing too fast and shallow. Once they changed the setting he was breathing much better.

Saving the best for last, when we went in to see Luke today, his nurse said that he was more coherent than he had been. I was standing beside his bed talking to him when he turned his head towards me, looked me straight in the eyes and gave me a huge smile! What a wonderful moment! Even typing this I can't hold back the tears of joy. Praise God for this huge step forward!

He was pretty much awake for the whole afternoon and, of course, with his awareness comes the discomfort of his injuries and the catheter. The other bad part is that he wants very much to talk to us but can't with the respirator. I sure wish I could read lips! We have to keep asking yes/no questions that he can respond to by nodding or shaking his head. We'll get a small dry erase board for him write down what he wants to say. Once he gets off the respirator, he'll be able to talk.

---Bill

Applebees Pancake Breakfast

Bill, Paula, and Luke:

Your physical presence was not with us while we ate a great breakfast today, but you were in the thoughts and prayers of everyone in attendance. Applebees management and staff were well prepared and organized for the crowds of people that entered their door. It was a great event. Thank you to the people who were generous enough to plan and carry out this breakfast in honor of a great young man!

So you would not miss out on the excitement of the event, here are a few photos to enjoy. A book of photos will be mailed to you next week to enjoy! We love you, miss you, and are praying for you all!

P.S. Luke, Dustin wanted to make sure you could see that he was eating the pancake breakfast...so he made sure to show you via the picture below!

Mandie M.

Day 18 - Another Day of R & R

Luke had a quiet day today resting and letting his body heal. They have lowered the oxygen concentration on respirator to 40%, again the lowest setting they use, and also the pressure that it uses to breathe for him from 40 down to 26. All good signs that he is able to do a little more breathing on his own. They removed the splint from his left arm and we were able to see it for the first time. It is healing well from the incision made to insert the plate.

For the past several days we have had to wear gowns and gloves to go in his room to see him. It is so we don't carry the infections he's had out of the room, but it's probably just as good for him that we aren't giving him anything we might be carrying.

We met with a doctor from the orthopaedic team today and he explained their plan for Luke's leg. He is scheduled to go back to surgery on Sunday to do another cleanup of all the damaged tissue and replace the vacuum bandage that is on the leg. Then they plan to take him back in on Thursday and hopefully everything will be in good shape and they can do a final close. Pray with us that this time all will go according to plan.

Paula and I were honored twice today by very special visitors. First we had a visit by representatives of the Federal Law Enforcement Officers Association, a non-profit organization that offers financial support to the families of injured federal officers. They presented us with a very generous check to help with Luke's and our expenses.

This evening we were visited by United States Border Patrol Chief David Aguilar the nation's highest ranking Border Patrol Agent, his Deputy Chief Ronald Colburn and San Diego Sector Chief Michael Fisher. Chief Aguilar talked with us about the importance to the Border Patrol of family support and how much he appreciates the parents and families of the Border Patrol agents. We were pleased to be able to take them in to see Luke (despite the fact that Luke didn't stand to attention). Chief Aguilar quipped that he does not like to see agents out of uniform and presented Luke with a Border Patrol pin. I'm sure when we are able to tell Luke about the visit he will be very disappointed he wasn't awake for it!

I've said it before, but I must again express, Paula and I are overwhelmed by all the prayers and support from family, friends and even so many people we don't know, in additon to all Luke's fellow agents all the way to the very top people in the Border Patrol, to Luke and us. Saying thank you just doesn't come close to expressing how we feel. God has truly blessed us through you.

---Bill

Day 17 - Leg Surgery

Sorry this post is so late but I wanted to talk to the surgeon before posting about the surgery. Luke did have surgery on his leg this morning but it didn't go as planned and as I posted yesterday. The damage to his upper leg was more extensive than originally thought and when they opened it up they found two areas of concern. First the muscle tissue on the inside of the leg had more dead tissue so they removed that and cleaned up that area. Second, they found the section of the femur from the fracture down also was dead and they had to remove it as well. The end of the bone at the fracture was viable so there shouldn't be any more problems there. After cleaning the leg up they put a vacuum bandage on it, but didn't close.

They will do another surgery, probably Sunday, to move the bone to the center of the muscle tissue and bring the muscle tissue together at the end. Somewhere down the road there will be another surgery to shape the end of the bone to make it receptive for a prosthesis.

So, today was another unexpected turn in the road for us, but we are assured that God is in control and His timing is the only timing that counts.

They removed the staples from the incision from his spleen removal and that looks good.

