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May 31, 2006

Interview with Courtney

For those of you who missed the short window of opportunity to see Courtney's television interview on the WSLS website. I finally managed to rip a copy of the interview with Courtney. I've encoded two options: A high resolution option (43MB), and a low resolution option (14MB). The low-res version is perfectly adequate, but I'm posting both for long-term archival purposes.

I don't know too much about video formats, but hopefully you'll be able to watch it without too much difficulty. NOTE: I wouldn't suggest trying to "stream" these files (although it *might* work if you're patient). I would recommend downloading first, and watching offline. On most computers, if you hold down the right mouse button and click the link, you'll have an options to "Save target/link as". If you're on a Mac, and don't have a right mouse button, I think you can hold down the CTRL key and click the link to get download options.

05-15-2006: Interview with Courtney (14 MB) (high-res link is at the bottom)

I'm posting "with assumed courtesy" of:
WSLS News Channel 10
401 3rd Street SW
Roanoke, VA 24011
540-981-9110
05-15-2006 6:00/11:00 PM broadcasts

I'm also planning to post digital copies of the other news reports as I have time.

05-15-2006: Interview with Courtney (43 MB)

[ UPDATE: I've encoded these vides to the AVI format which requires the DivX codec. You can download it from this page:
http://www.xvidmovies.com/codec/
Actual link to file is here: (http://download.divxmovies.com/XviD-1.1.0-30122005.exe)

Or you can download it here:
http://www.divx-digest.com/software/divxcodec.html#downloads
Actual link to file is here: (http://www.digital-digest.com/software/download.php?sid=622&ssid=0&did=1)

After installing the codec, you'll need to restart Windows Media Player. Thanks Nate! ]

Posted by mark at 6:39 PM | Comments (0)

May 27, 2006

Unwired jaw

Courtney can now open her mouth. Yesterday, at Dr. Park's office, they removed the rubber bands that held her jaw together. I had misunderstood Dr. Park, and she didn't get the arch bars removed. Since the jaw has been shut for 6 weeks now, it is important for her to slowly stretch out the jaw muscles. I'm guessing they don't remove the arch bars because the muscles in the jaw are so tight that they don't have the clearance desired for extraction. Even if Courtney *could* fully open her mouth, and felt like chewing, she's not allowed. Dr. Park said that he wasn't worried about the strength of the jaw anymore, but really the facial fractures above the jaw. Since they were so many plates, it might take longer to fully mend. However, Courtney was able to finally clean the other teeth. I don't think Courtney's in the mood to French kiss right now, but it sure is nice to see her tongue. ;-)

Dr. Park seemed genuinely pleased with her occlusion (ie. how her teeth came together in back), so it looks like the setting/plating of the jaw bones went about as well as it could have. I'm sure it was mildly disappointing that she didn't get the arch bars removed. They are terribly uncomfortable, but Courtney was pretty worried about the process of taking them off, so I'm guessing that she tempered her frustration with knowledge of avoided pain.

Courtney's eyebrow and eye have continued to improve, but one of the issues that had become increasingly apparent is that her right eyeball is somewhat sunken. The level of the eyeball is correct, but the depth is not. It doesn't look terrible, but it is noticeable, so I asked Dr. Park about it. He agreed that the eyeball is definitely sunken, and that he would guess as much as 4-5 mm (I think that's what he guessed). He said that there was a procedure that they could do to try and move the eyeball forward, but that it had to be done sooner rather than later. When he asked Courtney how she felt about more surgery, her first response was, "I'm tired, I'm just really tired." However, she held it together, and he said that we could take the week, and next Friday when we return to have the arch bars removed, we could give him our answer. They would reopen/make and incision beneath her right eye, and also possibly go in through her mouth. The surgery would likely happen on Thursday the following week. At this point, I think we're leaning towards the procedure, but we have a few follow up questions that will help with the decision. Obviously, we need to weigh the risks, the likelyhood of sucess, and other complications. On the way home Courtney suggested that if she was going to have the surgery, perhaps they could remove the arch bars while she was under -- smart woman.

As far as Courtney's teeth are concerned, it doesn't seem to be nearly as bad as I initially thought. Courtney thinks that she's only missing 4 teeth. By missing, I mean above the gum line. In at least two of the front teeth, you can see that the root of the tooth is still there. Of course, the condition of the remaining teeth is somewhat in question, since it's obvious that some of her front teeth have been moved, but there's a LOT more to work with in terms of good teeth than I had thought. I cancelled the dentist appointment I had made for next Tuesday since I want the panoramic x-ray to be taken without the metal arch bars. I'll reschedule when I know more about the next surgery.

All in all, Courtney is doing fantastic. She's getting lots of exercise by walking, and is holding up really well. My step mom, Lynne, has been helping out this week (Emma went to Columbia with Courtney's mom). Lynne brought some exercies resistance bands and has helped Courtney with an exercise routine every day to start getting some strength back into her legs. She's been a huge help! Thanks for your continued prayers; we still have a long road ahead of us.

