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April 28, 2006
Prayer needed for Andrew Sandberg (Seneff family)
Many of you probably know the Seneff's. They have been family friends of both Courtney and my families for years. Rebecca Seneff (married name Sandberg) and her family are living in Kenya, Africa as missionaries. Their two-year old son, Andrew, had a bad accident a couple days ago and injured his eye. The Seneffs have been a huge support for us through the past two weeks, so naturally I offered to use the network that I've built up to pray for Courtney to help spread the word about Andrew. It's been a tremendous blessing for me to see how many people have prayed for Courtney and I'm sure the Seneff family would take comfort in knowing that you were also praying for little Andrew. Here's the info from Rebecca (I knew her as Becca):
-- from Rebecca --
Hello to all of you…
Well, we leave for the airport in abut 3 hours. We are flying to London and then on to Maryland to Johns Hopkins where Andrew will be seen on Friday afternoon. Most of you already know the happenings of the past 48 hours. But in short, Andrew and Jake were playing with a small metal airplane and somehow Andrew pulled it with enough force that the wing of the airplane cut into his eye. He had emergency surgery and now has 10 stitches stretching from one side of his cornea to the other. The doctor had to cut the iris as it and the pupil had already begun to protrude through the cornea. The wing of the plane went through his cornea, iris and then his pupil. We are not sure if it hit the lens or if there is damage to the retina. We have exhausted our resources here in Kenya thus the trip to the States. The doctor here is unable to assess whether or not there is permanent damage to his sight. We will know more after this weekend. Please pray that there will be no infection in his eye. Please pray that Andrew does not touch his bandage/patch on his eye. Please pray that God would do a miracle and that his eye would be completely healed. We believe that the Almighty is good and that He is gracious. Andrew is His child and Andrew’s sweet blue eyes were formed in the strength and wholeness of God’s hands. We trust that God will indeed watch over Andrew and be with us.
Andrew’s spirit is so beautiful. When we went to the doctors for our initial visit we were really unsure about how bad his eye was. Jake was with me at the time. When the doctor said that he needed surgery and that it was a serious injury, Jake and I started crying. Jake immediately hugged Andrew and told him that he would be ok.
The next day after the surgery the nurse from that office came to our hospital room and told us that when we had left the office they prayed for Andrew.
Andrew has comforting eyes. He draws people in with his eyes. It was astonishing to me to watch Andrew minister with his quiet spirit to all of the people at the hospital. Without any words, he brought a smile to people and somehow made them feel at peace.
Thank you for your prayers and for your love.
Roger, Rebecca, Jake and Andrew
-- end from Rebecca --
Thanks again for all of your prayers for Courtney!
Posted by mark at 7:26 PM | Comments (1)
Home sweet home!
This morning Courtney and I left Charlottesville at 10:30 and had a leisurely drive back to Harrisonburg. It was an emotional moment for Courntey as she was both excited and nervous about being home. The kids had been well coached with regard to Courtney's appearance, speech with a wired jaw, and the need for caution with her face. After a few moments of nervousness (more with Emma), they eventually warmed up and were obviously happy to see their mommy. They were generally happy to see me as well, but I was definitely the side-show.
Courtney continues to improve. She's very weak and tired a lot -- the fatigue can be attributed to the liquid diet and pain meds, but the swelling continues to subside and her vision still seems to be great. I would guess that she has lost about 15 lbs since the accident. She was already very trim, so it's weight that she didn't need to lose. Gaining weight on a liquid diet is very difficult if not impossible. Her trach hole is continuing to heal although it's been difficult to keep the dressing tight. When Courtney talks and coughs, she has to push on the location of the hole, and it's often difficult to press hard enough. However, I think it's still healing and should be closed back up in a few more days. When that's healed, she'll feel a lot more comfortable.
We're obviously thrilled to be home, but there's still a lot of recovery. She's so weak and tired that the thought of visitors is still something that concerns her. We'll probably keep it to 2-3 people per day, and maybe not start until Monday. That's completely up to her, but I think she'll be feeling a LOT better by Monday.
