Well, the other day was a really busy and hard one for Jim. He started tremoring at the beginning of the week. It could be from the drugs, or that the drugs were simply supressing the tremors, and now since they are slowly lowering them, they are now becoming visible. Jim was given an EEG to see if maybe the tremoring was because of seizures. During the EEG the tremoring was so bad that the only thing the results could tell the doctors is that it's not seizures, but there was insufficient data to tell them anything else. They are going to give him another EEG on monday and give him a paralytic to stop the tremors so they'll be able to have accurate results.
Jim also received another CT scan of most of his body. The results were that his hip is broken, but does not need surgery. There appears to be no infection anywhere, but he still has the fevers. And he has suffered a stroke. Not a big one, but not a small one either. It's in the right side of his brain, in the sensory area, and will probably affect his entire left side. He had another CT scan this morning, and there was no change, which is good in the sense that it didn't get any worse. The doctors told me that the stroke was caused either by a fatty embolism traveling from his broken legs and up through his heart, or maybe some plaque was knocked loose from his arteries by the hard impact he took when the other car hit him and it made its way into his brian. Either way, we need to pray for his brain.
It has also been determined, now that the sedative is being lowered, that Jim is in a coma. Why? They don't know. The drugs? It could be. He has been on pretty high doses of them. Some unseen brain trauma? Could be. Oxygen loss? Maybe. There are so many variables in the whole thing.
I do know this though. The doctors and nurses have told me that Jim has come so far in the last three weeks that it's amazing. A miracle. None of them thought he would make it that first night. His main physician has told me that in all his years as a doctor, he has never seen anyone who has received so much bone surgery in such a short space of time and tolerated it as Jim did. He's had patients who've had more bone surgeries, but never who had as many as Jim had over the course of these past few weeks. They are all concerned about Jim's progress, and would like to see improvement, but at the same time he has come farther than anyone thought possible. And that's the miracle. It is not Jim's time. He is still here, and my faith is is such that I fully believe that despite everything the doctors are throwing at me about Jim's condition, that Jim will recover.
There are still a lot of "what ifs" and "we don't knows" and "we'll have to wait and see", but that's medicine for you. The human body is ever changing, and as complex as anything out there. What one persons body does, anothers doesn't. But I'm praying not only for Jim, but for the doctors and nurses and all the medical professionals that are caring for Jim that they might be guided to do what is best for Jim and gain whatever insight they need to help him.
Keep up your prayers too, as I am ever thankful for all your prayers. They are helping Jim in ways I'm sure we'll never know.
Oh, and to everyone at Jim's place of work, thank you. Thank you so much for helping to give our kids the best Christmas. I have never seen so many wonderful presents in my entire life, and our children were utterly delighted with everything, and amazed that Daddy's work friends loved our whole family so much. You have helped make our Children's lives brighter this Christmas season, and done a very wonderful, and kind thing for our family. Thank you.
Saturday, December 26, 2009
Tuesday, December 22, 2009
I'm realizing that it's going to be nearly impossible to keep up to date as often as I thought. My posts are probably going to be shorter and not as often, but I'm sure that's ok.
Suffice it to say that all the major surgeries for Jim are done. There are probably going to be more down the road, but all that can be done for bone fixing has been done.
They were able to close up his abdomen part way this last week. All the muscle has been closed, and the skin in partially closed with large stitches about every inch or so, with it being left open to drain in between the stitches. The final stitching up will be done later on, when more swelling has gone down. Jim is still very swollen. But they are giving him medicine to help with that. The fluid is neither in the cells or his blood stream, but inbetween the layers of tissue, so it really simply takes time for that to go away. The medicine can help, but really it's just time as well.
They have started backing down on the seditives. He was on major high doses of it, and they've backed down to about half the original dose over the course of a couple days. His temp is still high, it seems to follow a course of going really high, and then coming down again just to go right back up over the course of the next day. He has chills and sometimes tremors. The doctor thinks it's a combination of the fever and also maybe related to withdrawal issues from the medicines, so they are going to stop backing off on the seditive for a few days to let his body catch up.
He is making more facial expressions. Mostly frowning, and pained expressions, but it's nice to see any expression on his face at all. I can see him swallow occasionaly as well. Any time they mess with him his heart rate goes up and he starts to breath more rapidly so he is becoming a little more aware of the pain.
The doctors tell me that this is going to be the truly hard part for me, seeing all the pain he is in. And of course it'll be way harder for Jim. He was so sedated before he wasn't really aware of anything. Now he's going to become more aware, and it's not going to feel good at all. So much of him is broken.
So we still need your prayers and blessings, all that we can get.
And I want to say how thankful I am to all our friends and family for the outpouring of love and concern for us and our family. It means a lot to me, and I'm sure when Jim realizes the massive support we've received during this time that he'll be thankful as well. What a blessing to us you all are.
Suffice it to say that all the major surgeries for Jim are done. There are probably going to be more down the road, but all that can be done for bone fixing has been done.