Once again, I'm sorry for the delay in posting this update. Work has gotten pretty busy, and I had a father-son campout at the neighbor's house last night. James and I had a lot of fun, but I probably only slept a total of 2 hours.

Posted by mark at 1:18 PM | Comments (4)

May 15, 2006

WSLS NBC follow up interview with Courtney

Yesterday, Melissa Martin from the Roanoke NBC affiliate came to Harrisonburg to do a follow up story on Courtney's progress. It was entirely Courtney's decision, and she agreed. She wanted an opportunity to share her testimony, and her biggest concern was that she didn't want anyone to think that she just wanted her 15 minutes of fame. I assured her that nobody would think that after hearing what she had to say. I hope you agree.

You can see the video of that interview for the next day or so here:
http://www.wsls.com
In the lower right corner, the video is titled, "Brake Drum Accident Recovery." Again, they did a nice job editing. They talk with you for 30 minutes, and then edit it down. I apreciated the fact that Courtney's testimony was left intact. It truly captured Courtney's spirit through this ordeal. You can read a transcript of the video here:
"Woman Talks About Being Hit By Brake Drum"
I have DVD copies of the previous news reports done by WSLS. If copyright allows, I may encode those and post them here for archival purposes.

Courtney is now almost entirely narcotic free. In the past days she's only taken 3 half doses, and those only at night. In fact, last night she didn't have any. Last week she was taking 5 full doses a day. The pain is under control with OTC Advil and Tylenol. Her primary discomfort now is jaw pain (possibly muscular), and major neck and shoulder stiffness. She had a professional massage last week, and we're scheduling one for later this week.

I heard back from our family dentst. He is going to contact Dr. Park to make sure that they are both on the same page. He was very sympathetic to Courtney's situation and offered to do anything necessary and possible in the interim to make her comfortable. Thankfully, she's doing pretty well, and can probably wait until after the jaw is unwired.

Overall, Courtney is holding up well. She has moments when she gets discouraged by the discomfort and knowledge that it's going to take a long time to fully recover, but she's hanging in there. She's still eating well, and continuing to slowly gain weight. She's taking short walks with friends and trying hard to stay up as much as she can during the day. She hasn't slept very well the past few nights, and is pretty frustrated about that, but that could be attributed to removing the narcotics after taking them pretty heavily for a month.

My mom and John left on Sunday, and Courtney's mom came back on Monday. We've still got tons of family help and fantastic food being delivered by our friends. If I continue to eat at the rate I've been eating, by the time Courtney is fully recovered, I'm sure to weigh 300 lbs.

[ UPDATE - The video is no longer available on WSLS via the links above. If legal, I'll post permanent links at some point in the future. It make take a few weeks. ]

Posted by mark at 4:07 PM | Comments (12)

May 12, 2006

Appointment with Dr. Park

We drove to Charlottesville this morning for a checkup with Dr. Park. The visit went well. He was happy with the trach hole, and said that we could take off the the cumbersome dressing and just use some vaseline and a bandaid. That made Courtney very happy.

He didn't say much about the eye or eyelid. He said that her eyeball movement is much better and was pleased that the double vision is mostly improved. He muttered a few things about something being off by a millimeter, and that the eyeball level seemed to be correct. I mentioned the opthomologist's statement about the eyelid being pulled down by the incision beneath the right eye, and I'm pretty sure that he dismissed this with mention of a structural issue caused by the amount of damage to the socket. He's definitely a perfectionist and the future of her face is most certainly in capable hands. I intentionally didn't ask any questions about the eyelid because he's been very forthcoming with details when he's ready. Courtney and I are both comfortable waiting and don't really need to be placated with doctor speak. All in all, he seemed to be pleased with her progress and that she's started to put some weight back on (about 4 lbs). He did express a desire to see her take less narcotic as soon as possible. We'll see how that goes.

He said that he would see us back in 2 weeks with the possibility of removing the "arch bars" and unwiring her jaw. The arch bars are wired through the gum and cinched down tight over the teeth near the gumline. In order to remove them, they'll give her a local injection and then pull the string/wire (whatever it is they use to tie them into place), out. He said it might be uncomfortable and a little painful, but I'm betting that the reward will be worth it.

I contacted a local dentist yesterday to start the process of getting him ready to see Courtney when the jaw is unwired. I haven't heard back from him yet, but I'm sure I will early next week. I want to make sure that Courtney will get priority attention as soon as she's ready.

Courtney is moving around a lot better, and seems to be holding up really well. It will be interesting to see how the reduction of narcotics helps her mobility and energy levels. We've both known that weaning off of pain-killers is a good idea, but the jaw pain has been pretty unbearable. I think it's probably gotten a little better over the last few days. When I ask her to describe the pain she says muscle tension in the left and right jaw and major irritation from the arch bars, and not nervey pain. We've applied liberal amounts of dental wax and will be adding in OTC advil and tylenol, so that should help. Please pray that if she experiences any discomfort that it won't be too much for her to handle. I think I've mentioned in previous posts that pain has been an emotional trigger for Courtney. Psychologically speaking this is probably healthy and necessary, but I don't want overwhelming emotions to affect her desire for increased mobility, etc.

