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
Sunday, November 30, 2008
Saturday, November 29, 2008
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
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
Friday, November 28, 2008
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
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
Thursday, November 27, 2008
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
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
Wednesday, November 26, 2008
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
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
Tuesday, November 25, 2008
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
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
Monday, November 24, 2008
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
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
Sunday, November 23, 2008
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
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
Saturday, November 22, 2008
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
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
Friday, November 21, 2008
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
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
Thursday, November 20, 2008
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
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
Wednesday, November 19, 2008
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
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
Tuesday, November 18, 2008
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
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
Monday, November 17, 2008
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
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
Sunday, November 16, 2008
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
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
Saturday, November 15, 2008
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
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
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
Thursday, November 13, 2008
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
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
Wednesday, November 12, 2008
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
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
Tuesday, November 11, 2008
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
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
Monday, November 10, 2008
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
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
Sunday, November 9, 2008
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
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
Saturday, November 8, 2008
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
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
Friday, November 7, 2008
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
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
Thursday, November 6, 2008
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
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
Wednesday, November 5, 2008
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
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
Tuesday, November 4, 2008
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
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
Benefit Breakfast
Applebee's Restaurant in Meadville, PA is hosting a benefit breakfast...all-you-can eat pancakes, sausage or bacon, and coffee, tea or soft drinks. The managers and staff have donated all the money to cover the event's costs, allowing for ALL proceeds to go toward the Luke Dithrich Benefit Account.
The event is set for Saturday, November 15 from 8 t 10 a.m. at Applebee’s Meadville at 11227 Shaw Ave. in Vernon Township. The donation is $6 per ticket and advance tickets are available. Call 814-333-2848 for information.
A big thank you to the Applebee's family for their thoughtfulness and work in organizing this event.
The event is set for Saturday, November 15 from 8 t 10 a.m. at Applebee’s Meadville at 11227 Shaw Ave. in Vernon Township. The donation is $6 per ticket and advance tickets are available. Call 814-333-2848 for information.
A big thank you to the Applebee's family for their thoughtfulness and work in organizing this event.
Monday, November 3, 2008
Day 7 - Back to the O.R.
LATE BREAK: The plastic surgeon called us tonight after he finally finished up in surgery (11:00 p.m. out here!). All they decided to do for Luke today was to clean up the ends of the three fingers. They will fix all the broken bones at a later date. Also, we did find out this evening that Luke will be having dialysis done tomorrow.
Luke returned to the operating room today to finish up his left leg. The surgeons flushed out the wounds for one last time and then closed the leg up. They took a skin graft from his right leg in order to complete the covering. The procedure went fine.
Since he was going to surgery, the plastic surgeons that are caring for his left hand took the opportunity to do some work as well. The plan was to clean up the end of his little finger which was taken off at the first knuckle from the base, clean up the end of his ring finger which was taken off at the second knuckle from the base and to put a wire in his middle finger to straighten it. If the bone damage was bad enough they felt it would be better for functionality to remove the tip to the knuckle as well. They did take an X-Ray prior to going to surgery so they could see exactly what they were working with and he does have several broken bones in his hand. In fact, only his index finger escaped unharmed. They didn't think they would be able to repair everything today because they didn't want to keep Luke on the operating table for that long. We didn't get to meet with the plastic surgeons after Luke came out of surgery so I don't know the details of exactly what all they accomplished. We will most likely find out tomorrow.
Luke remains unresponsive after being off sedation for over a day. The reason for this is that he was under sedation for an extended period in addition to the fact that it is cleared from the system by the kidneys. Although they are functioning, they still aren't up to the task. There is a good chance they will start him on dialysis tomorrow to give the kidneys some help.
His oxygen level for his respirator remains at 50%. They did lower it this morning to 40% for a while but bumped it back up to 50 following the surgery.
Please keep him lifted up in your prayers as we know you have been. Pray specifically for his kidneys and lungs, as well as general healing. Although we have been very anxious for him to wake, we feel it is best for him to rest and recover for a few days.
---Bill
Luke returned to the operating room today to finish up his left leg. The surgeons flushed out the wounds for one last time and then closed the leg up. They took a skin graft from his right leg in order to complete the covering. The procedure went fine.
Since he was going to surgery, the plastic surgeons that are caring for his left hand took the opportunity to do some work as well. The plan was to clean up the end of his little finger which was taken off at the first knuckle from the base, clean up the end of his ring finger which was taken off at the second knuckle from the base and to put a wire in his middle finger to straighten it. If the bone damage was bad enough they felt it would be better for functionality to remove the tip to the knuckle as well. They did take an X-Ray prior to going to surgery so they could see exactly what they were working with and he does have several broken bones in his hand. In fact, only his index finger escaped unharmed. They didn't think they would be able to repair everything today because they didn't want to keep Luke on the operating table for that long. We didn't get to meet with the plastic surgeons after Luke came out of surgery so I don't know the details of exactly what all they accomplished. We will most likely find out tomorrow.
Luke remains unresponsive after being off sedation for over a day. The reason for this is that he was under sedation for an extended period in addition to the fact that it is cleared from the system by the kidneys. Although they are functioning, they still aren't up to the task. There is a good chance they will start him on dialysis tomorrow to give the kidneys some help.
His oxygen level for his respirator remains at 50%. They did lower it this morning to 40% for a while but bumped it back up to 50 following the surgery.