They were able to close up his abdomen part way this last week. All the muscle has been closed, and the skin in partially closed with large stitches about every inch or so, with it being left open to drain in between the stitches. The final stitching up will be done later on, when more swelling has gone down. Jim is still very swollen. But they are giving him medicine to help with that. The fluid is neither in the cells or his blood stream, but inbetween the layers of tissue, so it really simply takes time for that to go away. The medicine can help, but really it's just time as well.
They have started backing down on the seditives. He was on major high doses of it, and they've backed down to about half the original dose over the course of a couple days. His temp is still high, it seems to follow a course of going really high, and then coming down again just to go right back up over the course of the next day. He has chills and sometimes tremors. The doctor thinks it's a combination of the fever and also maybe related to withdrawal issues from the medicines, so they are going to stop backing off on the seditive for a few days to let his body catch up.
He is making more facial expressions. Mostly frowning, and pained expressions, but it's nice to see any expression on his face at all. I can see him swallow occasionaly as well. Any time they mess with him his heart rate goes up and he starts to breath more rapidly so he is becoming a little more aware of the pain.
The doctors tell me that this is going to be the truly hard part for me, seeing all the pain he is in. And of course it'll be way harder for Jim. He was so sedated before he wasn't really aware of anything. Now he's going to become more aware, and it's not going to feel good at all. So much of him is broken.
So we still need your prayers and blessings, all that we can get.
And I want to say how thankful I am to all our friends and family for the outpouring of love and concern for us and our family. It means a lot to me, and I'm sure when Jim realizes the massive support we've received during this time that he'll be thankful as well. What a blessing to us you all are.
Friday, December 18, 2009
12/13/09
Surgery today on the lower legs. The tibias. They took him about 8:25 am. It's going to be a 5 hour surgery. They are going to put a plate on both tibial plateus (that's the top of the tibea bone, I think) and then a rod in his left tibea. And a pin in his left ankle. The doctor said that this should be the last of the big bone surgeries. He might need a few more in a few months time, but at this point the major surgeries are finished. Now we just have to get his abdomen closed up.
The surgery went fine!
More medine to help get rid of the fluids.
Jim was coughing again today. It's a sight to see. He has a nice strong cough, which is good, but nothing to hold anything back, which is bad. The nurses, are holding his stomach to support it-and it takes all their strength when he coughs.
12/14/09
Jim is over breathing the ventilator a lot, which is good in a way, but it also means that he is probably feeling pain. So they are upping his pain medicine a little. I don't like to think that Jim is in so much pain, but I know that it's inevitable.
They are going to be more agressive with the fluid medication today, in an effort to get more fluid off of him.
Jim is starting to move his head a little, most especially when they are trying to clean out his mouth. You can see his eyes moving under his closed eyelids, and he moves his head away from the nurse ever so slightly.
12/15/09
No change for the worse overnight. So that's good. They changed the dressing on the wound vac again. I usually sit in the birthing center area when I'm waiting for surgeries. It's a much happier place than the surgery waiting area. There are pictures of cute babies on the walls and you see excited grandparents waiting for their grandbabies to be born. I'd much rather sit in a happy place while I'm waiting for my husband to get patched up than in a nervous surgery waiting place.
The fluid medicine is helpng, they pulled off more fluids from him than the day before so I'm really glad. Jim's abdoman looks slightly smaller, though still much larger than it usually is. The swelling in his arms and legs has decreased slightly as well. I brought in a picture of Jim and put it on the wall so the doctors and nurses could see what he really looks like as well. People kept commenting that he looked like this big beefy guy, and I'd say, "No, that's not the way he is at all!" So I thought the picture would help.
Oh, and they started Jim on IV nutrition a few days ago. So that's good.
They're talking about needing to be more aggressive with his lungs. They don't want him coughing, but that's going to impact his lungs negatively. It's a catch 22, really. He can't cough because of his abdomen, but he has to because of the phlegm in his lungs.
Jim is jaundiced now. It's from all the bruising , but he's definately a yellow color. They're monitoring his liver though and don't seem too worried about it. Today when they changed his wound vac they got a good look at all his organs, and they all look really healthy. So that's good.
Ok, I keep changing tenses as I write this, but that's because I'm keeping a journal of notes for Jim, and I write directly to him, and when I transfer the notes to the blog here sometimes I still write "you" instead of "he". It's another grammer thing that I feel I must explain mostly because it would bug me so much if things were going normally for our family! I try to catch them, but I know I've missed a few.
The surgery went fine!
More medine to help get rid of the fluids.
Jim was coughing again today. It's a sight to see. He has a nice strong cough, which is good, but nothing to hold anything back, which is bad. The nurses, are holding his stomach to support it-and it takes all their strength when he coughs.
12/14/09
Jim is over breathing the ventilator a lot, which is good in a way, but it also means that he is probably feeling pain. So they are upping his pain medicine a little. I don't like to think that Jim is in so much pain, but I know that it's inevitable.
They are going to be more agressive with the fluid medication today, in an effort to get more fluid off of him.