We don't have any doctor's appointments for a couple weeks, so my updates might be less frequent, but I'll try to post something at least 2-3 times per week.

Thanks again for praying, sending cards, helping out with the kids, making meals, mowing the grass, etc. The knowledge that there are so many friends out there has kept Courtney sane, and really helps to put this whole crazy ordeal into a wonderful perspective.

Posted by mark at 3:49 PM | Comments (2)

May 11, 2006

Opthomology Report

Yesterday I took Courtney to Charlottesville for an appointment with the opthomologist. The visit went well. To summarize, Courtney currently has 20/40 vision in her right eye. I think this means that it takes Courntey 40 feet to see what most people can see in 20, but I'm not certain. The important thing is that this isn't bad at all, and I don't think that this would legally prevent her from driving; even without glasses. Assuming no change, she'll be able to correct this to 20/20 with glasses.

The only thing that they were somewhat concerned about was the lower eyelid. Her lower eyelid is pulled down slightly and is preventing her eyelids from closing completely. The opthomologist felt that the surgical incision beneath her right eye is drawing the eyelid down. I would guess that it could also be imperfections resulting from having a rebuilt eye-socket. We're keeping the still healing incision moist with vaseline, and hopefully it will stretch out as time passes. In the meantime, we're keeping her eye from drying out with drops during the day, and ointment during the night. The doctor surmised that some of her decreased vision could be the result of dryness.

They also re-did the same double vision test that Courtney did the night before her 3rd surgery (first with Dr. Park), and she showed dramatic improvement. She still has some double vision when looking down and right, right and up and right. They didn't seem to be too worried about the double vision. I would guess that as the muscles around that eye strengthen things could improve. The good news is that she doesn't have double vision when looking straight ahead, like she did before the surgery.

The swelling in her face continues to slowly decrease. Her right upper eyelid is slightly better, but I would still estimate that it's only opening 60-70%. There is still some swelling in her face, so it's still to early to know with any degree of certainty what we'll need to fix. She's starting to take longer walks, and that exercise should expedite the reduction of remaining swelling. She's amended her numbness meter to pretty much her entire face from the middle of her nose down, with the small exception of an area to the left of her mouth. Either it's gotten worse, or she is just more aware.

It's been a couple days since we've heard any air through the trach hole. We thought it was closed two days ago, but during a bad coughing fit it definitely leaked some air, so Courtney has had to still remain diligent in applying pressure when talking and coughing. I think we're really close to being able to remove the dressing from her neck. The dressing is comprised of a 5"x6" thick foam sticker that covers a piece of petroleum gauze and normal gauze. It prevents her from full and comfortable movement of her neck, and it's really uncomfortable. She can't wait to take it off. When it's off, she'll be able to take a REAL shower.

The mouth area is still the primary area of discomfort. I estimate that she'll only have a wired jaw for 2 more weeks. The sooner it gets unwired, the sooner she can get a full diagnosis from a dentist. I'm sure there are some pretty basic things that a normal dentist can do to alleviate a lot of pain. I can even see Dr. Park moving the unwiring up a week since it's pretty clear that she's not going to be using her teeth even if she can open her mouth. That is most certainly wishful thinking. I'll update you tomorrow after the appointment.

Sorry for the delay in posting this report. Now that I'm back at work and ramping up some moonlight client work as well, life is certainly getting back to it's pre-accident busyness.

Posted by mark at 10:23 AM | Comments (2)

May 8, 2006

X-Ray for Emma (she's okay) and status quo for Courtney

On Saturday night, my dad was passing through town to see Courtney and the kids. He was swinging Emma around by the arms for a few seconds, and immediately after putting her down, she started complaining about a sore arm -- thanks Dad! ;-). I thought the arm might have just gotten tweaked and that she was scared to move it out of remembered pain. She wasn't crying at all, just not moving the arm. When I tried to move the arm, it did cause pain, but I've seen enough episodes where the "memory" of pain looks the same as actual pain. So, I figured it would be better in the morning after a night to forget that it had happened. On Sunday, she was still complaining about the arm, and didn't use it much all day. If it hadn't been Sunday, I would have taken her to the doctor then, but naturally, these things ALWAYS happen on Sunday (see below for story about Emma's stitches). Emma was able to bend it up and down without pain, but any sort of rotation of the forearm caused pain. I decided to give it until Monday morning. This morning, it was still about the same. She was acting totally normal, but not using the arm. So, after dropping James off at school, I took Emma to the doctor. The first doctor/nurse-practioner thought that the elbow had gotten dislocated and popped back in, and was concerned about the clavicle (collar bone). In retrospect this was the extreme diagnosis. So we were sent to the outpatient clinic for an x-ray .After the x-ray, we went back to the pediatrician where we were informed that thankfully, nothing was wrong. Another doctor/nurse-pracitioner came in and told me that Emma most likely had a "nursemaid elbow." (the practical diagnosis) In short, a tendon in the elbow pops over to the wrong side of the elbow bone. If I had known the procedure, that I know now, I could have fixed it in 2 painful seconds on Saturday night and it would have been better in 20 minutes. Either the tendon had popped back in place when we were positioning Emma for the x-ray, or when the nurse was checking her before or after the xray. Some children are more inclined to get this type of thing, and should be less so as the elbow bone grows bigger with age. I'm thrilled that I don't have TWO patients in the house.