I forgot to mention that the morning after the surgery when Dr. Park was checking on Courtney said, almost as an aside, that Courtney was "tough as nails." I couldn't agree more. Courtney is doing great handling all of this. I'm sure that she's been internalizing a lot of emotions, which has been necessary up to this point, but I'm certain that the next few weeks of laborious healing are going to be seem long and tedious. Pray that she'll continue to be encouraged with the progress and patient in the next few weeks. You can also pray that the kids would be patient as we continue to remind them to BE CAREFUL and in fact have already asked why mommy doesn't talk much.
A hearty thanks to the crew of friends that mulched our yard. It was awesome to drive up and see such amazing landscaping. Also thanks to the friends who have overseen the mowing of our yard. I'll try to thank each of you personally in the next few days, but please know that it was hugely appreciated.
Posted by mark at 6:08 PM | Comments (1)
April 26, 2006
Out of the hospital and trachless
I was sitting with Courtney at 8:30 AM when Dr. Park walked in. I didn't realize that he was also planning to come by. Anyway, he was very happy with what he saw. At the time Courtney was sitting up in a chair drinking her breakfast and looking pretty good. He checked out some things and then I could see his wheels spinning for a second. He asked if we felt confident being out of the hospital, and a few other questions about our plans if we were out, and then said that if we could come by his office at 1:00 he would take out the trach. He felt that she was breathing really well through her mouth/nose and was obviously happy enough with the surgery results that he didn't see another surgery in the near future. So, given that, he gave the order to set us free. That was obviously a very exciting moment for Courtney.
We were discharged from the hospital, and went to Dr. Parks' at 1:00 PM. He removed the trach and bandaged up her throat with a tight dressing and said that in a few days it would close up on it's own and heal itself without any stitches. Pretty cool. The key is to keep your fingers pressed over the hole when coughing and talking to prevent as much air from escaping as possible. She is having some air containment issues, so I'm going to try to retighten the bandage in a few minutes.
We're settled into a local hotel and are comfortable. We're going to take our time here until she feels strong enough to go home. She's obviously desperate to see the kids, but we want to make sure that she's ready. At this point emotions are literally painful as they are usually accompanied by facial movement. ;-) Also, even though they discharged her from the hospital, she did have 6 hours of surgery yesterday and is still getting all of the anesthetics out of her system, and being close to the hospital and Dr. Parks' clinic for a couple days is reasurring to Courtney.
I want to thank you all again for being the best friends on the planet. We couldn't have made it this far without your prayers and support. Thanks!
Posted by mark at 6:17 PM | Comments (15)
Morning update
Amazing! I saw Courtney this morning about 6:30AM and she looked great. There is a lot of swelling, but she is able to open both eyes and according to Courtney, she no longer has double vision. The swelling is nothing like it was in Roanoke (and is much more uniform). They switched out her trach to a #4 cuffless which is about as small as they come. Essentially this is the best scenario for normal breathing assuming they want to leave the trach in for a few days. They still haven't capped the trach, but I don't think her upper airways are too swollen, so that shouldn't be a problem.
About the only difficulty for Courtney was coughing. She was having trouble coughing stuff up so they had to suction her airway a few times which, according to Courtney, is scary. Getting the smaller trach should help her to get more coughing strength and also as she wakes up more and starts to sit up this should improve. I don't think they had her on too many narcotics this morning, she was really sharp and writing clear notes on her clipboard.
According to the 4 or 5 residents (believe it or not I don't know how many) we saw this morning from Dr. Park's office, they would like to discharge her at some point this afternoon, assuming she is able to drink enough. They are going to give her a portable suction device to take with her, which will be handy with a wired jaw (actually, it's just a bunch of rubber bands).
As far as the eye alignment goes, it really is an amazing improvement. The lack of double vision is a huge encouragement as this would seem to indicate that everything is back to normal. I think it's entirely possible that the slight disparity I see is only swelling. Regardless, the improvement is dramatic and I couldn't be happier. None of the doctors this morning verbalized any concerns, so I take that as implicit good news.
