Monday Update on Joseph

I assume after this update on Joseph, I will return to my regular blogging (whatever that is) 

He came home this afternoon. He will have some recovery time, but all in all is doing well considering what he went through the past week. Recap ...

1. Saturday January 16, 2010 around 12:30PM - Joseph (age 19) landed on his right side while doing a back flip on his snowboard. He's been doing flips for about 3 or 4 years - he's a safety conscious kid - always wearing a helmet, wrist guards, etc.
2. He was taken by ambulance to Lehigh Valley Trauma Center
3. We arrived around 3PM and he was in surgery already. 
4. Sometime in the evening, doctor informed us Joseph was in a critical life-threatening situation, due to internal bleeding from his right kidney. It was damaged, but the doc was going to do everything to try to save it.
5. Around 7PM - the doc made the call to remove the kidney. They couldn't stop the bleeding and the cat scan showed severe damage to it. 
6. 9:30PM - Doc came back from surgery, said the kidney was split in two, so removing it was the right call. Upgraded Joseph to stable, but critical. Incision on abdomen was left open due to swelling.
7. Joseph received a total of 13 units of blood on Saturday and Sunday
   
8. Incision was partially closed in surgery on Monday. Joseph stayed on Breathing Machine and was sedated until Thursday, when incision was fully closed in his 4th surgery.
   
9. Moved out of ICU on Saturday - almost exactly a week after entering it.
   
10. No driving or lifting for at least a week - he should recover well and be able to live a full life without side effects of only having one kidney.

He's in fairly good spirits - though annoyed that he received this severe an injury from such an 'easy' trick. As the nurse was giving him discharge instructions - she mentioned that he might need to have us tie his shoes for a week or so. With a grin on his face, he mentioned that he was wondering how he was going to buckle his snowboarding boots. "Will you help me with them too?"

Funny - not!

Physically, he knows snowboarding is out of question for this season and we'll cross the bridge next winter when we get there. I got hurt in a vehicle accident and I drive/ride in vehicles regularly, but vehicles are essential to life (unless you are Amish) and snowboarding is not. He will be 20 years old this May, so I think come next winter, he'll have to make the call whether or not he wants to do flips while snowboarding again.

Right now we are celebrating life and thanking God for healing and that Joe is home again!

Happy Sunday Update on Joseph

Yippee!!!
If Joesph's temperature stays down, he can come home tomorrow! All his tubes and lines have been removed. He's on an oral pain killer and after he took that, he said he only has a little bit of pain.

He's eating and walking - he walks slowly and carefully, but is happy to be up. He wondered why he couldn't just go home today because he didn't sleep well last night. He has a roommate now - a dear sweet older gentleman, that talked half the night.

Hopefully he can sleep better tonight and then sleep in his own bed tomorrow night!

Thanking God for the way he created our bodies that they can heal. And thankful for the people, skills and technology here at Lehigh Valley Hospital.

This was the scene about an hour ago when Jerry and I left the room ...

Saturday Update on Joseph

Joseph will be moving out of ICU today - praise God!

He's eating jello now ... which is tough for him because he doesn't even like jello on a good day. The nurse informed him he has to eat all of it before he gets anything else - so he asked Nikki if she'd eat it for him. She politely declined.

He walked around the nurses station this morning and is now exhausted from the workout.

By last night, Joseph was not confused anymore and starting to remember details about life. Hearing two friends talk about college, he remembered his classes and asked what he will do about college. We told him not to worry about them at this time.

He remembers coming into the hospital. “I was in a room with a lot of people. I heard someone yell, THIS ONE’S A CODE RED! Then I was quickly moved to another room with a lot more people and that’s all I remember.”

Jerry and I had been told on Saturday night that his situation was dire ... but it didn’t really sink in. On Sunday, a nurse again told us how critical a ruptured kidney is and that they thought they were going to lose him a time or two. We then told Nikki how life-threatening his situation had been. Nikki is like me in that she wasn’t ready to share that with everyone yet. We needed to absorb it first. Over the last few days, we’ve talked to more of his doctors/nurses and they all repeat similar words that make us shudder every time. “You had a very sick boy.” “I didn’t know if he would make it.” “He almost bled to death.” “He’s very fortunate to be alive.”