The reason I waited until Monday was because I wanted to avoid the emergency room at all costs. The Sunday before the accident, Emma had slammed her thumb in my car door. She had a pretty deep laceration, so a friend took me and Emma to the hospital where she got two traumatic stitches. Given that recent experience, and the emotional trauma of "the accident", I was hoping that we could avoid the emergency room. She actually liked going to the doctor and getting an x-ray.

Courtney is also doing pretty well. Her eyelid still only opens about 50-60%. There's definitely *some* swelling left in her face, but I'm not certain that the eyelid is going to improve a lot more past it's current point. It's very possible that we'll have to deal with that issue later with an octal-plastics surgeon (a year from now). She's been washing her face with a washcloth without pain, and the lacerations and surgical incisions seem to be healing nicely. Courtney definitely looks a little different, and is still pretty banged up, but I remind her daily of the fact that God spared her life and that she looks fantastic given the extent of her injuries. We're being diligent about managing her pain in order to keep the dental/mouth pain at bay, and that seems to be really good for spirits. I'm dissolving chewable ibuprofin in water, and the addition of that OTC medicine seems to have helped with the time between doses of the strong stuff.

Courtney mentioned a few more details about her condition that I wasn't fully aware of. When I described the extent of her numbness in an earlier post, I only referred to the tip of her nose ... I guess her whole nose is numb. Also, when she mentioned that she didn't have double vision, she failed to mention that sight out of her right eye really isn't that great. Some of this is caused by having an eyelid over a portion of her eye, but even if I were to pry that eyelid up, her vision wouldn't be pre-accident normal. We have an appointment with the opthamologist in UVA on Wednesday, so I'm sure we'll know more later this week.

Courtney's parents left on Sunday morning, and we both miss the help of her mother. She was a great help and huge emotional support for Courtney. My mom and John are coming to town on Tuesday night to help out for a week, but it's just the 4 of us in the house for a couple nights. It was weird to be sitting in what felt like an empty house last night. Yesterday, the kids and I bought a new TV and DVD player for our bedroom. The one we had in there was pretty lousy and hard to see from bed. I also got Courtney a handful of movies (mostly Indie films and chick flicks) ;-). Since she's going to be in our room a lot more over the next month or so, I thought that it would be money well spent. Sometimes, Courtney needs to escape the downstairs chaos for some mental rest, but doesn't really want to sleep. Since she can't read for too long because of the eye, movies are the best option. A friend also brought by a couple books-on-tape that will also be nice.

Thanks for your continued prayers for Courtney. She still has a long road ahead, and is encouraged daily by knowledge of your support. I read all of your comments and emails to her every night.

Note to local friends: Courtney is ready to start seeing more visitors, so give me a call if you would like to stop by for a few minutes. I want to coordinate the visits to one 15 minute visit per morning and a possible 15 minute visit in the afternoon -- so hopefully you can try to combine visits with other people that you also know. I know I sound like the visit-cop, but there are a hundred people that want to see Courtney, so thanks for putting up with me. My cell phone is 540-421-1367.

Posted by mark at 10:38 AM | Comments (10)

May 5, 2006

Appointment with Dr. Park

The appointment this morning with Dr. Park was somewhat disheartening. We were both a little too optimistic, and feel like our expectations after this morning are more reasonable given the extent of her injuries.

I'll start with the right eye. When I asked about the eyelid opening, he reminded us that it wasn't going to be perfect, and that it would likely improve from where it is now, but that it probably wouldn't open as much as the left eye. He was very guarded about saying just how much the difference would be. He also mentioned that the lower eyelid does seem to be a little lower than the other eyelid, however the level of the eyeball does seem to be correct. He said that you can see a little too much white beneath Courtney's right eye. He then mentioned that after at least a year, depending on how things look, he might recommend an ocular plastic surgeon to make some additional adjustments. Again he was very guarded about giving us anything definitive with regard to the final result, which really is quite sensible. I remember the head trauma surgeon in Roanoke warning us not to start making plastic surgery appointments until 6 months had gone by. I guess it's pretty common for things to change slightly throughout the healing process. It certainly wasn't what we wanted to hear, but putting it into the perspective of the past two weeks it is definitely something that we can live with for now. Courtney seemed to handle this pretty well.