If we get out of the hospital today, perhaps I'll let Courtney give you the next update. Thanks for keeping up with our progress and your continued prayers. When I think of where we were 12 days ago, and see where we are now, it is nothing short of miraculous.
Posted by mark at 6:26 AM | Comments (8)
April 25, 2006
Post surgery update
I was finally able to see Courtney after her surgery. I was a bit mistaken in my previous post. When Dr. Park called me it was to tell me that all of the plates had been replaced and that things had gone well. What I misunderstood was that she was still "open." Two hours of stitching later, she was out of surgery. The surgery took a total of 6 hours. So, 2 hours after THAT we eventually saw her at 7:15PM. Her room and/or nurse wasn't immediately available, so I sat with her (only mildly conscious) for about 2 hours before her room was ready. She got into her room sometime after 9:00PM. During transfer to the room, she awoke fully and was quite alert for the last few minutes that we were with her. She is breathing exclusively through her trachiostomy. In order to administer the anesthetics, they installed a "cuffed trach" which has a balloon that occludes the airway to the mouth/nose forcing all air out of the trach, and hence all of the anesthesia into her system. Prior to the surgery, she had been using a capped cuffless trach which essentially forces most air out of the mouth/nose, with the exception of air that leaks out the edges of the trach hole.
In order to be discharged tomorrow, her swelling will have to be reduced to the point where they can install a capped and cuffless trach, and be convinced that she can breath through her upper airways. She'll also have to be able to drink enough sustenance through a straw as there isn't a NG feeding tube this time. Finally, she'll have to be able to controll whatever pain she has through liquid form (ie. not iv narcotics). If her swelling doesn't get worse over night (I'm not sure if it will or not), she should be able to see. She opened both eyes reasonably well despite the new swelling.
They really did a GREAT job with the adjustments. It's still too early to tell HOW good, but both Dr. Park and the chief resident are confident that the imperfections will not be too noticeable. A huge improvement from this morning. The protrusion to the right of her right eye is completely gone, the jaw which previously seemed ever so slightly misaligned does seem better, and the eye is MUCH better. I do think the eye *might* still be a little off, but it's too early to tell. After surgery, the chief resident did remind me that she had some pretty serious bone fragmentation and that the repairs won't be perfect. So, while I've been rather positive in posts up to this point, I have to be realistic in that the repairs might not be able to hide the damage 100%. At least I have the confidence that we've done everything medically possible. We'll have to wait and see what is revealed as the swelling goes away. Dr. Park does his rounds at 6:30 AM so it's possible we'll get something more definitive at that time.
Courtney doesn't have a private room as they don't exist at UVA. If her pain can be controlled and Dr. Park is comfortable discharging her, it might be nice to get her back into a hotel room for a few nights of REAL peace and quiet.
Good night!
Posted by mark at 9:44 PM | Comments (1)
More good news that I forgot to mention earlier
I completely forgot to mention that Dr. Park said that the Corona incision (from ear to ear above the hairline) wasn't necessary. I'm sure that along with the obvious other good news that this will be a great source of comfort for Courtney.
Posted by mark at 5:11 PM | Comments (2)
Out of surgery and initial report from Dr. Park
Courtney is out of surgery. I got a call from Dr. Park about 4:30 to tell me that they were done. He said that they had replaced all of the plates in her face including her jaw which is now wired. I asked specifically about the eye, and he said that in the operating room the eye alignment seemed great, but that he wouldn't be surprised if after the swelling went down that there was a slight disparity. However, given that they were specifically trying to fix that problem, I doubt that a slight disparity will be anywhere near as noticeable as it was this morning. He said that they were able to get the jaw aligned better as well. He did say that she was pretty swollen again and that it would be 7-10 days for that to go away completely. Given the extent of the surgery he did decide to admit her for the night, if I didn't have any problems with that ... of course I didn't. Although given his feelings about hospital stays and limited use of pain meds, I fully expect him to discharge her tomorrow. We'll just go straight to the Hampton Inn and camp out there until Courtney feels ready to go home. I'm guessing this will be Friday or Saturday. The phone call was more of a courtesy to let me know that the surgery went well and that he was done. He said that it would be at least a couple of hours before she was in her recovery room.