Please keep him lifted up in your prayers as we know you have been. Pray specifically for his kidneys and lungs, as well as general healing. Although we have been very anxious for him to wake, we feel it is best for him to rest and recover for a few days.
---Bill
Sunday, November 2, 2008
Day 6 - Watching and Waiting
This morning they took Luke off his sedation medication. He still hasn't woken up or really moved. He did have a couple slight toe movements when the nurse was touching his toes, but nothing significant. Luke is still pretty swollen. Although he got rid of about 1 gallon of fluid yesterday, his kidneys are still not functioning fully. They will continue to run blood work to make sure his kidneys are continuing to function at a satisfactory rate. There is a possibility of kidney dialysis if they feel his kidneys need more help.
He has also been started on a nutrient enriched liquid (like Ensure) through a feeding tube.
His respirator is still at 50% oxygen and he's been maintaining a satisfactory blood oxygen level. It isn't quite enough to reduce the ventilator to 40% (their ideal level for now) but his lungs are working well despite the trauma they received. He still has fluid/blood being drained from his lungs.
Luke is scheduled for another surgery tomorrow to do a final flushing out of his left femur (thigh). They will then close up all the incisions. There is a possibility they will not have enough skin to close and may have to do a graft from the right leg. Surgery scheduled for 11:30 PST (2:30 for all you easterners).
We will soon be heading back in to see him for evening visiting hours and if there are any changes I will make a late update.
---Bill
He has also been started on a nutrient enriched liquid (like Ensure) through a feeding tube.
His respirator is still at 50% oxygen and he's been maintaining a satisfactory blood oxygen level. It isn't quite enough to reduce the ventilator to 40% (their ideal level for now) but his lungs are working well despite the trauma they received. He still has fluid/blood being drained from his lungs.
Luke is scheduled for another surgery tomorrow to do a final flushing out of his left femur (thigh). They will then close up all the incisions. There is a possibility they will not have enough skin to close and may have to do a graft from the right leg. Surgery scheduled for 11:30 PST (2:30 for all you easterners).
We will soon be heading back in to see him for evening visiting hours and if there are any changes I will make a late update.
---Bill
Saturday, November 1, 2008
Day 5 - Progress update
Late Edition: More positive news! The percentage of oxygen in Luke's ventilator has been able to be reduced. It had to be very high because of the problems in Luke's lungs which prevented oxygen absorption into the blood. Yesterday it was 80%.
It had to be that high to keep the oxygen count in his blood at 100. They have been dropping it throughout the day today and when we left Luke at 10:00 tonight it was down to 50% and he was maintaining the oxygen count in the blood. The air we breathe is 21% oxygen. They are hoping to get it to 40% and they can begin the process of Luke breathing totally on his own. They also gave him a couple of treatments to first draw fluid from the tissues into the blood and then help the kidneys flush it out. This too was successful.
Bulletin! Results of the X-Rays on spine taken yesterday ... no damage to the thoracic or lumbar vertebrae. Luke is now in a partially inclined position. This will help with the clearing of his lungs.
Luke remains sedated as he continues his long recovery. Last evening they took X-Rays of his spine to make sure there is no damage there. The final reading from the radiologist has not come back yet, but if it comes back OK they will be able to raise Luke up from his laying flat position.
Luke was showing some cloudiness in his lungs so this afternoon they did a procedure where they put a scope down and checked all the bronchial passages. There was some blood which was most likely from the impact. They also found a blood clot which they removed. This should greatly improve his oxygen intake. The ventilator is set at 12 breaths per minute and he is currently registering 16 which means he is taking 3 or 4 breaths a minute on his own!
We anxiously await the time when he recovers sufficiently to allow them to lower his sedation to the point where he will be awake and able to respond and communicate with us. Could be a day or two ... could be several days. In God's good timing.
As always, thanks so much to all for your prayers and support.
---Bill
It had to be that high to keep the oxygen count in his blood at 100. They have been dropping it throughout the day today and when we left Luke at 10:00 tonight it was down to 50% and he was maintaining the oxygen count in the blood. The air we breathe is 21% oxygen. They are hoping to get it to 40% and they can begin the process of Luke breathing totally on his own. They also gave him a couple of treatments to first draw fluid from the tissues into the blood and then help the kidneys flush it out. This too was successful.
Bulletin! Results of the X-Rays on spine taken yesterday ... no damage to the thoracic or lumbar vertebrae. Luke is now in a partially inclined position. This will help with the clearing of his lungs.
Luke remains sedated as he continues his long recovery. Last evening they took X-Rays of his spine to make sure there is no damage there. The final reading from the radiologist has not come back yet, but if it comes back OK they will be able to raise Luke up from his laying flat position.
Luke was showing some cloudiness in his lungs so this afternoon they did a procedure where they put a scope down and checked all the bronchial passages. There was some blood which was most likely from the impact. They also found a blood clot which they removed. This should greatly improve his oxygen intake. The ventilator is set at 12 breaths per minute and he is currently registering 16 which means he is taking 3 or 4 breaths a minute on his own!
We anxiously await the time when he recovers sufficiently to allow them to lower his sedation to the point where he will be awake and able to respond and communicate with us. Could be a day or two ... could be several days. In God's good timing.
As always, thanks so much to all for your prayers and support.
---Bill
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