Now for the teeth. I asked him if he had any oral surgeons that he recommended and whether or not we should start trying to schedule this next step. He said that we were months away from oral surgery, and that we have a few months of "hygiene" and cosmetic dentistry before we get to the implants. I had been thinking along these lines when we were in Roanoke, but had started to think that it would be quicker than I originally feared. In considering this on the drive home, it certainly makes sense. First we'll have to restore and care for the teeth she HAS in all sorts of ways: Moving them into the right position, adding crowns and other cosmetic restorative work, gum healing, etc. before we even consider replacing the missing teeth with implants. I'm not exactly sure what he meant by hygiene (in the context of healing), but I'm assuming this has something to do with restoring gum health and other daily maintenance issues. Perhaps there are temporary dentures that Courtney can use in the interim between real teeth maintenance and oral surgery. Dr. Park suggested we start with our family dentist and then proceed from there.

Courtney has some numb spots on her face and head. The biggest spot that feels numb is from her right chin up to the tip of her nose and then draw a semi-circle back to the chin. She also pointed to a numb spot on her scalp that I wasn't previously aware of. We asked about these and Dr. Park said that some would heal within a month, some would take a year, and some numbness could be permanent. There's no way to say definitively which would heal and which wouldn't.

He did remove the nose-cast, and told Courtney that she could start washing her face more aggresively, and in fact encouraged her to gently scrub the cuts in order to keep them clean. He looked at the trach hole, and said that while it is only a pin-hole, we still need to try hard to prevent air from escaping so that it can close up completely. It might be a few more days before that's completely closed up. Who knows? He did say that with the trach bandage on, and not having a nose cast, Courtney could be a little less careful about splashing water. Washing her face and hair just got a lot easier.

Courtney has major pain and discomfort with the teeth right now. Some of the holes from missing teeth and broken teeth are really painful. Even though she's still taking her pain medicine regularly it often doesn't eliminate the mouth pain. This pain and today's confirmation that the teeth restoration process is going to be lengthy was pretty discouraging to Courtney. I didn't ask about the timing of unwiring the jaw since we're planning to see him next Friday.

Overall, I'm thankful that Dr. Park didn't voice any serious concerns and that, while slow, Courtney is healing. Obviously, we're both still very thankful that she's alive and doing this well only 3 weeks since the accident.

Posted by mark at 10:57 AM | Comments (4)

May 4, 2006

Message from Courtney

Courtney didn't want to hassle with typing (and possible looking at a computer screen) so she hand-wrote a note to all of you.

-- MESSAGE FROM COURTNEY --
To my dear friends and family,

I just wanted to let all of you know how much (and words can't express) I appreciate your prayers, kind notes, phone calls, visits, yard work, house cleaning, flowers, etc., etc., etc. I've been so overwhelmed by all of the love and concern you have shown towards my family and me. God has graciously placed us in a sweet little nest that has surrounded us in love. I send much love back to friends and family near and far. Let me just tell you, I don't have a cute little basket of get well cards, I literally have a laundry basket full!

I want everyone to know one thing for sure. The accident was horrible, the pain real and I have been scared at times but ... from the moment that thing smashed through the window to this present moment the Lord Jesus has not left my side. I have felt His strong arms around me and He has gently and lovingly carried me through this ordeal. I just want everyone to know that. I can't remember all the verses, but since I woke up from my first surgery I've had the hymn "O Father You are Sovereign" running through my head. What a blessing those good hymns have been to me. My God is an awesome God. The God who created this beautiful earth is also our Great Physician, and praise the Lord He chose to spare my life and is now healing me.

I wish I could hug each of you and look you in the eye to tell you I love you, but for now I send via blog!

Love,
Courtney
-- END MESSAGE FROM COURTNEY--

I took the liberty of Googling for those lyrics. I'm 95% sure I got the right hymn, I'm not at home to confirm with Courtney:

Words: Mar­ga­ret Clark­son, cir­ca 1980. These lyr­ics won a hymn writ­ing con­test in Christ­i­an­i­ty To­day.
© Hope Publishing Company.

O Father, You are sovereign
In all the worlds You made;
Your mighty Word was spoken,
And light and life obeyed.
Your voice commands the seasons
And bounds the ocean’s shore,
Sets stars within their courses
And stills the tempests’ roar.

O Father, You are sovereign
In all affairs of man;
No powers of death or darkness
Can thwart Your perfect plan.
All chance and change transcending,
Supreme in time and space,
You hold your trusting children
Secure in Your embrace.

O Father, You are sovereign
The Lord of human pain,
Transmuting earthly sorrows
To gold of heavenly gain,
All evil overruling,
As none but Conqueror could,
Your love pursues its purpose—
Our souls’ eternal good.

O Father, You are sovereign!
We see You dimly now,
But soon before Your triumph
Earth’s every knee shall bow.
With this glad hope before us
Our faith springs forth anew:
Our Sovereign Lord and Savior,
We trust and worship You!

