Today has been more of the same. The nurses are working to ween Sam off of the meds that are keeping him down. The less medication, the more able he will be to breathe on his own. Right now he is regulating the rate of breathing, but the ventilator is providing extra air on each breath so that he gets enough. But as they reduce the meds, the more the vent tube bugs him and he tries to pull it out.
As I type this, Cameron and Jenn, Sam's terrific night nurse, have him sitting up in a chair with restraints loosened on his left hand. He squirms a bit, uses the left hand to push himself into a more comfortable position, scratches his chest a bit, then tugs at his neck brace -- "No Sam, you need that to protect your neck" -- hands down and then -- "Sam, let go of the tubes, you can't take that out . . .." Then repeat. Jenn says this is a part of recovery and is really good, just a little hard to watch. There is some hope of getting the vent tubes out tomorrow which may make him more comfortable.
For those who are wondering about what specifically you can pray for, you might try for Sam to stay calm, relaxed, and rest.
-- Patton
Tuesday, August 12, 2008
Tuesday morning brief update (Aug 12th)
This will be brief as both Cameron and I are really tired this morning.
Sam was quite active all night last night. His body is trying to wake up more fully but his brain needs more time to heal.
He continues to open his right eye and partially his left eye; he doesn't quite focus on anything or anyone yet but he seems to be looking out. He responded to several verbal instructions last night including raise your thumb (left side only; he hasn't been able to do it on his right side yet); give a peace sign; squeeze someone's hand; and shrug your shoulders. He also seemed to wiggle his left toes - at least I believe he did but am not sure the doctor would agree.
He is becoming increasingly curious about his situation which is evidenced by his reaching for tubes, neck brace and other things. When we tell him what the item is and that he can touch but not pull them, he is very good about it. He squirms quite a bit in an effort (it seems) to get comfortable.
As we continue our prayers, please remember to give thanks for progress that has been made. Sam is starting his 10th day in the hospital and he has come a long way. It's important to pause and remember that each day.
Dart/Karylinn
Monday, August 11, 2008
Sunday Night Monday Morning
Well tonight started off like anyother with the anticipation of being tired the while time and the distinct possability of nothing happening at all. Other than that we encountered the usuall ICP spikes with Sam's temp staying around where it should be.
Some excitement did take place when one of the many bags containing Sam's meds ran out and the machine it was attached to began to beep letting anyone within earshot know. It continued and as Tom had stepped out for a second the on duty RN came in and to tend to things. That seemed to be the end until the RN left and Tom came in and as he (Tom) and Dart were standing on either side of Sam's bed, Sam began to get quite restless and actually needed to be restrained and held down.
After moving quite a bit Sam opened his eyes and on command managed to wiggle his thumb again when prompted by Dart. And even squeezed anyone's hands with plenty of strength and I think he took a couple of nurses by surprise at how strong he actually is. At that point it seemed a good idea to Bolus Sam with more sedatives to calm him down because his ICPs spiked to about 28 but then made a quick drop to a little below 10 or so and everything kind of smoothed out from there. But it was really awesome for him to open his eyes and be able to listen to some one then perform the action required by them. But even though this is great the spike in his ICPs shows that his brain isn't ready for any significant kind of pressure required to operate while not sedated.
After just a bit we left the room because Sam required a bath, but from what I could tell it was only me that needed a bath 'cause Sam seems to be getting more than I ever have. It also seems that he is taking more baths than he ever did at home and he doesn't have to do anything, LUCKY! except the being in the hospital thing kind of sucks. After his bath we came back to his room and noticed the lights were all the way on and his ICP was staying at 5. Tom thinks it is due to Sam not being/wearing the Arctic Suite Cooling Unit and as long as his temp stays where it is (37.0) he won't have to wear it. This is a big deal because the Arctic Suite is like wearing a nearly ice cold wet suit that is constantly wet where it is making contact with you skin but not anywhere else on your body and it is also coated with some sticky stuff on the inside that makes it stick to your skin and causes quite a bit of discomfort. And that is one of the reasons Sam's ICP was so high while he was wearing it.
Here are some quickly formulated notes from last night:
2:15am- ICP staying between 5 and 7 Temp at 36.8, no body suit no cold blanket and everything looks good.
2:50am- Tom and 2 others moved Sam and he woke up and on command he opened his right eye and almost his left and wiggled his thumb too. Tom feels Sam is regulating his temperature more on his own. Sam has really been working at waking up most of the night.