Jim is starting to move his head a little, most especially when they are trying to clean out his mouth. You can see his eyes moving under his closed eyelids, and he moves his head away from the nurse ever so slightly.
12/15/09
No change for the worse overnight. So that's good. They changed the dressing on the wound vac again. I usually sit in the birthing center area when I'm waiting for surgeries. It's a much happier place than the surgery waiting area. There are pictures of cute babies on the walls and you see excited grandparents waiting for their grandbabies to be born. I'd much rather sit in a happy place while I'm waiting for my husband to get patched up than in a nervous surgery waiting place.
The fluid medicine is helpng, they pulled off more fluids from him than the day before so I'm really glad. Jim's abdoman looks slightly smaller, though still much larger than it usually is. The swelling in his arms and legs has decreased slightly as well. I brought in a picture of Jim and put it on the wall so the doctors and nurses could see what he really looks like as well. People kept commenting that he looked like this big beefy guy, and I'd say, "No, that's not the way he is at all!" So I thought the picture would help.
Oh, and they started Jim on IV nutrition a few days ago. So that's good.
They're talking about needing to be more aggressive with his lungs. They don't want him coughing, but that's going to impact his lungs negatively. It's a catch 22, really. He can't cough because of his abdomen, but he has to because of the phlegm in his lungs.
Jim is jaundiced now. It's from all the bruising , but he's definately a yellow color. They're monitoring his liver though and don't seem too worried about it. Today when they changed his wound vac they got a good look at all his organs, and they all look really healthy. So that's good.
Ok, I keep changing tenses as I write this, but that's because I'm keeping a journal of notes for Jim, and I write directly to him, and when I transfer the notes to the blog here sometimes I still write "you" instead of "he". It's another grammer thing that I feel I must explain mostly because it would bug me so much if things were going normally for our family! I try to catch them, but I know I've missed a few.
12/12/09
Changing the wound vac again today. The doctor tells me it's no big deal to change it, it only takes about an hour to do, and it's really very simple. I hear what he's saying, and I'm thankful he feels so comfortable about the whole thing, but in my mind it's such a huge deal. I mean, it's Jim's intestines they're dealing with!
I feel very calm and at peace about the whole thing though. I'm very aware that without this procedure Jim would not still be here, so I am very grateful for it.
Tomorrow is surgery for Jim's legs.
It's a miracle that Jim is still here with me and our family. It's not his time to go, and I have faith that he will recover. But that doesn't mean that it's not going to be the hardest thing he's ever done. I'm fully aware of the fact that during this time while Jim is unconcious is the hardest time for me and all the people who love him. But when he wakes up, that will be the hardest time for him. He's gonna be in a lot of pain, and it's going to be very hard for him. That will be when he needs his family and friends most. So I guess what I'm saying is, keep praying for him even after he wakes up, because he'll need all the blessings he can get. He's not going to just wake up and hop out of bed one day. He's facing months of rehabilitation.
Our son was worried about what Daddy's face looked like. He thought maybe Daddy wouldn't look the same, so I told him that Jim was still as handsome as ever, and would only have a couple of manly scars on his chin. Kind of like Harrison Ford. (Our son loves the Indiana Jones movies).
- Jim is swelling more but they feel that he is finally stable enough to give him medication to help get rid of all the excess fluid.
Today the doctor came to talk to me and tell me that he's concerned about the swelling that is still occuring in Jim's abdomen. He's hoping the medications to get rid of the fluid will work, but if they don't there's not much they can do. This is not something I want to hear. It makes me scared and I feel like my heart has stopped. So I called my brother-n-law and they are going to come and give Jim another blessing. You can never have too many blessings.
The blessing for Jim made me feel better. Jim is fighting right now and trying so hard. He is doing remarkably well considering the amount of damage that was done to him. The kids and I have put up pictures in his room that say "My Hero" and I told the kids that Daddy is like a super hero, he's fighting so so hard and working so hard to get better.
Please excuse any grammar and spelling errors. It's my pet peeve when things are not properly edited, but I really don't have time right now to care about such things so I'm just posting things without editing.
I feel very calm and at peace about the whole thing though. I'm very aware that without this procedure Jim would not still be here, so I am very grateful for it.
Tomorrow is surgery for Jim's legs.
It's a miracle that Jim is still here with me and our family. It's not his time to go, and I have faith that he will recover. But that doesn't mean that it's not going to be the hardest thing he's ever done. I'm fully aware of the fact that during this time while Jim is unconcious is the hardest time for me and all the people who love him. But when he wakes up, that will be the hardest time for him. He's gonna be in a lot of pain, and it's going to be very hard for him. That will be when he needs his family and friends most. So I guess what I'm saying is, keep praying for him even after he wakes up, because he'll need all the blessings he can get. He's not going to just wake up and hop out of bed one day. He's facing months of rehabilitation.
Our son was worried about what Daddy's face looked like. He thought maybe Daddy wouldn't look the same, so I told him that Jim was still as handsome as ever, and would only have a couple of manly scars on his chin. Kind of like Harrison Ford. (Our son loves the Indiana Jones movies).