We didn’t think he needed to know about losing a kidney and that he almost died yet. But one of his nurses told him ... I really like the nurse, so I wasn’t totally upset about it, but I would have appreciated if Joe won’t have known quite so soon.

Last night, he said he’s thankful he’s alive, but he’s sad about losing a kidney ... especially from doing a simple backflip (to me a backflip is not simple!) he wishes he could at least blame it on a major tough trick or jump.

Please pray for peace for him as he processes this major life incident.

He told us he created some unintentionally excitement in his room last night ... “I needed to use the bathroom and couldn’t find my call button. I had to go BAD! Looking around for it, I saw that call button (red button on the wall above his bed) I propped myself up on one arm and was able to reach it.”

“Pulling it down, I quickly found out that’s not a normal call button - it's the “OH SH*T” button! Four nurses came running in here in a panic.”

Thankfully his sense of humor is still intact :)

Friday Update on Joseph

Joseph is more alert and less confused today. He is still on a morphine drip, but it doesn't seem to be affecting his mind as much. He remembers his fall ... telling us that it was just a normal back flip (something he's been doing for 3 years) and he landed on his arm with his elbow jamming into his side.

The doctors have given the okay to move forward a few steps today ... catheter removed, clear liquid diet, stomach suction tube will be removed around noon and then getting out of bed later today. If all goes well, maybe out of ICU by tomorrow.

Please pray his temp comes down - it continues to be around 100 - but there are no other signs of infection, so they think its from inflammation.  

Yesterday's update was fun to write ... but as the day went on, I found myself concerned about his long-term recovery again. I'm encouraged after seeing him this morning and trying to rest in "the peace that passes all understanding." 

Thursday Update on Joseph

Surgery went great this morning. He was back in his room by 10AM - and I’ve been busy ever since ... helping him become human again (his words) Nikki and I have been trying to decipher how his ship crashed and what the little men at his feet and the creatures behind his head are doing.

The incision was closed the whole way in surgery - praise God!! He is off the vent and sedation meds. He has a morphine drip now - hence the stories. OMG - morphine must affect him the same way it affected me. When a monitor beeps - he tells us to answer his cell phone. He is very annoyed if he hears Nikki and I laughing, so we play along with his stories, telling him we will get his car keys and a magnet for him. (and not just any magnet, it must be 5” long!)

The nurse has given him a few sips of water already - which he was very grateful for saying, “Thank you.” As long as Nikki or I are in the room, the nurse will leave the restraints off his hands. He itches is face/nose, but seems to remember that the nurse told him not to pull out the tubes, but we have to watch him closely.

Nikki and I are getting T-shirts made saying Mom and Not Mom. When the nurse first asked if he knew who we are - he looked at me saying “Mom” and at Nikki saying “Not Mom.” But he knows her name, because a minute later when she turned away from the bed laughing, he said, “Nikki - seriously!" He also wanted her to sit on the bed near him.

He’s sleeping at the moment - I think it will be a day of sleeping and stories :)  The nurse said he should improve fairly quickly now - maybe some food later today. Out of bed tomorrow and out of ICU soon after that.

Thank you God!

Question - The Good, Bad and Ugly?

Last week I posted a question and wrote "I plan to post a question every week. Sometimes the question will have more depth than others - depends what stirs my curiosity at the time."

This is an another question post.

Most people that believe in God give him credit for the good things in life. But when it comes to the bad and ugly in life - there are different opinions.

Some people think the bad and ugly are a result of choices someone (ourselves or others) makes.

Others think that everything - including the bad and ugly - that happens is part of God's plan for us.

Others see the devil behind every corner and think that bad and ugly is a direct result of his plan.

Still others think its all a result of this earth we live in.

