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.