- Jim is swelling more but they feel that he is finally stable enough to give him medication to help get rid of all the excess fluid.
Today the doctor came to talk to me and tell me that he's concerned about the swelling that is still occuring in Jim's abdomen. He's hoping the medications to get rid of the fluid will work, but if they don't there's not much they can do. This is not something I want to hear. It makes me scared and I feel like my heart has stopped. So I called my brother-n-law and they are going to come and give Jim another blessing. You can never have too many blessings.
The blessing for Jim made me feel better. Jim is fighting right now and trying so hard. He is doing remarkably well considering the amount of damage that was done to him. The kids and I have put up pictures in his room that say "My Hero" and I told the kids that Daddy is like a super hero, he's fighting so so hard and working so hard to get better.
Please excuse any grammar and spelling errors. It's my pet peeve when things are not properly edited, but I really don't have time right now to care about such things so I'm just posting things without editing.
Thursday, December 17, 2009
12/09/09
12/09/09
They are going to let Jim rest today, to let his lungs sort themselves out. Jim is off all his blood pressure support medication which is a good thing. The medicines were the whole reason he had a blood pressure at all, so it's nice now that he can sustain a blood pressure all by himself.
I suddenly have tons of paperwork I need to figure out. Yuck. That's the last thing in the world I want to be doing.
The nurses are telling me that I can't take this day by day, but I should take it week by week. He's gonna have good days and bad days. And the bad days will be really scary. But if I look at things over the course of a week, then things should even out and I will be able to see that he is getting a little better.
12/10/09
They are letting Jim rest today because he's too unstable to do anything with. He is substantially more swollen. You can see his intestines all around the edge of the wound vac. They're all sealed in plastic, but he's so swollen that they're bulging out. I saw the kids today too which was nice. They are being very brave, and their prayers for Daddy are so sweet.
Before all this had happened, Jim and I had planned to take the kids on a Santa Cruise-which is basically a christmas cruise on the local lake, We'd never done it before so thought we'd give it a go. But then the accident happened. I thought Jim would want me to go with the kids so I went ahead and took them, but let me tell you it was the hardest thing I ever did to go there and pretend like I was so excited about the whole thing. But the kids had a good time so I am glad for that.
I went back to the hospital after the cruise, and the night nurse is concerned about the extra swelling on Jim's abdomen. They're concerned about the coughing and there being no muscle support when he coughs. He could literally bust his gut open. So they are going to give him a paralytic, which, you guessed it, will paralyze him. The risk of using this drug too much, though, is paralysis. Long term, but hopefully not forever. It's only a risk, but a risk nonetheless, so they are trying not to use it too much, and only when absolutely necessary.
12/11/09
The paralytic helped, the wound vad was unchanged overnight. They are planning to change the dressing on the wound vac Saturday morning and surgery on his legs Sunday.
Jim got a new bed today. An air bed that rotates by inflating and deflating different compartments, which will be good for his lungs, and hopefully help with pressure sores (bed sores). Jim tolerated being moved fairly well.
The nurse gave me some vaseline for Jim's lips, which were getting pretty dry. I was really excited because it was something I could actually do for Jim all by myself. I feel pretty helpless not being able to do anything for him.
Ok, more in the next day or so. Hopefully I'll get caught up soon.
They are going to let Jim rest today, to let his lungs sort themselves out. Jim is off all his blood pressure support medication which is a good thing. The medicines were the whole reason he had a blood pressure at all, so it's nice now that he can sustain a blood pressure all by himself.
I suddenly have tons of paperwork I need to figure out. Yuck. That's the last thing in the world I want to be doing.
The nurses are telling me that I can't take this day by day, but I should take it week by week. He's gonna have good days and bad days. And the bad days will be really scary. But if I look at things over the course of a week, then things should even out and I will be able to see that he is getting a little better.
12/10/09
They are letting Jim rest today because he's too unstable to do anything with. He is substantially more swollen. You can see his intestines all around the edge of the wound vac. They're all sealed in plastic, but he's so swollen that they're bulging out. I saw the kids today too which was nice. They are being very brave, and their prayers for Daddy are so sweet.
Before all this had happened, Jim and I had planned to take the kids on a Santa Cruise-which is basically a christmas cruise on the local lake, We'd never done it before so thought we'd give it a go. But then the accident happened. I thought Jim would want me to go with the kids so I went ahead and took them, but let me tell you it was the hardest thing I ever did to go there and pretend like I was so excited about the whole thing. But the kids had a good time so I am glad for that.
I went back to the hospital after the cruise, and the night nurse is concerned about the extra swelling on Jim's abdomen. They're concerned about the coughing and there being no muscle support when he coughs. He could literally bust his gut open. So they are going to give him a paralytic, which, you guessed it, will paralyze him. The risk of using this drug too much, though, is paralysis. Long term, but hopefully not forever. It's only a risk, but a risk nonetheless, so they are trying not to use it too much, and only when absolutely necessary.
12/11/09
The paralytic helped, the wound vad was unchanged overnight. They are planning to change the dressing on the wound vac Saturday morning and surgery on his legs Sunday.