4:50am- Sam stirred and opened his eyes, kicked off the PT boot on his left foot. Squirmed, opened right eye and mostly opened left eye. ICP got to 30. No shivering since removal of Arctic Suit.
So, as you can tell Sam is very determined to wake up whether he is being sedated or not. This is a good sign as the doctors think that Sam is over the hardest part of this but his brain still can't take the pressure right now. Yet, even though it can this is a good sign, and we know that this could be a dance of 2 steps forward and 1 step back we will eventually get to the end and that is okay cause we know that Sam is gonna pull through. We have also begun to tell him he is in the hospital, when he wakes up, but that there is family there with them because when he wakes up he seems a little unsure of where he is and maybe a little scared. That is the main reason that there is always a family member in the room with him just in case.
Well everyone that is this morning's update and I am tired and need to go to bed, but keep praying because it is helping and you can never pray to much for anything. So, do whatever it is you do to think of Sam, light candles, pray for him, think of him or anything it is all helping and will continue to help into the future.
Thank you and Good Night (maybe a little cliche but I am the one writing this section of the blog so get over it.)
In God We Trust>>>Cameron Huntting
--
Cameron Huntting (chunttin@uoregon.edu)
Some excitement did take place when one of the many bags containing Sam's meds ran out and the machine it was attached to began to beep letting anyone within earshot know. It continued and as Tom had stepped out for a second the on duty RN came in and to tend to things. That seemed to be the end until the RN left and Tom came in and as he (Tom) and Dart were standing on either side of Sam's bed, Sam began to get quite restless and actually needed to be restrained and held down.
After moving quite a bit Sam opened his eyes and on command managed to wiggle his thumb again when prompted by Dart. And even squeezed anyone's hands with plenty of strength and I think he took a couple of nurses by surprise at how strong he actually is. At that point it seemed a good idea to Bolus Sam with more sedatives to calm him down because his ICPs spiked to about 28 but then made a quick drop to a little below 10 or so and everything kind of smoothed out from there. But it was really awesome for him to open his eyes and be able to listen to some one then perform the action required by them. But even though this is great the spike in his ICPs shows that his brain isn't ready for any significant kind of pressure required to operate while not sedated.
After just a bit we left the room because Sam required a bath, but from what I could tell it was only me that needed a bath 'cause Sam seems to be getting more than I ever have. It also seems that he is taking more baths than he ever did at home and he doesn't have to do anything, LUCKY! except the being in the hospital thing kind of sucks. After his bath we came back to his room and noticed the lights were all the way on and his ICP was staying at 5. Tom thinks it is due to Sam not being/wearing the Arctic Suite Cooling Unit and as long as his temp stays where it is (37.0) he won't have to wear it. This is a big deal because the Arctic Suite is like wearing a nearly ice cold wet suit that is constantly wet where it is making contact with you skin but not anywhere else on your body and it is also coated with some sticky stuff on the inside that makes it stick to your skin and causes quite a bit of discomfort. And that is one of the reasons Sam's ICP was so high while he was wearing it.
Here are some quickly formulated notes from last night:
2:15am- ICP staying between 5 and 7 Temp at 36.8, no body suit no cold blanket and everything looks good.
2:50am- Tom and 2 others moved Sam and he woke up and on command he opened his right eye and almost his left and wiggled his thumb too. Tom feels Sam is regulating his temperature more on his own. Sam has really been working at waking up most of the night.
4:50am- Sam stirred and opened his eyes, kicked off the PT boot on his left foot. Squirmed, opened right eye and mostly opened left eye. ICP got to 30. No shivering since removal of Arctic Suit.
So, as you can tell Sam is very determined to wake up whether he is being sedated or not. This is a good sign as the doctors think that Sam is over the hardest part of this but his brain still can't take the pressure right now. Yet, even though it can this is a good sign, and we know that this could be a dance of 2 steps forward and 1 step back we will eventually get to the end and that is okay cause we know that Sam is gonna pull through. We have also begun to tell him he is in the hospital, when he wakes up, but that there is family there with them because when he wakes up he seems a little unsure of where he is and maybe a little scared. That is the main reason that there is always a family member in the room with him just in case.