And many believe in varying combinations of the above.

~~~~~~~~~~~~~~~~~~~~~~

Me ... I'm trying to figure it out.

I know enough to know that I don't know why some things happen. I know there are mysteries in life and if I ever tell you why this or that happened - please ask me how I think I know. 

So that's my question to you. Do you have theories about why/how 'the good, bad and ugly' happen in life? If so, care to share? 

Wednesday Update on Joe

I'm having a day of rest at home today. Jerry is with Joe. He called with a report after the doctors came by on rounds. Joe continues to be sedated and on the breathing machine, but he is stable and progressing ... slowly, but surely.

Still has a fever and he was restless in the night and seemed in pain, so the meds have been increased slightly, so he's really out of it - not even opening his eyes.

The MRI last night showed that his neck is fine - so the neck brace has been removed. Jerry said they washed his hair and shaved his face, so he is looking good now :)

Plans are to take him into surgery tomorrow to further close his abdomen incision. The swelling is going down a lot ... but only after they have him in the OR will they determine whether they can close it the whole way.

As for visitors ... he can't have visitors until that wound is totally closed. You are welcome to come visit Jerry and/or I when we are at the hospital, but you might want to check with us first to make sure we are available - thanks.

Tuesday Morning Doctor Report

Doctors were very encouraged with his progress ... they say he's doing well considering the severe injury he had. He will recover and be fine! Thanks Dr. S and Dr J - I needed to hear that!!

During surgery yesterday a type of wound-vac called the Whittman Patch (don't google if you don't like gruesome pics) was placed in the open incision.  This promotes healing and allows them to gently close the incision little by little at bedside or in the OR. They described is as pulling velcro together. Dr. S will be looking at it today and probably pulling it shut a little more at bedside, then tomorrow Joe will go to OR again. The docs seemed semi confident that it can be completely closed tomorrow - but it might be Thursday.

They were happy with the changed feeding tube, his vitals, temp (its down to 99 now) and his urine - clear, no more blood!

With an injury - a neck collar is standard procedure until cleared. Earlier x-rays and/or cat scan have shown there are no fractures, but they cannot remove it unless an MRI clears the potential of ligament damage or the patient can clearly say that he has no pain in his neck. Trying to avoid a MRI, they were waiting until Joe wakes up, but now that it could be Thur or Fri until he's not sedated, they have scheduled an MRI today - so hopefully the collar can be removed after that.

Yesterday I noticed his right elbow was slightly black and blue, so I asked for an x-ray. The results are back - no breaks, just bruised.  The docs feel that is probably what he jammed into his kidney and caused the rupture.

He hasn't responded to me this morning, because he is really groggy from the extra meds to change the feeding tube. So, I didn't stay in long, because I want him to be able to sleep - so he doesn't feel or know anything!

Now ... off to call Penn State Berks to cancel his classes for this semester. He has calc II and chem II this semester, along with a few other classes and he will be too far behind by the time he can go. He will so annoyed when he realizes this ...

Monday Evening Update on Joe

Tonight ... is hard. I was hoping he would be awake more today, but his temperature rose around noon again. His white cell count hasn’t changed, so they don’t think he has an infection, but they are doing blood and urine cultures to check.

They are using ice and Tylenol to try to bring his temp down. Plus, when the nurse asked him if he’s having pain, he shook his head yes, so his pain meds were increased. So with the duo of more pain meds and Tylenol - he’s really sleeping soundly all the time.

Which is good ... I know that’s best for him, but I’m tired of this already. Please pray that I can have patience and peace.


I wrote the above ... then Nikki and I went in to see him during the evening visiting hour and he was awake!! Thank you God! He shook his head no when I asked if he's having pain. Nikki and I stood there and talked to him for a little. Then wanting to give Nikki a few minutes alone with him before we left, I told him I'm going home for the night and will see him in the morning. I kissed his hand, said good bye and started walking out of the room. Nikki called me back and pointed out that he was slowly wiggling his fingers. I asked him if he was waving good-bye and he shook his head yes.

So I go home with a measure of peace - it will be okay.

Monday morning update on Joe

Joe’s surgery this morning was delayed ... just spoke with the doc 30 minutes ago, then went to see Joe. The surgery report is a mixture of good and bad news. Doctor said everything in his abdomen looks good and is healing well - but swelling is still too much to totally close the incision. It’s partially closed and at this time the plan is to try to close it again on Wednesday - which means he will be on the vent and sedated until after that :(

We are sad about that - for him and ourselves. Nikki was hoping he’d have it out before she heads back to college on Wed.