Jim got a new bed today. An air bed that rotates by inflating and deflating different compartments, which will be good for his lungs, and hopefully help with pressure sores (bed sores). Jim tolerated being moved fairly well.
The nurse gave me some vaseline for Jim's lips, which were getting pretty dry. I was really excited because it was something I could actually do for Jim all by myself. I feel pretty helpless not being able to do anything for him.
Ok, more in the next day or so. Hopefully I'll get caught up soon.
Tuesday, December 15, 2009
Surgeries:
Here's a list of surgeries Jim has had so far, plus a short run down of the days he's been in the ICU.
Dec. 4th, the first day/night and Saturday: Emergency first aid to tuck the bone back into his right leg, and the wound vac procedure on his abdomen.
Saturday was spent just trying to keep Jim stabilized. He's so swollen and continuing to swell. He looks like he's this big beefy guy, but he's not at all. He's a regular sized guy that usually weighs around 170, usually a little less. When they weighed him after the first couple days, he weighed around 200 pounds. That's right, he has gained about 30 pounds in fluid that his body is trying to retain.
Sunday the 6th: Jim was more stable so they were able to take him to surgery. Both upper legs were operated on. He received a titanium rod in each upper leg.
Monday the 7th: Able to lower blood pressure support slightly. Surgery on his left arm. A titanium rod in the upper arm, and two plates and screws on the lower arm. They needed to change the dressing on his wound vac as well. They have to change this every two to three days to keep the area clean. They literally lift out his intestines and irrigate his abdomen with some kind of disinfectant and then tuck it all back into place and cover it with a layer of plastic that's tucked under his skin, and then the sponge goes on top of that, then another layer of plastic that looks like it's been shrink wrapped there. There's a suction tube on it that helps to suck out fluid that wants to gather there. They also had to switch out iv's that were placed at the accident site and therefore not sterile. They placed a port in his chest, which can accommodate several medications at once. Then they let him rest for the rest of the day. On monday night he needed his lungs suctioned out pretty aggressively. When they suction his lungs it makes him cough. Imagine coughing when your muscle and skin is not there to hold back your organs. It's not good. He's also still swelling, which means that you can literally see his intestines around the black sponge. That's something I didn't realize until a few days later, that I was actually seeing Jims intestines. I'm told they are very healthy looking. If I watch carefully, I can actually see the peristalsis-that is, I can visually see his intestines moving around. There's not many a wife that can actually say they've seen their husbands peristalsis, I can tell you that.
Tuesday Morning: Surgery again. They had to place something called an IVC filter. When you break bones in the legs, you're at hight risk for blood clots or pulmonary embolisms, basically from the fatty tissue of bone marrow (from broken bones) traveling up the artery into the lungs and getting stuck there. So they placed a filter in his artery in an attempt to combat it.
Did an ultrasound on his legs as well, to check for blood clots. Later that day, they switched him from being intubated, to haveing a trachiostomy - which is a hole cut in your through in which they place a tube to help you breath. Basically he's still on the ventilator, but he's being ventilated through the trach. Also his jaw was wired shut, because it's broken. He's got several broken teeth, a couple of the front ones were broken right off with just the nerve showing. They were able to get a good look at his tongue and re-sutured it, they told me it basically looked like hamburger. But they also told me that the tongue is very resiliant, and he should be able to talk once it's healed. His jaw will be wired shut for about 4-6 weeks.
Wed: I met with our kids in the cafeteria. I feel very strongly that they not be put through the trauma of seeing their daddy in such critical condition. But I thought it would be good for them to see the hospital, and to see that Daddy is in a good place. I've explained to them that Daddy was in a bad accident, but instead of telling them everything that is wrong with Daddy, I drew a picture for them telling everything that will be fixed. It was a good visit, and they were even able to meet a few people who are helping their Daddy get better.
12/09-Wed: coughing again, and they have to hold his stomach when they suction him. They tried to take him to a ct scan, but when they put him on the transport ventilator, he started coughing so bad the icu nurse put a stop to the whole thing declaring that Jim was too unstable to move. His oxygen levels dropped really low, and he had to be suctioned again, though they didn't get much gunk out. So now they are going to let you simply rest today. They are worried that you may have pulmonary embolisms in your lungs even though they installed the filter in you. So now you're taking a blood thinner, and you'll have to keep taking it for 6 months or so.
The dr said that since Jim was to unstable to be moved, he would bring the OR team to Jim, and change the wound vac in his icu room instead. I get the feeling that this is a pretty rare occurance, but i am thankful that the Drs. are accomadating to what is best for Jim.
Ok, that's all for now.
I'll try to catch up more in the next day or so.
Here's a list of surgeries Jim has had so far, plus a short run down of the days he's been in the ICU.
Dec. 4th, the first day/night and Saturday: Emergency first aid to tuck the bone back into his right leg, and the wound vac procedure on his abdomen.
