Wednesday, December 7, 2011

One Month Post-Surgery

Jack has been doing better since his surgery at the beginning of November. The surgeon was able to close up the wound without a skin graft; Whitney took his sutures out a couple weeks after that, and everything is healing really well, though he does have some really big scars.

Unfortunately, Jack is constantly in a lot of pain. He attends both physical and occupational therapy about four times a week and they have him doing exercises with his uninjured arm, too, so that messages will hopefully go to his other arm.  The hope is that eventually his other arm can move too.

Though Jack still doesn't have any feeling in his arm other than pain, when you touch his arm now it starts hurting faster than before so his nerves are reacting quicker, which is good. The injured arm swells a lot so Jack sees a therapist for a special kind of therapy to work with his arm and help lower the pain and inflammation.

On a positive note, Jack has been driving himself occasionally when he isn't in a lot of pain. Sadly the pain keeps him from doing many activities, but he still keeps up on his hay work phone calls, which gives him something to focus on other than the pain. The therapists all seem to have high hopes for him regaining movement in his arm, but they are unsure exactly how long that will take. It could take anywhere from six months to a year or so.

It's hard to say at this point what kind of recovery rate Jack will have, but he is in high hopes, and enjoys watching his sermon videos during the day.  Feel free to call and say hello to Jack; he probably wouldn't mind the distraction!

Wednesday, November 9, 2011

All Stitched Up

Jack had surgery on his wounds last Friday (Nov. 4) and the doctor was able to complete the surgery without the use of skin grafts.  Below is a picture of his sewn up wounds, which seem to be doing quite well.  He's on the mend!  What are we thankful for this Thanksgiving season?  Advanced medicine.



Wednesday, October 19, 2011

Progress

Oops, I received pictures on Friday of last week and it completely slipped my mind to upload them.  My apologies for the tardiness.  I've been a little absent-minded lately.  WARNING: The first image below is of Jack's wounds. Though clean and improved, they may still be a little graphically disturbing to anyone with a weak stomach.  Just a warning! The second photo is not so graphic and shows the setup he currently has on his two worst wounds.  If you don't want to see the graphic image, scroll past it to view the second.




As you can see above, the wound vac is doing its job and creating new tissue around the wound.  This will be useful when the surgeons begin the skin graft process.


Above is an image of the new wound vac Jack had put on/in last Friday.  It includes a bridge which links the two wounds together.  They both drain into one machine.

Jack and Carol Ann are in Portland today seeing a surgeon to discuss skin grafts.  More updates soon, we hope.

Wednesday, October 12, 2011

Plastic Surgery

Jack and Carol Ann will return to Portland on October 19 (next Wednesday) to meet with the plastic surgeon.  For now he is seeing the wound specialist at the hospital in La Grande.

Monday, October 10, 2011

Double Your Fun

Today Jack's wound vac (sorry to have called it a "rack" earlier - getting information via voicemail can be tricky) was split into two.  He now has not only the original in the large wound near his armpit, but now he also has one in the puncture wound on his chest. 

As a refresher: The wound vac is a sponge-like piece of foam inserted into the wound and attached to a tube.  The tube is connected to a machine which pumps out any and all drainage from the wound.  The sponge-like foam contains organisms or chemicals (not sure which...) that encourage regeneration of tissue and fight bacteria, cleaning out the wound and giving the doctors extra tissue with which to work when doing skin grafts.  Jack's two wounds are now connected to one tube that drains both into the same machine. 

He is very much enjoying being home, as you can guess.  On Saturday he thoroughly enjoyed a large omelet, specially prepared just for him by Rolie (Whitney's husband).

Friday, October 7, 2011

GRAPHIC IMAGE

WARNING: The post today is a photo of Jack's worst wound.  It is doing much better, and the photo is to show improvement (compare it to the earlier post of his injuries).  Please do not scroll down if you don't want to see the image.












Wednesday, October 5, 2011

Going Home!


Jack was released from the hospital on Tuesday afternoon.  Here he is enjoying visiting with family at his sister-in-law's house in Portland, where he and Carol Ann stayed the night last night.  They plan to drive home to La Grande today. 