Good news ... he doesn’t have a fever anymore and his swelling continues to go down, so he looks better. And the big news - he’s peeing well, which means the other kidney is working good. (its amazing what you get excited about in a hospital) Also, with all his internal bleeding some of the blood had gotten into his bladder and his urine was very bloody at first ... but now it is clearing up.

Some of you asked what he was doing when he got hurt. He was doing a back flip - which he did many times before. The front of his board caught something and flipped him at an odd angle and he landed on his right side without having time to put his arms out to stop himself. He’s fairly safety conscious - always wears a helmet and wrist guards to snowboard. Guess he should have had a worn a bullet proof vest or something to protect his kidney!

Here's the first post about Joe getting hurt on Saturday.

Sunday Evening Update on Joe

Today has been a calm day for Joe - no major procedures or things happening. The docs wanted his body to have time to catch up on all that its been through. His vital signs have stayed stable. He's had a temp around 103 most of the day and we're still waiting to hear what the blood test show the white blood cell count was from the blood drawn at 4PM.

Unfortunately, a MRSA nose swab that was done when he came in showed positive ... nurse said its colonized, which I understand to mean he's had it in the past, but it isn't necessarily active now. The nurse said it shouldn't be any big deal, but now we do have to wash and suit up when we go see him.  

He's been sleeping almost every time we went in - expect one time when Jerry told him Nikki (his girlfriend) was there, Joe motioned with his hand that he wants to hold her hand. So she held his hand (gladly!) and he squeezed it a time or two, then fell asleep again.

Surgery is scheduled for 8:40AM tomorrow to determine the condition of the abdomen incision. They started a diuretic today to help bring the swelling down and already the protrusion is looking smaller. There are three options they will consider while in the OR.

1. close it completely
2. close it partially and take him back to OR in a day or two to totally close it
   
3. put a wound vac on it to help it heal more and try closing it in a few days

Obviously, we are praying for option #1!

That would also mean the breathing machine would come off and the sedation would end - so we could communicate with Joe again :)

I'm tired and plan to go home to sleep tonight and be back in the morning before he comes back from surgery around 9:30 or 10. 

Sunday Morning Update on Joe

Jerry and I were in with Joe when the doctors came to do rounds aroung 9AM. They are happy with his progress. Heart rate and temp up slightly, but vitals are stable. Protrusion from incision is still the same - it's covered with gauze but still disgusting. (can you tell I couldn't be a nurse) 

He is swollen from all the fluids they pumped into him. He's had 13 units of blood and multiple liters of other fluids. His face looks round and chubby like it did when he was a toddler. (except for the whiskers on it now)

They are scheduling him for OR tomorrow to see if the swelling is down enough to close the incision - which means he would then be off sedation and the vent :) That is my prayer! The vent is miserable!

The nurse said when she rolled him slightly this morning, he tried to help by moving himself. She said, "Don't - you'll hurt yourself. Don't you have pain?"

He shook his head no.

Tough, determined kid that he is ... I know he won't complain about pain very easily, even if he's feeling it. So my prayer right now is that he isn't feeling pain ... and my practical 'help' is telling the nurse to give him regular pain meds even if he's not complaining! Hey, a mom has to do what a mom has to do to keep her kids comfortable.

 Joseph - last year at age 18

Son Joseph Injured

My 19 yr old son Joseph fell while doing a flip on his snowboard around 12:30 on Saturday. His friend Eric said he had a hard time catching his breathe. He throw up the lunch he had just eaten, but then got up and snowboarded the rest of the way down the hill. He said it felt like he might have broken a rib so they went to ski patrol. Eric said then Joe started to walk really slow and bent over. As he was being examined, he really started to fade and an ambulance was called.

Eric called Jerry and I and by the time we drove the hour to Lehigh Valley Hospital, Joe was in surgery.

Doctor came out an hour or two later with grim news. Joe had fallen hard on his right side and that kidney was severely damaged. Doc wasn't sure it could be repaired, but wanted to give it a little time to see if the bleeding stops.

Bleeding did not stop, so kidney was removed in a 2nd surgery. Doc said this surgery could take up to 4 hrs, but it only took an hour and a half. Doc said it went really well.

Joe's vitals stabilized after that.

Abdomen is swollen from bruising everywhere, so the incision was left open to allow his guts room to expand. It is covered with a dressing, but it looks really odd. His normally very flat abs now have a major distension protruding out about 5" x 7" or so.
This incision will remain open for a few days until the swelling goes down. He will be sedated and on a breathing machine so he doesn't move.

As for me, I've already been scared, sad, anger, annoyed (not at him, just at the circumstances) and grateful! Grateful at the love of people.... there was a roomful of friends here and many more (near and far) sending messages of love - thank you!

And I am grateful that Joseph survived! And he should be able to do life almost as before with one kidney - minus snowboarding, of course.