After I've had a chance to see Courtney, I'll post again to let you know how she's feeling and how things look, although I might play the same card as Dr. Park and reserve judgement until the swelling has receded.
Thanks for the prayers!
Posted by mark at 4:31 PM | Comments (0)
Courtney is now in surgery
Courtney has been in surgery now for 2 hours. I got a call from her nurse after she was asleep to tell me that the anesthesia had gone smoothly. The chief resident confirmed that the surgery would be 4-5 hours long, I didn't see Dr. Park this morning. Courtney was calm and holding up really well before surgery. My sister came back over from Charlottesville this morning to help me get Courtney to the hospital. My dad flew in from Orlando at about 11:30 and was able to pray with us before they wheeled her away. Believe it or not, but I'm not 100% certain that Dr. Park plans on admitting her to the hospital after the surgery. I would be VERY surprised if she wasn't, but there is enough ambiguity that her location tonight is up in the air. All of my nurse friends tell me that she'll be admitted.
I stil think that she'll get discharged at some point on Wednesday. Currently I'm planning to stay here in Charlottesville with Courtney the first night out of the hospital. So that would put us home Thursday or Friday.
Also, Courtney is not ready to get visitors. It's been a pretty emotional couple of weeks and she has only seen family with the exception of Carolyn and her friend JT (who have been helping us out). I know that a bunch of you are itching to see her, but I'm certain that we'll be back in Harrisonburg before she'll feel like she has the emotional strength for visitors. Thanks for your patience.
I'll be sure to post an update tonight after the surgery, but not until after I see Courtney, and then get back to the hotel after dinner.
Posted by mark at 1:09 PM | Comments (3)
April 24, 2006
update after a VERY LONG DAY
Okay, where do I start.
After talking with the docs in Roanoke, and some nurse friends, it was determined that ambulatory transfer to UVA was a long shot. So, after a few conversations with Courtney she agreed to make the trip in "the van" with our neighbor Carolyn, also a doctor, along for the ride. Early this morning, I dropped off Courtney's brother at the hospital to see Courtney before flying home, and then I drove to meet Carolyn at the halfway point to Harrisonburg since Courtney's dad was able to drive her halfway.
We went straight to Roanoke Memorial Hospital and Courtney was unplugged from the IV (for morphine), and she was given an oral pain medication, her discharge papers, her films/xrays, etc. on CDROM, and prescriptions. There wasn't a pharmacy in the hospital so we decided to just fill it in Charlottesville. Carolyn read to Courtney throughout the trip to keep her occupied, and the trip went very well. Courtney even remembered to ask about the accident location as we got near it. I wasn't going to say anything.
After filling her prescription, and getting directions to Dr. Stephen Park's office (the ENT/facial surgeon), we made it with 15 minutes to spare. We were admitted quickly, and met with Dr. Park's chief resident for a few minutes where he just checked out Courtney. A few minutes after that, about 5 doctors walked in, including Dr. Park. He did a bit more poking and prodding, and then sat down to give us the scoop. He said that he was going to make a number of "adjustments" to the initial surgeries. I'm too tired to go into too much detail, but basically he said where they would go in to make the fixes. Over the eyebrow (from the accident), through the jaw, under the right eye -- there was actually an incision here from the first round of surgeries that I didn't notice previously because of the swelling. He also said that they would have to add an incision on the bridge of her nose, and then the kicker was when he said that given the protrusion of her right cheekbone they would most likely have to do a Corona cut which is basically temple to temple over the high forehead (above the hairline) in order to make the necessary fixes without interfering with a rather important optical nerve above the eyebrow. This of course, really upset Courtney, she wasn't prepared for a shaved head. However, in less than 30 seconds she had already regained her composure and told him to do whatever he needed to do in order to fix the problems. I can't tell you how proud I am of the strength that she has shown through all of this. He also mentioned that he was planning to make adjustments to her jaw as well. All of this was more than we expected, but it was encouraging to know that he felt that he could make improvements. He of course gave me the, "We might not get her back to exactly the way she was before the accident..." line, but it was still encouraging.