Saturday was spent just trying to keep Jim stabilized. He's so swollen and continuing to swell. He looks like he's this big beefy guy, but he's not at all. He's a regular sized guy that usually weighs around 170, usually a little less. When they weighed him after the first couple days, he weighed around 200 pounds. That's right, he has gained about 30 pounds in fluid that his body is trying to retain.
Sunday the 6th: Jim was more stable so they were able to take him to surgery. Both upper legs were operated on. He received a titanium rod in each upper leg.
Monday the 7th: Able to lower blood pressure support slightly. Surgery on his left arm. A titanium rod in the upper arm, and two plates and screws on the lower arm. They needed to change the dressing on his wound vac as well. They have to change this every two to three days to keep the area clean. They literally lift out his intestines and irrigate his abdomen with some kind of disinfectant and then tuck it all back into place and cover it with a layer of plastic that's tucked under his skin, and then the sponge goes on top of that, then another layer of plastic that looks like it's been shrink wrapped there. There's a suction tube on it that helps to suck out fluid that wants to gather there. They also had to switch out iv's that were placed at the accident site and therefore not sterile. They placed a port in his chest, which can accommodate several medications at once. Then they let him rest for the rest of the day. On monday night he needed his lungs suctioned out pretty aggressively. When they suction his lungs it makes him cough. Imagine coughing when your muscle and skin is not there to hold back your organs. It's not good. He's also still swelling, which means that you can literally see his intestines around the black sponge. That's something I didn't realize until a few days later, that I was actually seeing Jims intestines. I'm told they are very healthy looking. If I watch carefully, I can actually see the peristalsis-that is, I can visually see his intestines moving around. There's not many a wife that can actually say they've seen their husbands peristalsis, I can tell you that.
Tuesday Morning: Surgery again. They had to place something called an IVC filter. When you break bones in the legs, you're at hight risk for blood clots or pulmonary embolisms, basically from the fatty tissue of bone marrow (from broken bones) traveling up the artery into the lungs and getting stuck there. So they placed a filter in his artery in an attempt to combat it.
Did an ultrasound on his legs as well, to check for blood clots. Later that day, they switched him from being intubated, to haveing a trachiostomy - which is a hole cut in your through in which they place a tube to help you breath. Basically he's still on the ventilator, but he's being ventilated through the trach. Also his jaw was wired shut, because it's broken. He's got several broken teeth, a couple of the front ones were broken right off with just the nerve showing. They were able to get a good look at his tongue and re-sutured it, they told me it basically looked like hamburger. But they also told me that the tongue is very resiliant, and he should be able to talk once it's healed. His jaw will be wired shut for about 4-6 weeks.
Wed: I met with our kids in the cafeteria. I feel very strongly that they not be put through the trauma of seeing their daddy in such critical condition. But I thought it would be good for them to see the hospital, and to see that Daddy is in a good place. I've explained to them that Daddy was in a bad accident, but instead of telling them everything that is wrong with Daddy, I drew a picture for them telling everything that will be fixed. It was a good visit, and they were even able to meet a few people who are helping their Daddy get better.
12/09-Wed: coughing again, and they have to hold his stomach when they suction him. They tried to take him to a ct scan, but when they put him on the transport ventilator, he started coughing so bad the icu nurse put a stop to the whole thing declaring that Jim was too unstable to move. His oxygen levels dropped really low, and he had to be suctioned again, though they didn't get much gunk out. So now they are going to let you simply rest today. They are worried that you may have pulmonary embolisms in your lungs even though they installed the filter in you. So now you're taking a blood thinner, and you'll have to keep taking it for 6 months or so.
The dr said that since Jim was to unstable to be moved, he would bring the OR team to Jim, and change the wound vac in his icu room instead. I get the feeling that this is a pretty rare occurance, but i am thankful that the Drs. are accomadating to what is best for Jim.
Ok, that's all for now.
I'll try to catch up more in the next day or so.
Monday, December 14, 2009
For Jim
It has been suggested that I start a blog about Jim, to keep all our family and friends up to date on Jim's progress, so that is what I'm doing.
On Friday December 4th, my wonderful husband, Jim, suffered a tragic car accident. It was his day off from work. We had a lovely morning together as a family, and then Jim went off to get snow tires put on our car. On his way out, we remembered the box of items we had been meaning to take to donate to the Goodwill for awhile. So Jim grabbed the box, and said he would take it over. That is why he was in the area where the car accident occurred.
I could say a whole lot about the car accident, but I won't. The police are still investigating it, and I make no comment at this time about the other party involved, besides to say that Jim was not at fault. But I will provide some links to newspaper articles.
http://www.spokesman.com/blogs/hbo/2009/dec/05/3-badly-injured-post-falls-accident/
http://www.khq.com/global/story.asp?s=11621662
There are some inaccuracies in the descriptions of the injuries received by all parties involved. Jim's injuries are by far the worst of the three.
I've been keeping notes, for Jim's sake about what happened, because I think at some point he'd like to know. So here are some of the notes.