Thank you all for your prayers, thoughts, and for visiting this page to keep up with how Jack was doing.  I would guess there will be a few more updates over the next few weeks as Jack goes in for a checkup next week, schedules surgery, discusses skin grafts with the doctors and surgeons, and works in physical therapy to ensure he regains range of motion with his arm and hand.  However, those updates will be much more infrequent.  Stay tuned, though - we'll keep you posted on his full recovery.

Tuesday, October 4, 2011

Release?

Monday morning Jack's creatinin levels were at 2.76; if you will recall, the goal is to get them down to 1.3, so we are getting ever closer. 

His legs are getting stronger every day; he is now using the restroom regularly on his own, and this not only indicates healthy kidneys, but also assists in his muscles regaining their strength. 

Doctors are hoping to be able to discharge Jack from the hospital tomorrow (Wednesday), though only time will tell if his body will be ready for that.  Once he is released he will need to return to the hospital for a checkup in a week, and hopefully at that point the surgeons will be able to discuss skin grafts and surgery with him.

Monday, October 3, 2011

Up and About



As you can tell, Jack loves having his picture taken.  :)  Here he is enjoying some time OUT of bed, visiting with family from the chair in his room.

Right now I'd like to give a huge thank you to everyone who has shown support and love for Jack and his family during this crazy situation.  The shelf next to his window has a number of cards from various people who care about him, and currently there is a beautiful bouquet of orange and yellow fall-looking flowers brightening up the room.  (There's also a box of chocolates which I'm sure won't last long.)  All of your thoughts, prayers, and gestures of solidarity mean a lot to all of us, and we are so thankful for such wonderful friends and family members.

The Weekend

Sorry for the delay in updates since Friday; I wasn't around a computer very much over the weekend, as we went to visit Jack in Portland again.

While his creatinin (apologies for any misspellings, I am NOT a doctor) levels started at 9 (people with absolute kidney failure often have levels this high), they have dropped significantly over the last couple of days, ending up at 3.87 on Saturday.  Once they get to 1.3 he will be allowed to go home.  If things continue as they have been that could be as early as Tuesday.


On Sunday morning Jack was released from his renal diet to a regular, "eat almost anything you want" diet, which was a joy for everyone because now he could eat some of his favourites from the menu.  He is now trying to decide between everything that sounds delicious on the hospital vegetarian menu.  His favourite item: Raspberry or mango sorbet.

Ever since he was moved from ICU he has been much more alert and awake; the IV pain medications were keeping him knocked out most of the time.  Now that he is on simple oral pain meds ("simple" meaning as little as Tylenol), he only naps once or twice during the day and the rest of the time he spends chatting with family, watching football and baseball, and reading.

The room he is in now is a private room on a floor that was recently remodeled, so everything is bright, cheerful, and modern.  He has his own bathroom with a large shower including a fold-down seat, and can see a little bit of Portland from his room window.  There are several outdoor areas where you can go walking and sit and watch the tram (which goes from OHSU to the South Waterfront), and on a clear day even see Mt. Hood, Mt. St. Helens, and Mt. Adams.  Jack has been taking "walks" in his wheelchair to get some fresh air, and it seems to be doing him good.

Friday, September 30, 2011

Friday Morning: Waiting Game

Still no surgery on the docket...though creatin (sp?) (the bad protein) levels in his system are going down, his kidneys are still not quite at the point doctors want them to be before he undergoes surgery.  So we will wait and continue to pray that he is able to have surgery soon.

Today while trying to work with his injured arm Jack felt burning pain in his wrist nerves, which is both good and bad; bad because it's pain but good because he's able to feel sensation in the wrist, which has not often been the case since the accident.

Thursday Evening

 Jack was more tired today, but he was very awake yesterday so he is most likely recuperating from being more active yesterday.  He was able to take two good naps and got some good rest, which is good for his body. 