I've downplayed the appearance up to this point because I wanted to wait until the swelling had gone down enough to make a fair estimate. The right eye is noticibly lower and slightly sunken. While I would be perfectly happy to have Courtney live the rest of her life the way she is now, it was still hard to see her that way, knowing that if that WAS the final result how hard that would be for HER.
The first hurdle of the day was when Dr. Park said that Courtney had to report tomorrow at 11:00 AM for surgery at 12:00 PM. He had no intention of admitting her to the hospital today. So, I thought Courtney could just stay at the hotel that I had arranged for myself, so I didn't think there would any problem. In the meantime, Carolyn caught a ride home with a nurse friend of ours who also works at UVA.
Dr. Park's team was also concerned with the functionality of her right eye, since it's slightly dilated more than the left eye, so they decided to get a full workup from an opthomologist. After leaving Dr. Park's, I drove Courtney by myself to the eye doc. About 20 minutes into this visit, Courtney started to feel some pain, and started to get upset; she was exhausted, and was really starting to hurt. At this point, given Courtney's anxiety/pain and all of the coordination that was still necessary, I started to mildly panic. I made a few phone calls, and eventually got my sister to come over from Harrisonburg (1 hour away) to help me out. We eventually left the eye doc after about 2 hours. The prognosis was generally optimistic, but guarded. I was pretty distracted, but I think most of the issues they noticed are swelling/trauma related and should improve/heal over time. Dr. Park should be informed of their findings and the surgery should continue as planned. Part of this is CYA on the part of Dr. Park. They wanted to make sure that her current eye condition was documented so that we can't say that they caused new problems. Regardless, I feel comforted by the thoroughness of the exam.
Anyway, because of the pain she was having, I called the ENT doc on call and got him to up Courtney's pain dosage and that seems to have done enough to keep her from getting acute pain.
Now for the second hurdle. We got to the "RED ROOF INN" one block away from the hospital which I had booked earlier for $70 per night. I figured, it's next to the hospital in the middle of UVA, and couldn't be THAT bad for $70 bucks. Anyway, I couldn't have been more wrong. They were doing construction EVERYWHERE. I thought it would be constrained to the lobby, so after registering, I walked Courtney through the construction and drywall dust to the one working elevator (the other was being used by construction workers). We went to the room, and I knew almost immediately that it wasn't going to work. It smelled like paint, and was really lousy. I've stayed in some really bad drive-up motor lodges and this was worse. When I went to take Courtney back to the car, the elevator was broken. After trying to call the lobby to figure out what was wrong (they never answered), I went to see what was going on. I found some workers who didn't speak English who helpfully pointed out the stairs. Anyway, to make a long story short, I had to help Courtney walk down 5 flights of stairs in order to escape that RED ROOF INN. Given the extent of the work they were doing, they should never have opened for business. Even if it was just me staying there, I wouldn't have stayed. Trust me, I'm not being picky, it really was terrible. Tell all of your friends to never stay at a RED ROOF INN. There, I feel better now. ;-)
We found a Hampton Inn down the street which is fabulous. Only $20 more a night, but 1000% better. I gave her the slightly overdue pain meds in the parking lot, my sister showed up, and the day got a lot easier. Courtney immediatly took a bath (something she's been dreaming about for days), and seems to be doing really well. It was a long day, but I think she is really enjoying being out of the hospital.
Thanks for the continued prayers, tomorrow is going to be a big step in the right direction. They think the surgery will last about 5 hours. Please pray that everything goes smoothly and that Courtney will get some rest tonight.
Excuse the length and type-os, I'm pretty tired.