After the surgery they put in a pick line. This is a long term IV line that goes in the arm above the elbow and runs up and into the upper chest. That process went fine and later on in the day they removed the other IV line in his neck.

When we went in to see Luke around noon all his vitals were really good, but his temperature did rise through the afternoon.

They continue to work on him with the respirator. His lungs seem to be getting a little better each day. The last culture on his blood didn't show any infection, but he did get a positive on his sputum culture. His Kidneys continue to improve as well.

---Bill

Day 16 - Doing Better

After Luke's blood pressure took another dive during the night last night, he had a much better day today. His lungs are sounding better and his blood pressure has been good all day along with his heart rate and oxygen concentration.

The physical therapist stopped in this morning and worked him through a series of exercises. This was his second session with her and Monday he was more responsive than he was today but she still put him through the paces.

I was able to find out why Luke needs to go back for another surgery on his left leg tomorrow. When they did the last surgery, they put a plate over the fracture of the femur. They left as much bone as they could and still have the minimum three screws below the fracture. Their hope was that they would be able to preserve enough muscle tissue to cover the bone. It turns out because of the extensive tissue damage there wasn't enough. One option would be to have plastic surgery work with it but it would require several surgeries and probably would have problems down the road. The better solution is to go back in, remove the current plate and replace it with two shorter plates, one on each side of the bone with two screws on each side below the fracture. This will give them the minimum number of screws to keep the plate secure. They can then take a little more of the bone off and use his muscle tissue to cover the end. I don't know the time he will be going to surgery as it will depend on how many emergencies come in during the night.

We found out today that Luke was approved to receive leave time that can be donated from any Department of Homeland Security employee. Already from the Imperial Beach station there has been two months donated. Their goal is to have two years donated to Luke. What a tremendous blessing!! We thank all who have, and who will give their hard earned leave, so Luke will have one less thing to worry about.

---Bill

Day 15 - Some Good, Some Not So Good

Late addendum: Further detail on Luke's "respiratory condition" - Monday evening the oxygen concentration in the blood, which optimally is 100, had dropped a little. I noticed when we left him it was down to 93. It continued to drop through the night, so the oxygen percentage in the ventilator was increased. That is what led to the x-ray and brachioscope done today. They were able to decrease the oxygen percentage through the day and when we left this evening it was at 65%.

This afternoon his blood pressure took a dive and they stopped his ativan (sedative) and fentenyl (pain medication) and increased the IV saline solution. He responded and by this evening it was back up to around 100/65. He was resting comfortably during our visit.

Luke begins week three with another trip to the O.R. but it was a brief one and not a lot was accomplished. The doctor said that his respiratory condition wasn't good enough to fix everything on his hand, but they did put pins in his thumb to keep those bones straight.

They took x-rays of his chest and his lungs appeared cloudy so they did another brachioscope and found some lesions in his right lung. These are probably from an infection so he'll be getting more antibiotics to clean that up. The scope also showed some plugs and they removed those.
The kidney doctor stopped in this afternoon and told us that his kidneys are doing better.

Luke will be going back to surgery on Thursday for his left leg. The muscle tissue must have retracted more than expected and they are going to have to remove a little more of the bone in order to be able to get a good covering of muscle over the end.

They keep fine tuning his pain medication and sedative up and down to meet his needs at the time. He remains pretty much sedated with some movement and responding to voices and occasionally partially opens his eyes, but not enough to focus or make eye contact.

After two weeks he has come a long way and of course we would like to see giant leaps forward every day. However, some minor steps backwards must be expected and the Lord is giving us a good exercise in patience as we wait for the next forward leap.

---Bill

Day 14 - R & R

Luke had a day of rest and recuperation today. His biggest activity was a breathing exercise this morning. Paula was there to talk him through it, encouraging him to take deep, slow breaths. He will have another one later this evening.

He will be going in for surgery tomorrow morning to repair the broken bones in his left hand. He also needs some more work on his leg to have more muscle covering the end of the bone. They may do that while they have him in the O.R.

Today he followed the same cycle that he has the past couple of days. His temperature is down in the morning but through the course of the day gets up to over 101°. They took more cultures today of his blood, urine and sputum.

He does respond to some voice commands, but stays in a sleepy state. Continue to pray for the infection and his surgery(ies) tomorrow.

---Bill

Day 13 - Looking Better!

Luke had the tracheostomy this morning. He looks so much better! No more tubes in his mouth with his lips swelled and chapped. He does have his small feeding tube going in through his nose to his stomach.