© Hope Publishing Company.

Posted by mark at 5:08 PM | Comments (2)

Quick update

Nothing much to report, so I'll be brief.

Courtney is moving around a lot more.
Her jaw/teeth hurt a lot more, so she's actually talking less and less.
The trach hole will likely close up either today or tomorrow ... it's really close.
Her eyelid still only opens about 50-60% so despite what the doctor said two days ago I'm still concerned about that. We see Dr. Park tomorrow morning at 8:45 so hopefully he'll have the same hopeful diagnosis. I'll be sure to give a full report on the appointment.

Sorry for the short update. I'm trying to get back into the groove at work, somewhat reluctantly, and it's more difficult than I would have suspected. Probably because Courtney is still at the beginning of the healing process, and it would be nice to stay with her and help out, but the show must go on ... and she's in good hands with her mom.

Posted by mark at 1:55 PM | Comments (3)

May 2, 2006

Unexpected trip to Charlottesville

Courtney is still doing great. She's still lethargic and weak, but she is hanging in there. Her mom has been with us now for quite a while now and her assistance has been invaluable. The kids and household are definitely in good hands. With all of the great food that's been delivered I'm eating better than ever.

Now for the unexpected trip to Charlottesville. Courtney had a "nose cast" thats sole purpose was to keep the bridge of her nose from flattening out while healing. In other words, it was there to keep the bridge of her nose pinched. It fell off, and one of the things that Dr. Park was explicit about at the hospital was to keep that on as long as possible, and hopefully for 4 weeks. I called the practice and they said that given the explicitness of Dr. Parks' comments (he's on vacation until Thursday), it would be a good idea to come on over to Charlottesville to get a new one put on. I guess it's pretty common for them to fall off, and they usually only last about a week. We only had 1 hour and 45 minutes to make the drive to Charlottesville before the office closed, so we had to take the highway route and Courtney was very brave and didn't experience an unmanageable amount of anxiety during the trip.

I do have some good news from the trip. While we were there, I asked the resident doc that replaced the cast a few questions. 1. Is it normal for a trach hole to take this long to close up?, and 2. Are you concerned about the eyelid only opening 60%? To the first question, he said that trach holes often take a while to heal up and that we shouldn't be concerned. To the second question, and also the best news was the he didn't think that there was any problem with the eyelid and that it was most likely swelling. I asked about possible nerve damage and he said that the nerve that controls eyelid control is pretty deep and that its unlikely damage would have many other obvious repurcussions. He said that blood that drains out of an eyebrow often pools in the eyellid/socket and doesn't continue to drain downwards like other areas, so it's common for swelling in that area to take a long time to subside. While it wasn't from the mouth of Dr. Park, it was said with great confidence and I have no reason to think we were misinformed. That was very encouraging.

Courtney's mouth has started to bother her more and more. She has these two metal bands strapped to the upper and lower jaws. They are stiched in all the way through the gum and cinched down tight (thankfully while you're completely asleep). They are necessary for "wiring" the jaw. I can't remember the technical name for them at the moment. Anyway, as you can imagine, they are enormously uncomfortable and as the other surgical pain subsides mouth pain will most certainly rule the day.

As expected, the pain of this ordeal and the protracted nature of her recovery has started to take a minor toll on Courtney's resolve. She's still doing great, but she knows that she's a long way from fully healed and is tired of being the helpless patient. In other words, she is emotionally tired and will continue to need daily empathy and support. My goal in the next few days is to get as many calories and nutrients into her system as possible, encourage a lengthening of the span between pain meds (only if possible -- I can just hear all of our nurse friends telling me to take this slow, and I do agree with them), and to try to get her more mobile. The sooner she can feel like a "woman with a wired jaw in need of dental work" and less like a "woman recovering from trauma and multiple surgeries" the better. I'm sure it's difficult for her to hear me and her mom dealing with discipline issues with the kids, cooking, laundry, etc. and she can't do anything to help.

She was awake a lot today, so she should rest well tonight. I would say that on average she was alert for most of the day today, which is a big improvement.

Anyway, I'm certainly good at being verbose when there's not much to report. I get daily reminders to post these updates, so I know they are appreciated for the moment. However, I can't help feeling a bit like the latest reality show. ;-) I promise to shut up when Courtney or my audience tells me they've had enough.

Posted by mark at 7:03 PM | Comments (5)

May 1, 2006

The accident

Based on a number of queries, it's obvious that not everyone knows the full story of our accident. I thought it might be helpful to get the full story in writing from my perspective to appease the curiosity of our friends and save me from a sore throat. ;-) This is mildly graphic, and was actually more difficult to write than I thought it would be, so be warned.