Posted by mark at 8:53 PM | Comments (6)
April 23, 2006
Oh deer -- humorous aside
I completely forgot to mention something that I find kinda funny, perhaps my humor is a bit askew given my life these past few days. My brother in law Dan asked to borrow my car two nights ago when I was in Harrisonburg checking on the kids. His car was in the shop, and not needing the use of my car, I obviously said yes. I drive an old 1984 Volvo DL that I got for $1,200, so it's nothin' fancy. Anyway, about 10 minutes after leaving I got a call from Dan, it seems he had hit a deer going 60mph. Thankfully, he wasn't hurt at all, but the right headlight and fender were damaged, and the whole grille just fell off.
Sometimes, all you can do is laugh. Amidst all of the craziness, for whatever reason, this still makes me smile. Let's just hope these things don't come in threes. ;-)
Posted by mark at 12:25 PM | Comments (4)
More progress
Courtney continues to heal. Her right eye is now opening about 60%, but that is exposing the double vision which was to be expected, but it's pretty severe. Not only is she seeing double, but one of the images is lower than the other.
She's also started having anxiety issues at night. She remembers almost everything about the accident and much of the time in the helicopter on the way to the hospital and also while awaiting surgery. She's started to replay the accident in her mind. This happened to me for the first few nights, but I'm already sleeping well again. I'm expecting it will take a lot longer for her.
I was planning on taking her to UVA myself, but she's expressed a STRONG desire to be transported in an ambulance, so I'm going to look into our options today. She has occasional coughing fits that have her worried, especially since her jaw is wired shut. In the hospital bed she has suction available to help clear out what she coughs up. So, her concerns regarding transport are both psychological and practical. After researching the options, I'll talk with her about it more this afternoon.
One of the most encouraging things for me is to see the return of her personality. She's now talking and smiling (as best she can), and is showing amazing fortitude. She's still on a lot of pain medication, but is thinking clearly and is alert for most of the day. She's taking a walk with her parents at the moment. In an hour or so, they are heading up to Harrisonburg to spend the week watching the kids. Courtney's brother has been here the entire time and has been a huge help. It's been nice to have him to hang out with. He'll be heading home tomorrow morning.
I was in Harrisonburg for one night two nights ago. I went to see the kids, do some laundry, pay bills, and other micellaneous stuff. The kids are doing really well under the circumstances, but they are ready to see their mommy. Now that Courtney is talking better, we might try to call them for the first time this afternoon.
We've received good news about the doctor that the ENT surgeon here set us up with at UVA. It turns out he's one of the best ENT/facial reconstructive surgeons in the business. I think he literally may have even written the textbook. Of the six phone calls that we made to people in the medical community in UVA, all six came back with glowing endorsements for this physician. Once again, this underscores God's providence through this entire process. According to our doctor here, who filled him in on her condition, the UVA doc expressed confidence that he would be able to make the necessary adjustments. We'll know more tomorrow afternoon.
Sorry for the short delay in posting this update, the trip to Harrisonburg was quite a whirlwind.
Posted by mark at 9:45 AM | Comments (3)
April 21, 2006
Update and CT scan results
Courtney is doing awesome. She is completely alert, the swelling has continued to go down. I would guess that her right eye is now opening about 20-30%. She had the NG (nasal/gastric) feeding tube removed a few minutes ago and her mood improved immediately. That was a HUGE source of discomfort for her. With the tube out the extreme discomfort when swallowing was relieved almost instantly.
We did see the ENT doctor a few minutes ago as well and that visit wasn't quite as positive as we could have hoped, but it's good to have more information. I'm not exactly sure where there are bones and where there are plates, but here's the scoop. The bone/plate underneath and to the left of the right eye has basically floated out and to the right. This has resulted in the protrusion that I mentioned yesterday as well as a lowering of the right eye in the socket. If I had to guess, that eye is sitting a 16th of an inch lower than the left eye. The ENT surgeon here in Roanoke feels that she's done everything that her skills would allow and has recommended a transfer to UVA for some additional surgery by a specialist. The most important job in this sugery will be to raise the level of the right eye so that it's the same height. This should prevent double vision.