He is being kept sedated today and tomorrow until he goes in to surgery again on Tuesday to do repairs on his hand. They plan to bring him out of sedation early tomorrow morning for a brief time to get it out of his system. If they keep him in constant sedation the sedative will build up in his tissues and it will prolong bringing him out when he is ready. For now he is resting comfortably. His temperature was down this morning but went back up this afternoon. He is still probably fighting the bacterial infection. Continue to pray for that.

They didn't do a sprint this morning since he was going for the tracheostomy. They won't do one tonight either, so he can rest. The respiratory therapist was in this afternoon and did a suction on his lungs and got virtually nothing! Thank you, Lord -- prayers answered again!

---Bill

Day 12 - Slow But Steady

Luke is holding steady today with slight improvement in a few areas. His urine output remains good and his creatinine levels continue to drop so his kidneys are doing better.

This morning he lasted an hour on his sprint. His lungs are also holding steady but he's not breathing strong enough yet to be off the ventilator. He has about reached his limit for having the breathing tubes going in through his mouth so they are going to do the tracheostomy at 9:00 PST tomorrow. He will be alot more comfortable with that. They have not yet removed the last chest tube.

The orthopaedic doctors rewrapped his left leg this morning. They may have the plastic surgeons check the leg as the skin graft may not completely cover the area.

Luke was also at his limit for the IV lines going into his right hand and arm, so they put a central line into a vein in his neck to give him his medications.

He still has the bacterial infection so today they moved him back to a single room and we have to put the gowns on to go in. Pray for Luke to get over this infection so his temperature will go down.

Luke was restless today and tried to sit up. But he was having a lot of pain so they increased his pain medication and sedative. He was resting better this afternoon.

---Bill

Day 11 - More watching and waiting

Late night notes: Luke had another sprint tonight, which is what they call his breathing exercises. He is steadily improving by taking slower and deeper breathes. His blood sugar level is better and they reduced his dosage of insulin and they may stop it tomorrow. His drain from the spleen surgery is gone. The left chest tube remains but the suction has been shut off. This will most likely be removed tomorrow.

Things are pretty much the same for Luke today. When we got in to see him this morning, they had stopped the sedative for a while. He was moving quite a bit and would react to our voices but still no eye contact. He is receiving insulin today to get his blood sugar back to a normal range. He's still fighting a temperature and it did drop while we were visiting with him. His temperature, in addition to his blood pressure and heart rate all seem to be riding a roller coaster.

They are planning on removing his other chest tube and the drain from his spleen removal surgery today. It appears the hole in his left lung has now healed. They will take an x-ray later today to check it and if confirmed they will remove the chest tube.

They have postponed the tracheostomy until Sunday. There is still the possibility that his lungs will recover enough in the next two days that it won't be necessary. That is our hope.

---Bill

Day 10 - Breathing Exercises

Late update: The plastic surgeon met with us tonight and they have scheduled Luke for surgery Tuesday at 7:30 a.m. to work on the broken bones in his left hand.

When we went in to visit him tonight his nurse told us that he is also scheduled for a tracheostomy on Saturday. Instead of having the breathing tube going in through his mouth and throat and then into the trachea, they will insert directly into the trachea through his neck. Our hopes that he might be off the respirator today were based on his being able to breathe adequately on his own. With the extent of his injuries and the amount of medications he is on, that just isn't going to happen for a while. Having the tracheostomy will be much easier on him in the long run. We will meet with the doctors tomorrow about it.

Although Becki was determined to stay until Luke was awake, she really needs to be with her family and she was getting down to the wire with being able to fly at this stage of her pregnancy. This afternoon she booked a flight home for Saturday. She is disappointed that she most likely won't be able to talk with Luke before she has to leave.

Luke's blood pressure, temperature and heart rate were all good tonight after being somewhat elevated for the last day or so. The medications he is receiving appear to be doing the trick. He was resting comfortably while we were in to see him.

Today the medical staff is working with Luke giving him breathing exercises. They are working towards having him breathe on his own so they can take him off the respirator. Progress is slow, but progress none the less. He went for about 45 minutes on his own this afternoon.

Kidney condition remains stable, which is good in that they are not losing ground with all they are being asked to do. Output is still good. Ultrasound taken yesterday showed bruising on his right kidney from the collision. Also the creatinine level in his blood decreased meaning the kidneys are being more effective.

The CT scan did not show any pockets in his abdomen.