Well everyone that is this morning's update and I am tired and need to go to bed, but keep praying because it is helping and you can never pray to much for anything. So, do whatever it is you do to think of Sam, light candles, pray for him, think of him or anything it is all helping and will continue to help into the future.
Thank you and Good Night (maybe a little cliche but I am the one writing this section of the blog so get over it.)
In God We Trust>>>Cameron Huntting
--
Cameron Huntting (chunttin@uoregon.edu)
Sunday, August 10, 2008
God bless you all and Sam update!
Hi to all our friends God bless you and thank you. Your prayers and words of support and encouragement have meant so much to everyone holding down the fort here at OHSU. God's presence and love you can be felt when entering Sam's room. Many times I have gone into it with a heavy heart, I have started praying, and feel His presence and your prayers surrounding me. Sam is a wonderful young man and son of God and I know he is being cradled in God's arms as he heals.
A quick update: Sam's ICPs have been between 8 and 11 tonight, even as low as 5 and 6. They have only gone up when he has been moved or fussed with like having his teeth brushed or when the nurses wax put on his braces this afternoon (thank you Amanda). A CT this morning showed that the swelling has gone down, the brain contusion is smaller, and the spaces that should be open or have fluid in them do. His neurosurgeon told me this was a good CT and feels we are past the crisis. Now we need to continue getting the swelling down, wean Sam off of the respirator and IV meds, out of ICU and into a ward, and further down the road rehab.
Many of you that know me know that I'm quite the planner, probably from all those years in the military. I like to have everything just right so the project runs smoothly, either a vacation and even Sam's potential rehab. It has taken this tragedy for me to see that I truly have to take things one day at a time, that I cannot plan or predict the future, and that I have no control over so many things in life. Yes, I admit I was even planning in my head his rehab and we don't even know what he will need, but I was already figuring out who, what, etc. Only God knows what is in store for our precious son and as for me I will have to start each day with the simple joy and happiness I feel to see Sam alive and peaceful even with all tubes, IV lines, and machinery.
Thank you all for your words of love, support, encouragement, and even wisdom. Without God's love and your prayers, well life would be so empty and right now I am filled with love and peace.
Stephanie
A quick update: Sam's ICPs have been between 8 and 11 tonight, even as low as 5 and 6. They have only gone up when he has been moved or fussed with like having his teeth brushed or when the nurses wax put on his braces this afternoon (thank you Amanda). A CT this morning showed that the swelling has gone down, the brain contusion is smaller, and the spaces that should be open or have fluid in them do. His neurosurgeon told me this was a good CT and feels we are past the crisis. Now we need to continue getting the swelling down, wean Sam off of the respirator and IV meds, out of ICU and into a ward, and further down the road rehab.
Many of you that know me know that I'm quite the planner, probably from all those years in the military. I like to have everything just right so the project runs smoothly, either a vacation and even Sam's potential rehab. It has taken this tragedy for me to see that I truly have to take things one day at a time, that I cannot plan or predict the future, and that I have no control over so many things in life. Yes, I admit I was even planning in my head his rehab and we don't even know what he will need, but I was already figuring out who, what, etc. Only God knows what is in store for our precious son and as for me I will have to start each day with the simple joy and happiness I feel to see Sam alive and peaceful even with all tubes, IV lines, and machinery.
Thank you all for your words of love, support, encouragement, and even wisdom. Without God's love and your prayers, well life would be so empty and right now I am filled with love and peace.
Stephanie
Picture Change
The new picture in the Blog sidebar is the one that is printed out and hanging on the glass door of his ICU room. We thought it should be where it is too. But we like this one (Sam and the Elephant if you didn't look closely) So I though I'd post it here so's not to get lost.
If you have not been on today, don't forget the update below.
-- Patton
If you have not been on today, don't forget the update below.
-- Patton
Sunday afternoon (8.10.08) update from Aunt Dart
We've been asked to post a quick update each morning as Cameron and I leave the hospital and Stephanie arrives. We hear that folks sign on in the morning to see how the night went. It's good to hear the feedback as to what folks want and need to know, so we'll do at least a quick morning update before going to bed.
Last night (Saturday night) and up to this point today have remained status quo for the most part. They were able to get Sam's temperature down to under 37 last night and keep it that way. Sadly, the way they do it is by having Sam in a body suit (think wet suit that goes from just above the knees to just below his chest) that circulates cold (water?) continuously. We all feel so bad for Sam because it's just so cold, but necessary. We've asked that they keep socks on his feet and that makes us feel a bit better.