Thankfully, she has a collegue in UVA that is planning to see Courtney in his office on Monday afternoon. He does surgery on Tuesdays and Thursdays. We're going to check out of here on Monday morning and drive ourselves to Charlottesville on Monday morning. He'll admit Courtney on Monday night after seeing her and hopefully be able to perform the surgery on Tuesday. We're in the process of performing our due dilligence in confirming this doctor's credentials, but feel confident that this is the best course of action. He's also and ENT doctor, but is also a facial plastics surgeon, and feels confident that he can perform the necessary adjustments without the need for an octal plactics (eye socket) surgeon.
Courtney is charged with the tasks of excercise and eating (through a straw of course). Her spirits have improved dramatically since the feeding tube was removed. It was a little discouraging for her to know that more surgery looms, but I've tried to focus on the many positive things that have transpired up to this point.
Courtney's parents came back today and are planning to spend the next day or so with Courtney, but are then going to go back to Harrisonburg to be with the kids. My dad and Lynne are leaving doay; they've been watching the kids all week. I'm planning to go home tonight to do some laundry and see the kids. I'll come back tomorrow sometime. While I was praying that we wouldn't have additional surgeries, the head trauma surgeon here reminded me that this isn't a setback, but merely the next step in Courtney's recovery. Rarely is facial trauma of this magnitude repaired in one step.
Once again I want to thank you all of your prayers and support. Our whole family has been overwhelmed with the show of kindness. We love you all.
PS - If you've left me a message at home or on my/Courtney's cell phone and I haven't returned your call, please know that I've been on the phone about 3 hours a day and am not intentionally ignoring you. ;-)
Posted by mark at 2:01 PM | Comments (6)
April 20, 2006
CT scan
The ENT doc just checked on Courtney. They ordered a CT scan to see about two things:
1. The swelling to the right of her right eye seems to protrude too much, so they want to confirm that it is in fact swelling and not bone. If it's bone, than some adjustments might be necessary.
2. Since the eye in that right socket seems to have restricted movement when looking up and looking right, they want to make sure that the restricted movement is due to swelling and not the plates. That would also require a surgical adjustment.
I'm thankful that they ordered the CT scan as those were two concerns that I also shared. I'm praying that it is only swelling, but know that there's a good chance that Courtney will have to undergo a 3rd surgery.
To quote the ENT doc., "We really want to hit a home run with Courtney since she's so young." I couldn't agree more.
Thanks for praying. She is getting the CT scan tonight sometime after 4:30 PM.
Posted by mark at 2:36 PM | Comments (5)
What a difference a day makes!
Yesterday morning Courtney was disoriented, frustrated, and tired. Today, she is much more alert, a lot more lucid, and even took her first 25' shuffle down the hallway and back with the help of a nurse. She is getting a pseudo-shower at the moment, which, if I had to guess, is probably going to be a huge boost for her morale. The sponge cleaning that she's received to date have done little to placate her desire to be really clean.
Her trachiostomy tube has been capped for almost 24 hours, so that means that she has been breathing almost exclusively through her nose and mouth. This cap also allows her to speak with some difficulty so that has really helped. Given this progress, the head Trauma surgeon is prepared to remove the trach as soon as he gets word from the ENT surgeon that there aren't any more procedures (see below). She has started to take in some fluids through her mouth, and if she can down 3-4 cans of Ensure per day they'll take out her feeding tube. She still has trouble getting the strength to suck fluids through a straw, so she might not be ready for at least another day, but we are making progress.
She did see herself in the mirror for the first time, and didn't seem to be visibly upset, but I'm sure it was difficult for her. She really does look fantastic considering what she looked like 3-4 days ago. Please pray that she'll be patient and appreciative of small progress.
Her right eye is still swollen shut, but she can open it about 20% upon request which is definite improvement. She had a minor skull fracture above her nose that they have been monitoring. There was a chance that this fracture would not heal itself and slowly leak brain/spinal fluid out of her nose. We haven't seen any type of fluid for 3 days, which is a good sign that it has sealed itself. 80% of the time, this particular type of fracture will heal itself, so I'm happy to report that this seems to be the case.