Friday Dec 4, 2009
the accident occurred around 9:15 in the morning. There were two police officers who were first on the scene that practically witnessed the accident. One of those police officers belongs to our church and recognized Jim. We are new to the area, and to our ward at church, so it is a blessing that he remembered who my sister is. He was able to contact my sister, who then was able to tell him how to get in touch with me so I could be notified of Jim's accident.
Jim was hit head on and trapped in the car. They could not get him out without the jaws of life, and it took about half an hour to get him out of the car. During that time the paramedics were with him, trying to help.
The police came to notify me about 10:30 in the morning. My sister came right away to get the kids, and my parents drove me to the hospital. I had to wait about an hour before they even let me see Jim. He was bleeding everywhere, the blood was just flowing out of him. They kept giving him blood, but it would just come right back out. I was told that when he arrived at the hospital he had no pulse. He had a heartbeat, but the blood loss was so severe there was no pulse. I cannot even begin to describe how horrible it was. He was not sedated yet. He was trying to move his right arm when I saw him, and so I was able to hold his hand for a moment. We are Latter Day Saints (Mormon) and my father and brother-n-law were able to give him a blessing at that time.
Then we waited. And waited. And waited. We were told that Jim had broken ribs. A broken Jaw. His left arm was completely broken, both the upper and lower bones in several places (the humerus, radius and ulna). And his clavicle, that's a collar bone. Teeth knocked out and several cracked and broken. He bit completely through his tongue. Both upper legs broken (the femurs). On his right leg, the femur broke through the skin and muscle and severed a tendon. His lower left leg (the tibea) broken in two places. And his left ankle broken. The the top of both tibeas are also cracked, as are his knees. He has a small hip fracture. His right arm is bruised and sprained but not broken. His spine is not broken, and his brain appears to have no trauma, though in order to know for sure, due to oxygen loss, we'll have to wait untill he wakes up.
Some people do not truly understand what all this means. They think, "Oh, it's just broken bones, that's ok." But the shock to the body of having so much broken is so great that there is the risk of something called DIC.
Here's a link about it.
http://www.merck.com/mmhe/sec14/ch173/ch173h.html
Basically DIC is when the body uses up all the blood clotting factor it has. The result is uncontrollable bleeding. Bleeding that cannot be stopped. In Jim's case the risk was so severe he almost died. In an effort to combat this, they pumped him full of blood and fluids.
Finally late in the evening, we were able to see him. At that point all they could really do was 1st aid by tucking the bone back into the skin of his leg, and making him as stable as they could. He was not stable enough to truly operate on. Jim was totally unrecognizeable the swelling was so bad. From the shock of all the trauma his body had taken, he started to swell. He was also on a ventilator at this point, but not doing well. They could not get his body to receive enough oxygen, even when they were giving him 100%. His abdomen was so swollen, it was cutting off his ability to breathe. It was cutting off circulation to his intestines as well as the arteries. I was asked to leave the room twice as they bagged him, that is ventilated him by hand as a life saving procedure.
I was talked to about Organ Donation.
Then the doctors decided they would try an operation that I'm told is relatively a new procedure. It wasn't around 15 years or so ago, and without it Jim would have died. This was a life saving procedure. They rushed him to the OR and proceeded to make a vertical cut in his abdomen, through the skin and muscle, from under his ribs to right above the groin. The doctors told me that his intestines were pure white, which means that he wasn't getting any blood to them because the swelling was so severe. The procedure is called a "wound vac" and basically what they do is cut the abdomen open, place a sponge on the top, wrap the whole thing in plastic, and put a suction tube on it to help it drain. Wound vacs can be used on other parts of the body as well. Basically, though, Jim's abdomen has had to be cut open as a result of all the injuries his body has sustained.
After that, I was able to see him again. They had placed him on blood pressure support medication, which was basically the only reason he had a blood pressure (because of the medicine). He was on a ventilator, still with very low oxygenation. I think Jim received about three blessings from my dad and his dad and brothers during that time. All have said that Jim will recover. I have faith that he will, but it will be a long hard road. And Jim will continue needing all the prayers her can get.
Whew, ok, It think that's enought for now. That's just the first 24 hours after the accident but it's almost more than I can bear just to have typed all that. I must say I am so thankful for all the thoughts and prayers and love that so many people have been expressing for my wonderful husband. Of course I am partial, and think he is the best man in all the world, but I had no idea that so many people cared and loved him too. thank you.
Currently, Jim is still in critical condition. He has not woken up yet, but that may be due to the fact that he is heavily sedated due to all the trauma he has sustained. I will try to post each night about how he is doing to keep everyone up to date.
On Friday December 4th, my wonderful husband, Jim, suffered a tragic car accident. It was his day off from work. We had a lovely morning together as a family, and then Jim went off to get snow tires put on our car. On his way out, we remembered the box of items we had been meaning to take to donate to the Goodwill for awhile. So Jim grabbed the box, and said he would take it over. That is why he was in the area where the car accident occurred.