On Friday, April 14th, we were heading South on Interstate 81 in VA. to Courtney's parents house in Columbia, SC to celebrate Easter. Courtney was driving, I was in the passenger seat, and the kids were both in the back seat of our 1998 Toyota Sienna minivan. I believe they were watching Toy Story at the time. At approximately 11:00 AM, while driving in the left lane, Courtney was talking with her mom on the cell phone giving her our location and ETA in Columbia when an 11lb piece of steel (see pictures inline) came through our front windshield hitting Courtney square in the face. I don't remember the sounds, but I vividly remember seeing the gaping round hole in our windshield, about the size of a soccer ball, and seeing Courtney looking very awkward. She did not look natural, and her left arm was hanging off to the side with palm facing up. It was terrifying. I grabbed the steering wheel (I think we were in the right lane at this point), and righted the car and simultaneously slammed on the brake. I think we may have brushed the curb slightly, but there weren't any marks on the tire. I distinctly remember thinking as the car stopped, oh crap, I just stopped on the interstate. I looked behind and saw a dark SUV coming, but not too fast. I must have also been having the thought that I should continue driving to the shoulder, because when the SUV bumped us, we rolled forward about 50-100 feet where I steered the van to the shoulder. At the time of the incident, were were crossing over the James river about 50 or so feet below the car. There is a rather imposing railing, but it's not inconceivable that a car going 65 might crash through or over that barricade. At that point, with my foot on the brake, I opened Courtney's door from across her chest, threw out the piece of steel, which was sitting on her chest, and stuck my head out her door and screamed two or three times to the woman who had already gotten out of her car to call 911. I knew exactly where my cell phone was, but for whatever reason chose to let them call 911 while I tended to Courtney. I took off my polo and started to apply pressure to the big laceration above her right eye. I don't know why, but I actually opened her right eyelids to see that the eye was okay. She had a tear in her lip that was split wide open, and there were multiple teeth missing and one of her front teeth was hanging awkwardly. Every time I tried to tend to her lip and mouth, she would stop me, and at one point told me that she thought her jaw was broken.

At some point, I remembered that she had been on the phone with her mom, and I saw the phone lying open in a straw bag that we keep between the seats. I picked it up with my right hand and her mom was still on the phone and was obviously extremely upset -- she had heard everything. I told her that Courtney was badly injured and that we had called 911. She asked me where we were, and I looked over and saw that we wer exactly at mile marker 165. I think I told her a few times how badly Courtney was hurt. I may have tried to reassure her that she was going to be okay, but I don't remember. I certainly wasn't trying to soften the blow at that point. I then handed the phone to James and she tried to calm them down. Both kids had been crying hysterically since the accident. The woman, who's husband had called 911 was sitting half in the back seat trying to talk with the kids. I can't say enough about the people who bumped into us and then stopped. They were obviously uncomfortable, but they were doing everything they could to help me out. I think the guy called 911 three times to speed them up.

After about 10 minutes, Courtney told me that she thought she would need some help and that we should call someone. I'm a bit of a do-it-yourself-er, so humorously, Courtney may have thought that I would try to save a buck by fixing her up myself. I assured her that help was already on the way. I don't think she ever lost consciousness. I also realized that I was still pressing the brake with a lot of force. I put the car in park and relaxed my leg. I actually had hamstring soreness for a couple days after the accident from either the adrenaline response of first throwing my leg to the brake or the 10 minutes of pressing on the brake. Who knows? The emergency response teams showed up in about 15 minutes (I don't really know how long, but I wasn't getting impatient so it must have been no more than 15 minutes). I helped them put a neck collar on Courtney, and then I got out of the way while they got her out of the car and onto a backboard. They made the call to airlift her pretty quickly based on the extent of her head trauma. I answered some questions and talked with a state trooper for a few minutes. They eventually loaded Courtney onto an ambulance and transported her to the next exit for pickup by the helicopter. I wasn't present for the loading into the ambulance and stayed at the scene with the kids, so I never saw the helicopter. The emergency response team was great. They couldn't have been more helpful and responsive. When Courtney was being removed from the car, someone took the kids to the fire engine to preoccupy them. In fact, one of the workers gave Emma and James $10 for a treat when they got to the hospital. The couple driving the SUV that had hit us offered to take me and the kids to the hospital, which was nice because that was probably more expedient than waiting for the State Trooper. He was friendly, but his lack of urgency was mildly frustrating. After what seemed an interminable amount of time, I transferred our bags into the SUV, and had a few moments alone with the kids. We quickly prayed for Courtney, and a few minutes later we left to go to the hospital. The hospital was about 30 minutes from the accident. The kids talked up a storm the entire way.

At the hospital, I was met by a "patient liason" who was extremely helpful. She was available to help me out with the kids, and all of the luggage I had taken out of the car. They put us in the chapel, which was a nice quiet place to corral the kids. After the kids were settled, I went to check on Courtney. I was told pretty quickly that she was stable and getting a CT scan. I'm not really sure when I found out that her whole face was fractured, but I do remember the trauma surgeon telling me that due to the extent of Courtney's injuries, she was recommending that a local ENT surgeon look at her. She didn't think it would be a problem getting Courtney pushed to the front of the surgery queue, when/if the ENT surgeon on call was ready to go. When Courtney was admitted, they used the wrong name, and when the ENT doctor first showed up he couldn't find her, so he left. He was paged again, and thankfully this time he found us and informed me that his associate Dr. Mao would actually be doing the surgery and that he would go relieve her from her office duties so that she could come to the hospital. At some point along the line I was also informed that it didn't look like she had any major brain or skull injury.