Also exciting was his first shower of his hospital stay.  They had hoped to allow him to shower earlier this week but for various reasons it didn't happen; Carol Ann says they were finally able to clean out his ears, which still had hay in them from the field!  Jack is a much happier man now with clean hair and clean ears.  Though they had to be very careful not to get his major wound wet, it was still nice to be able to shower.

He was also able to stand over the sink and brush his teeth today, so things are looking up.

Jack's cousin Fairy came for a visit today and sat and chatted for a couple of hours, which was good for everyone; those who know Jack well know he loves family and enjoys chatting, so to see a family member he doesn't often see and be able to relax and have a visit was quite the treat.

The doctors are still keeping their eyes on his kidneys; they don't seem to be catching up as quickly as the doctors thought they would, so the expectation of dialysis is still 50/50.  Since they can't do anything else until Jack's counts (UC?) go down, they will continue to monitor his kidneys and wait for them to function better before scheduling surgery.

Wednesday, September 28, 2011

Photos

WARNING: Some of the images below may be disturbing to persons who do not deal well with graphic photos.  If you are at all squeamish about blood and injuries, you may want to reconsider scrolling through these pictures.  I will put the worst ones at the end so you can at least see a few, even if you do have a disinterest in the gory shots.


 Up for a walk!  (And annoyed that his sister is taking his picture...again.)

Learning how the remote works in his new private room so he can watch a western on TV.

THE IMAGES BELOW ARE QUITE GRAPHIC...THIS IS YOUR LAST WARNING!


The injuries...


Wednesday Morning

All good news today!  Jack ate a good supper last night and a great breakfast this morning and he is able to get up and use the restroom on his own now. 

His kidneys are stabilizing, and while they are not completely functioning normally, they are vastly improved, meaning dialysis is on the back burner, rather than the forefront of everyone's minds as it had been for the past week.  The doctors are still waiting for the kidneys to kick in completely and do their job at 100% before they decide what to do about surgery to repair Jack's wounds.

They have inserted what is called a "wound rack" in the larger wound near Jack's armpit; essentially it sucks up any drainage from the wound and stimulates growth and healing in that area.

He is no longer on very many pain medications, as he feels he can handle the pain he's feeling, though the doctors are still encouraging him to take some medications as his blood pressure goes up when he is not on them.

Due to being off the IVs and not on very many medications, Jack is awake a lot more and is able to get up and walk around a bit from time to time.  His number one hope for today is a shower, the first he's been able to have since the accident a week ago.  I'm told he is very excited about this - and so is Carol Ann...I'm sure the nurses are, too, since the nurses and Carol Ann are the ones having to smell him. (Just kidding, Jack!) :)

Tuesday, September 27, 2011

Tuesday Afternoon

The doctors are waiting for Jack's kidneys to function at 100% before they put him through surgery.  Though they don't expect there to be any lasting damage or treatment needed for his kidneys, his body has been through a lot and the kidneys are still not up to par. 

The current estimate is that they hope to do surgery on Friday to close the large wound near his right armpit where the skin is completely gone.  (It is a patch approximately 6 inches across and 3 inches wide.) 

Depending on how his kidneys are functioning, Jack may be allowed to go home on Sunday or Monday of next week.

Tuesday Morning Update

Late yesterday afternoon Jack was moved out of ICU and into a very nice private room.  He has been disconnected from the machines and IVs and is only taking oral pain medications, which means he can spend a lot more time awake. 

As of last night he was still quite bloated from retaining water, but now that he's moving around more on his own they expect things to improve in that area, as well as in his blood circulation and the mobility of his muscles.

Jack was able to eat a fairly decent supper last night, which is very positive, and the doctors postponed dialysis yet again to give him some time overnight to improve.  However, they cannot do surgery until his kidneys stabilize, so we hope to learn this morning more of a plan for when they intend to do surgery.

Though he is out of ICU, a phone call before visiting is still appreciated.

Monday, September 26, 2011

Monday Afternoon Update

Dialysis has been cancelled again; it was scheduled for this afternoon but things are going so well they have decided against it.  Jack has also been released from ICU and is now on the kidney floor, waiting  to see how things go over the next day or so.  He is also off of all IVs.

