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
Thursday, November 6, 2008
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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