I could say a whole lot about the car accident, but I won't. The police are still investigating it, and I make no comment at this time about the other party involved, besides to say that Jim was not at fault. But I will provide some links to newspaper articles.
http://www.spokesman.com/blogs/hbo/2009/dec/05/3-badly-injured-post-falls-accident/
http://www.khq.com/global/story.asp?s=11621662
There are some inaccuracies in the descriptions of the injuries received by all parties involved. Jim's injuries are by far the worst of the three.
I've been keeping notes, for Jim's sake about what happened, because I think at some point he'd like to know. So here are some of the notes.
Friday Dec 4, 2009
the accident occurred around 9:15 in the morning. There were two police officers who were first on the scene that practically witnessed the accident. One of those police officers belongs to our church and recognized Jim. We are new to the area, and to our ward at church, so it is a blessing that he remembered who my sister is. He was able to contact my sister, who then was able to tell him how to get in touch with me so I could be notified of Jim's accident.
Jim was hit head on and trapped in the car. They could not get him out without the jaws of life, and it took about half an hour to get him out of the car. During that time the paramedics were with him, trying to help.
The police came to notify me about 10:30 in the morning. My sister came right away to get the kids, and my parents drove me to the hospital. I had to wait about an hour before they even let me see Jim. He was bleeding everywhere, the blood was just flowing out of him. They kept giving him blood, but it would just come right back out. I was told that when he arrived at the hospital he had no pulse. He had a heartbeat, but the blood loss was so severe there was no pulse. I cannot even begin to describe how horrible it was. He was not sedated yet. He was trying to move his right arm when I saw him, and so I was able to hold his hand for a moment. We are Latter Day Saints (Mormon) and my father and brother-n-law were able to give him a blessing at that time.
Then we waited. And waited. And waited. We were told that Jim had broken ribs. A broken Jaw. His left arm was completely broken, both the upper and lower bones in several places (the humerus, radius and ulna). And his clavicle, that's a collar bone. Teeth knocked out and several cracked and broken. He bit completely through his tongue. Both upper legs broken (the femurs). On his right leg, the femur broke through the skin and muscle and severed a tendon. His lower left leg (the tibea) broken in two places. And his left ankle broken. The the top of both tibeas are also cracked, as are his knees. He has a small hip fracture. His right arm is bruised and sprained but not broken. His spine is not broken, and his brain appears to have no trauma, though in order to know for sure, due to oxygen loss, we'll have to wait untill he wakes up.
Some people do not truly understand what all this means. They think, "Oh, it's just broken bones, that's ok." But the shock to the body of having so much broken is so great that there is the risk of something called DIC.
Here's a link about it.
http://www.merck.com/mmhe/sec14/ch173/ch173h.html
Basically DIC is when the body uses up all the blood clotting factor it has. The result is uncontrollable bleeding. Bleeding that cannot be stopped. In Jim's case the risk was so severe he almost died. In an effort to combat this, they pumped him full of blood and fluids.
Finally late in the evening, we were able to see him. At that point all they could really do was 1st aid by tucking the bone back into the skin of his leg, and making him as stable as they could. He was not stable enough to truly operate on. Jim was totally unrecognizeable the swelling was so bad. From the shock of all the trauma his body had taken, he started to swell. He was also on a ventilator at this point, but not doing well. They could not get his body to receive enough oxygen, even when they were giving him 100%. His abdomen was so swollen, it was cutting off his ability to breathe. It was cutting off circulation to his intestines as well as the arteries. I was asked to leave the room twice as they bagged him, that is ventilated him by hand as a life saving procedure.
I was talked to about Organ Donation.
Then the doctors decided they would try an operation that I'm told is relatively a new procedure. It wasn't around 15 years or so ago, and without it Jim would have died. This was a life saving procedure. They rushed him to the OR and proceeded to make a vertical cut in his abdomen, through the skin and muscle, from under his ribs to right above the groin. The doctors told me that his intestines were pure white, which means that he wasn't getting any blood to them because the swelling was so severe. The procedure is called a "wound vac" and basically what they do is cut the abdomen open, place a sponge on the top, wrap the whole thing in plastic, and put a suction tube on it to help it drain. Wound vacs can be used on other parts of the body as well. Basically, though, Jim's abdomen has had to be cut open as a result of all the injuries his body has sustained.
After that, I was able to see him again. They had placed him on blood pressure support medication, which was basically the only reason he had a blood pressure (because of the medicine). He was on a ventilator, still with very low oxygenation. I think Jim received about three blessings from my dad and his dad and brothers during that time. All have said that Jim will recover. I have faith that he will, but it will be a long hard road. And Jim will continue needing all the prayers her can get.
Whew, ok, It think that's enought for now. That's just the first 24 hours after the accident but it's almost more than I can bear just to have typed all that. I must say I am so thankful for all the thoughts and prayers and love that so many people have been expressing for my wonderful husband. Of course I am partial, and think he is the best man in all the world, but I had no idea that so many people cared and loved him too. thank you.
Currently, Jim is still in critical condition. He has not woken up yet, but that may be due to the fact that he is heavily sedated due to all the trauma he has sustained. I will try to post each night about how he is doing to keep everyone up to date.
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