Monday Morning Update

The doctors have decided to go ahead with dialysis as a proactive move to clean the medications completely out of his system.  The meds were administered in an effort to dilute the proteins that were potentially damaging to his kidneys.  While they did their job, the medications need to be completely cleared from his bloodstream, so they will conduct dialysis this afternoon (Monday, 9/26).  His levels have been fairly stable, and things remain positive.

Surgery

They have waited this long to do surgery because the doctors don't want to sew anything up before all the toxins and poisons and dirt are out of the wounds.  So their hope is that everything continues to improve as it has over the last couple of days, so they can perform surgery tomorrow (Tuesday) to repair at least some of the damage.  Until then they continue to clean and dress the wounds regularly and Jack continues to rest and stay hydrated.

Friday, 9/23 - Sunday, 9/25

Jack's blood pressure went up because of the saline being pumped into his system, which made his heart pump harder to keep things moving.  The doctors expected this, and monitored things carefully, administering beta blockers on Saturday to bring his blood pressure down to safer numbers.

Nausea keeps Jack's appetite quite suppressed, making it difficult for him to eat the food he needs.  After a few bites here and there of various items we had hoped would keep the nausea at bay, he finally got his appetite back briefly on Saturday evening and polished off an entire fruit plate, which cheered everyone considerably.

On Saturday x-rays showed fluid in Jack's lungs, which caused concern for possible contraction of pneumonia.  To prevent this, the nurses keep his bed at approximately a 45-degree angle, which seems to be working well, though he has had to get used to sleeping sitting up.

Though he is very tired and spends most of his time sleeping, Jack responds well to questions and has been listening to baseball games (he's not wearing his glasses, so watching the games on TV doesn't work) and was awake enough to talk to, wave at, and blow kisses to his granddaughter, Kayla (Jason & Becky's 2-year-old). 

Because his body is focusing so hard on fixing the injuries, Jack's kidneys started faltering temporarily.  As a result, the doctors expected to have to put him through dialysis Sunday morning. A surprise to everyone Sunday morning was that everything seemed to be functioning and dialysis was put on hold indefinitely.

What Happened

On the afternoon of Wednesday, September 21, Jack was picking up bales of hay in a field a mile or so from home.  While attempting to clean some gunk out of the bale wagon, his wrist was caught by the machine and was pulled in.  He managed to free himself, but as he did his shirt caught in the metal teeth of the conveyor belt used for picking up bales, and his right arm was pulled into the machinery.

As he could not reach the ignition to turn off the bale wagon, Jack wedged his boot into the conveyor belt to keep it from moving.  This was how he stood for seven hours before family members found him around 9 p.m.

The helicopter from the La Grande (Ore.) Hospital picked him up in the field and flew him to Providence St. Mary Medical Center in Walla Walla, Wash., and Carol Ann, Whitney, and Rolie followed in the car.  Jason and Becky live a ten-minute drive from Walla Walla so they met Jack at the hospital there around 10:30 p.m. and stayed with him in Trauma 1 until the other three joined them an hour and a half later.

The Walla Walla medical team quickly realized they did not offer the specialized surgery Jack would need to repair his arm and side.  He had sustained significant injuries to his right wrist, shoulder, armpit, and side, including deep gashes, puncture wounds, scratches, and a burn on his chest where he had been pressed against the hot machinery.  Near his armpit was a large section where the skin had been completely removed.  They decided to Life Flight Jack to OHSU (Oregon Health & Science University), a large and very capable hospital in Portland.

Around 2:30 a.m. Life Flight left the Walla Walla airport for the 50-minute flight to Portland, where Katrina and Lorin met Jack and Carol Ann, who had accompanied Jack for the Life Flight.

At 7:30 a.m. the OHSU medical team did a minor exploratory surgery to determine the extent of the damages and to clean out the wounds as best they could.  Jack's arm and side were then wrapped and he was placed in a hospital room to recuperate.  When his blood pressure shot up that afternoon, they moved him to the trauma ICU where they could better monitor his situation, and he has remained there.