The time in the ER was surreal, the kids were pretty wild. The woman was great, but given the trauma of the event, and the lack of a schedule/routine, the kids weren't behaving well at all, so I couldn't just ignore them and stay with Courtney. I spent the next 2-3 hours bouncing between the chapel and the ER. Courtney was "stable" so she was being largely ignored during those 3-4 hours. There really wasn't much I could do and felt pretty helpless. They had given her something for the pain, but she was in obvious discomfort. At one point, she threw-up what looked like a quart of blood. All of the trauma to her lip/mouth was going straight into her stomach. During surgery they did give her one unit of blood. I cannot remember when she eventually went into surgery, but it was probably around 4:00 PM. I think she went into surgery a few minutes before Courtney's parents arrived. They had dropped everything and drove the 4 hours to Roanoke from Columbia. My sister and her husband showed up a couple hours later to help out.

I saw her just before she went into surgery to tell her that I loved her. She said a few somewhat unintelligible things, they gave me her rings, jewelry and she went into surgery.

Posted by mark at 12:45 PM | Comments (6)

Hurry up and wait

It's slow healing time now. Sorry for the delay in posting an update, but there hasn't been too much to report. Courtney is still very tired, and doesn't talk much. It is very tiring for her to talk. She's able to make it between pain medicine doses without too much discomfort and on a few occasions has stretched the time. Obviously, she's going to feel a lot more energetic when she's not on so much medication, but we want to make sure that the pain doesn't get out of control. She has her days and night a little confused. In the late afternoon she is a lot more alert, and I was able to watch a couple TV shows last night with her. It was nice to be doing something normal again. However, that alertness was also the cause of a restless and poor night's sleep. Hopefully, as she continues to heal, she'll be able to talk and walk around more during the day so that her schedule re-aligns with the rest of the world.

She's doing pretty well consuming her 4 Ensure shakes per day, and I'm starting to add in some other vitamin/nutrient/protein drinks into her diet as she is able. Friends and family have been great about sending us liquid-diet powders that should really help with her healing and energy levels. The primary concern in her diet right now is calories. I need to get the maximum amount of calories in her system with the least amount of fluid. Given that her energy level and desire to eat is limited.

Two days ago, we did have one minor issue that was a reminder of how weak she is and her need to take the recovery slowly. After a morning bath, I was taking her downstairs in preparation to see her first visitors for just a couple minutes when she said that she needed to sit down. So, we sat down on the top stair. After a few minutes she said that she didn't feel that great and wouldn't be able to make it downstairs. I told her I'd cancel the visitors and that she should get back in bed. Halfway down the hall, she fainted. Thankfully, I was fully prepared and we both gently sat down. I eventually got her in bed where she slept for a couple hours. That was scary for her because she equated the fainting feeling with not getting enough air, and made me take off the trach dressing immediately after sitting down. It's remotely possible that I put the dressing on too tight and restricted blood flow in her neck, but I'm guessing that the real cause was heat from the bath and over exertion. At least that's the story I'm sticking to. ;-)

The trach hole continues to heal ... slowly ... It's now the size of a pencil (down from a dime), so we're getting closer. I had hoped that this would heal faster, but it's really difficult to completely restrict airflow with bandages. Also, Courtney has been couging a lot so some air escapes even when she's pressing on the dressing while coughing.

Courtney is glad to be home, and the kids are doing great. They love having mommy home, and are being very patient. I've been able to play with them as well, so their life is slowly getting back to normal as well. The biggest issue with the kids is noise. One of the side-effects of the pain narcotics that Courtney is taking is sensitivity to noise. Our kids have never been good at "inside voices," so we have to limit their time with Courtney to times when they are mellow-tired (as opposed to cranky-tired) or watching television.

I do have a mild concern with regard to Courtney's right eye-socket. The eye level is almost perfect. I think the depth of the eye is also great. These conclusions are supported by her ability to see without double vision. However, her right eyelid still only opens about 50% - 60%. I would guess that the swelling is down about 80-90%, and it's difficult to quantify how much swelling it takes to obstruct eyelid functionality, but I would be lying if I said that I wasn't a little concerned. On this point, I am taking great confidence in Dr. Park and his staff who haven't mentioned anything as signifigant as a partially obstructed eyelid. I know that Courtney is likely worried about this as well, even though I've tried to reassure her that swelling is the likely culprit.

I'm partially back at work this week, and that feels really weird. Slowly but surely we're all moving back into our normal routines; at least what constitues the new normal.

Posted by mark at 9:06 AM | Comments (1)