Luke remains somewhat sedated. He hasn't opened his eyes today but he does follow commands and is stretching his arm and leg. He also moves his head and raises his eyebrows.

Today we had the great pleasure of meeting Luke's literal "guardian angel!" John is the motorcycle rider that was ahead of Luke that night. After he avoided getting hit by the wrong-way driver, he heard the crash behind him, immediately stopped, rushed back and found Luke lying on the highway. He stood guard over Luke keeping approaching cars from hitting him, since their attention was drawn to the wrecked car on the embankment. John, words cannot express our deepest gratitude to you for literally saving Luke's life.

Jess, what a coincidence that you should comment on my "medical knowledge." Just this morning I took one of Luke's fellow Border Patrol agents in to see Luke and went through explaining all the monitors that they have on him and what all the numbers mean. When I was finished the attending nurse asked, "Are you a doctor?" I must admit, it has been an education -- only one that I'd really rather not had to opportunity to receive.

I've said it many times here, but I will continue, because it comes straight from our hearts - Thanks so very much to all for the prayers and support for Luke. We appreciate so much your comments and encouragement.

---Bill

Day 9 - Steady progress

Evening update: Luke did have the pressure on the ventilator lowered to 5 late this afternoon, so now he is on the lowest settings for both oxygen level and pressure. If he is able to maintain the oxygen concentration in his blood at these settings, the plan is to wake him tomorrow and have him breathe on his own. If he can do this and continue for a few hours, they will be able to remove the ventilator! Pray for him in this area.

The CT scan was delayed because there were several emergencies that came in today which, of course, take precedence. They did, however, take ultrasound readings on his kidneys. The final results won't be available until tomorrow, but had anything out of the ordinary shown up we would have known right away.

Luke must have gotten pretty fiesty with the night shift last night. They started him back on a low level of the sedative to keep him calm.

We talked to his kidney doctor (he's got more specialists keeping tabs on him than you can imagine!). She told us that his kidneys haven't really improved a lot the last day or so, but the very good news is that they stopped the decline in condition that he had been experiencing. That's why they cancelled the dialysis that was scheduled. She said this is typical that they will level off and then begin to improve.

His lungs are improving. They lowered the oxygen percentage on the air he is receiving to 40% which is as low as the unit will go. They also lowered the pressure on the ventilator from 10 to 7.5 and will probably decrease it again to 5 this evening, which is the lowest for that setting that as well. He is moving towards getting off the ventilator.

His blood work did show a bacterial infection in his blood and as soon as they get the culture they will be giving him an antibiotic to take care of it. He was running a slight fever yesterday.

He is scheduled for a CT scan this afternoon to look at his abdomen to check for any minor problems that may be there. This is just a standard procedure.

Once Luke wakes up he's going to need the time he'll be recovering just to read all the cards and well wishes he's received here. Thank you all very much from all of us.

---Bill

Day 8 - Luke is responding!

Afternoon update: Luke continues to come out of his sedation. He still hasn't opened his eyes to make eye contact yet, but he is showing more response to voices and stimuli. We are elated but there is a down side. As Luke comes around he is going to be disoriented as well as being bothered by the breathing tube and his injuries. This will be very scary for him and he will most likely react violently and have to be restrained. Pray for him during this period, which should last the next day or so, and for us as it will be tough for us as well. With his improvement througout the day, I'm anxious to get back in to see him for the 8:30 to 10:00 visiting hours!

When we got in to see Luke this morning, the nurse told us that he was responding to commands. We were elated with the news and a little disappointed that we weren't there to see it, but it happened before visiting hours for the ICU. Later on I was there with a Border Patrol agent and the nurse worked with him again. On command Luke partially opened his eyes, moved his fingers and his toes. A little later when the nurse was cleaning out his mouth and throat with a suction tube it was causing Luke discomfort and he grimmaced. It reminded me of times when Luke was a small child and we tried to feed him something he really didn't like! Shortly Paula, Becki and I will be with him again and they will get to see him respond too. We've been waiting for this for over a week! He is still very out of it but what a wonder to behold!

God has answered prayer for Luke's kidneys. After being told last night that today he would definitely be put on dialysis, today his kidneys are functioning well enough that they are holding off that procedure.

They have reduced the oxygen percentage of the air in his respirator to 45% and they are going to remove today the chest drainage tube on his right side. They had put tubes in both sides because both lungs had collapsed from the impact. The left lung still has a small perforation so that tube will remain for a while.

Time to get back to Luke. If there is anything more to update, I will post it later.

---Bill