So, please pray that she'll be able to consume the requisite amount of liquid food so that she can get the feeding tube removed. They often cause ulceration and can be quite painful. Also pray that the swelling would continue to reduce and that the ENT surgeon would conclude that the initial surgery was a success. It would be nice to avoid adjustment surgeries if at all possible; specifically with the right eye socket. Finally pray that Courtney would keep her spirits up and not get too discouraged. She asked me what day it was today, and when I told her that she had been in the hospital for 6 days, she said, "Wow."
I think that's it for now. Thanks again for all of the encouraging notes, flowers, and prayers. It's made this experience a lot more tolerable.
Posted by mark at 11:42 AM | Comments (0)
April 19, 2006
Thanks and update on Courtney
Before I give you and update on Courtney, I want to thank everyone for their prayers, phone calls, and support during this ordeal. It has been a huge help to experience the overwhelming expressions of love for Courtney. Thank you!
Considering the magnitude of what happened, Courtney is doing really well. The swelling in her face and neck has continued to reduce, she is on a smaller diameter trachiostomy tube that should allow her to breathe more and more through her nose and mouth (which is wired shut). They are still confident that she will retain full unimpaired vision in both eyes. I don't know the exact count, but she has a number of titanium plates in her face. They had to rebuild her right eye-socket and has a plate behind her eye to keep it positioned in the right location on her face. Even though she has at least 5 plates in her face, there isn't a single incision, other than the two cuts from the accident (above the right eye and lip). Amazingly, they were able to do most of the work through existing lacerations and through the jaw. One of the things that the doctors are monitoring as the swelling goes down is the mobility of her eyeball in that reconstructed socket. They are also checking that it's on the same horizontal plane as the left eye. If mobility or level aren't correct, they may have to go back in to make some adjustments. It's too early to tell. As of today, she can open her left eye about 90%, but she keeps it closed most of the time. The right eye only opens naturally about 10%.
The dental work she's going to need will probably be the most signifigant long term recovery task. I just found out this morning that the damage was even more extensive than I had originally thought. However, this is most certainly a secondary concern. There are extremely advanced methods of restorative dentistry and orthodontia that will most certainly be able to help us out.
They moved Courtney out of intensive care yesterday morning, which is nice because the visiting hours are more relaxed. For the last few days Courtney has been in and out of restless sleep. When awake, she's generally alert. I don't think she's sleeping very well, and is growing more and more restless. It's easy to get really confused when your on so many narcotics and you haven't opened your eyes for 4 days. Since she has a head injury, they aren't able to give her any sleep medication. Hopefully, being out of intensive care will help to re-orient Courtney back to a more normal schedule. I think they also start the slowly reduce the narcotics. Both of these should hopefully alleviate some of her distress and impatience, and hopefully she'll get some restorative rest..
We're hoping that she'll be able to start swallowing better today, as this will precipitate being able to start on real food (blended of course), and water. She is desperate for liquid in her mouth, but they can't start that until they are convinced that she'll be able to swallow correctly, as they don't want it to end up in her lungs instead.
A local news station did a piece about our accident. I post this with some reservation, but they did a nice job, so ... for what it's worth. I was extremely reluctant to do the interview, as there were obviously other things on my mind. Also, I have an inherent distrust of the media, especially stories about personal tragedy that don't really effect other people. However, given that she asked nicely, the obvious highway safety issue, and my desire to give God the glory, I decided to relent. You can ignore the hero title, that's obviously a little much. ;-)
The kids are back in Harrisonburg with our awesome network of friends who have childcare lined up through June. I'm sure they can't wait to see their mommy, but we want to wait until she's a bit more presentable and can talk.
Anyway, I've got to get back to the room. I'll try to post some more updates here, as I have time. Thanks again for your prayers and support. It's been huge.
Posted by mark at 10:39 AM | Comments (9)