His ICP (inter cranial pressure) hoovered in the mid-teens most of last night except when they were tending to him (coughing him, moving him, injecting potassium into his tube, etc) at which time it'd go up to the mid to high 20s. We learned today that a 'normal' range for any of us is 5 to 15; with the higher number occuring when any of us are particularly agitated, angry or upset. So, his range mostly falls in the 'normal' numbers. Having a context for the numbers is helpful
Sam's nurse last night, Adia, was amazing. Well, actually they've all been beyond amazing. They work around us (we have two chairs in this very large but very crowded room, one on either side of Sam) without complaint. When we get in their way, they apologize to us. We've been told by the staff that our family is wonderful to work with and very easy to deal with. That is often not the case, as we can all imagine.
Adia kept talking to Cameron and I all night giving us information and answering questions. We're a curious bunch and want to know about all the tubes, numbers, graphs, medicines, protocol, etc and they are very willing to teach us. She also wanted to know about Sam; most of the staff does.
We have a great picture of Sam from our recent trip to South Africa posted on his glass door along with a poster that tells about him. Staff stop and look at the picture. It all makes Sam a person they can know while also treating the patient.
Yesterday and today (Sat & Sunday), Stephanie's sister Sue and neice Jennifer, along with baby Jordan, have taken Steph away from the hospital for a couple hours to get a break. Yesterday it was for lunch and to go the the McHouse (as the family calls it - the Ronald McDonald house) to do laundry and hang out. Today they went and saw the movie Mama Mia. Stephanie says the brief outings help her feel refreshed when she gets back to the hospital.
The family is holding up well given the situation; we're tired, sad and worried but we feel your prayers, thoughts and positive thoughts coming our way. We have established a routine where everyone is able to do what they can and Sam continues to always have a family member bedside or just down the hall.
Look for another update either later tonight from Cameron (who's able to blog from the hospital) or Monday morning after we change shifts.
Dart (Karylinn)
Saturday, August 9, 2008
Saturday 9th
This morning Sam's was improved with Temp as low as 37.0. They were able to get him out of his ice blankets and off of the paralytic drugs.
Later in the day, his temp was up again and it looked like his central line had the beginning of an infection. The central line is where all of his meds come together and are injected through one tube that is stitched into his chest. A quick count a few minutes ago looks like they have about 5 bags hanging and injecting various things. I'm sure that number changes from time to time. At any rate, a quick culture confirmed that the line needed to be moved / replaced; apparently quite the operation since every tube going in was replaced as well.
As of right now, he is getting some antibiotics and is back in his cooling suit. Temp was 38.2, and ICP about 20 though it has been hovering in the mid teens most of the day.
Here is my own personal, non medical, observation I had earlier today. I was trying not to scratch the itch where some of my scabs are coming off, noticing the color change in the airbag bruise on my forearm and stewing about why Sam was holding stable but not improving as fast as I would prefer. It occurred to me then that if my forearm was still bruised, and the brain is made of more fragile stuff, why would I expect him to heal any faster than me? I know that my arm is a poor comparison to Sam's brain, but it is a reminder that these things take time.
As with every day, your prayers, positive thoughts and meditations are gratefully received, appreciated and felt.
-- Patton
Later in the day, his temp was up again and it looked like his central line had the beginning of an infection. The central line is where all of his meds come together and are injected through one tube that is stitched into his chest. A quick count a few minutes ago looks like they have about 5 bags hanging and injecting various things. I'm sure that number changes from time to time. At any rate, a quick culture confirmed that the line needed to be moved / replaced; apparently quite the operation since every tube going in was replaced as well.
As of right now, he is getting some antibiotics and is back in his cooling suit. Temp was 38.2, and ICP about 20 though it has been hovering in the mid teens most of the day.
Here is my own personal, non medical, observation I had earlier today. I was trying not to scratch the itch where some of my scabs are coming off, noticing the color change in the airbag bruise on my forearm and stewing about why Sam was holding stable but not improving as fast as I would prefer. It occurred to me then that if my forearm was still bruised, and the brain is made of more fragile stuff, why would I expect him to heal any faster than me? I know that my arm is a poor comparison to Sam's brain, but it is a reminder that these things take time.
As with every day, your prayers, positive thoughts and meditations are gratefully received, appreciated and felt.
-- Patton
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