July 30, 2009

Dad has been moved to a new facility for his physical therapy/occupational therapy. It is called Stone Henge Nursing and Rehabilitation. It is located at 435 West Center Street in Orem. Last night he was in a lot of pain and very concerned about the fluid in his lungs. His nurse was very helpful. He will have a full examination this morning to determine what needs to be done while he is there. I don't think it will be a short stay. Mom arrived last night about 8pm. We stopped to see Dad on our way home. When she called him this morning. He asked that she come and be with him. This will be challenging for Dad in a lot of ways. He needs our prayers. Those wishing to visit are welcome. He is in room 102. No visiting hour restrictions.

A thought about our trials

Dad has maintained a positive, peaceful outlook on this experience for nearly the whole time he has been hospitalized. This is quite admirable in my thinking. In church on Sunday, we sang the familiar hymn "Come, Come Ye Saints". In light of the hardship Dad has been experienced I was touched by the second verse.

Why should we mourn or think our lot is hard?
'Tis not so; all is right.
Why should we think to earn a great reward
If we now shun the fight?
Gird up your loins; fresh courage take.
Our God will never us forsake;
And soon we'll have this tale to tell —
All is well! All is well!

I'm not sure I can articulate why this verse is so powerful to me right now, but I wanted to share it just the same. Andrew

July 27, 2009

About 11:00 am this morning Dad's chest tube was taken out. Hurray! This is an important milestone. He will spend one more night on the intermediate floor and then will move over to the rehabilitative unit sometime tomorrow. Dad looks good and is feeling a lot better. His energy is up and he is able to receive visitors more easily. Carma, your card arrived today and was much appreciated. Connie we will make sure that Dad views the card you sent as well. Thank you everyone for your thoughts and prayers. We look forward to Dad's continued recovery.

Sunday morning

The quick report this morning is that Dad had a good night sleep. He sure does have to stay on top of the pain meds to remain in the earth's gravitational pull. In my judgement, it is far more important to be liberal on the pain meds right now, even if it makes it harder to come off them later. The logic is that the more pain dad is in right now, the harder it is for him to expand his chest to breath and to expel fluid through coughing. Without deep breathing and healthy coughing he will be at greater risk for pneumonia. People die from pneumonia.

The x-ray this morning showed no fluid and very little air in the chest cavity, but this may be owing to the fact that the vacuum has been turned back on. So, we are repeating the experiment of a few days ago. They have turned off the vacuum and will see how much fluid or air returns to the chest cavity in its absence. If less than 100-150 ml of fluid comes out over the next 24 hours, the physicians assistant says we can "talk about taking it out". Either he is being deferential to the physicians decision or just being non-committal.

Getting the tube out will be a giant leap for Alan-kind - big reduction in pain.

Dad is in good spirits.

These pain meds are making me sort of.....(zzzzz)

Dad is really reminding me of Vanessa when she was on heavy pain meds in the hospital in 2007. He'll start out a sentence and halfway through it he'll just fall asleep. About 10-15 seconds later, he'll start talking again. It may be a related thought to the one he started before sleeping or a new thought. It is not at all worrisome, just an effect of the medicine. But as Laurie stated earlier today, not necessarily the right time to be receiving guests. Dad gets interrupted 25 times a day with all sorts of care related issues. When visits are layered on top of that, it puts him on the spot a little bit to force himself awake and attempt to be social. Of course, this will all change soon when his pain meds are reduced.

Dad asked for a blessing last night. I was happy he asked. Doug Rich and I administered. Dad was told that there was purpose in this event and promised he would be blessed with sufficient health to accomplish his mission and purpose on the Earth. He was counseled to remember patience with recovery and forgiveness of others who might lack patience with his recovery. He was admonished to seek comfort and counsel through prayer and through the Word of God. I know the Lord loves him and is watching over our family.

July 25, 2009

Today was a little discouraging. The chest tube will most likely not come out until Monday. Somehow we got the impression that it could possibly come out today. I think that we see a lot

of different nurses and the doctors only once a day, so we must have misunderstood. Anyway, today was more of the same. Dad is getting some fluid in his lungs so the breathing exercises are imperative and he needs to cough regularly to move the fluid out. Today Dad was particularly tired since he didn't sleep well last night. He has been getting a lot of visits and phone calls. Even though the visits and brief and from those he loves, it is wearing him out. To any family members that are viewing this blog we would invite you to send me or Andrew an email and we would be happy to relay your thoughts to him. If you choose to post a comment on the blog, we can make sure he hears that message too. Perhaps by Sunday evening he will be feeling more strength. This experience will certainly be a test of patience. Dad needs our prayers. Thank you so much for yours on his behalf!!

Laurie's Email: freddyandlaurie@gmail.com

Andrew's Email: andrewcroshaw@gmail.com

July 24, 2009

I (Laurie) spent a couple of hours with Dad this morning. Here is the update:

1. The chest tube is not ready to come out. In the x-ray this morning there was a tiny pocket of air. The tube was put back on suction and the air pocket should resolve itself. The tube should come out tomorrow or the next day.

2. Dad was a little swollen this morning from water retention. He was given Bumex and this should resolve itself throughout the day.

3. He should be on solids this evening. Yeah!

4. He is on lovenox (a blood thinner). The dosage was increased. We don't want blood clots.

5. Dad walked from his bed to the window in his room today. That is very good since he couldn't even sit up yesterday.

6. Once Dad walks around a bit more the orthopedic surgeon (Dr. Barker) will check the x-rays to be sure that there is no movement where the breaks are in the pelvis.

Dad had a sponge bath and a shave. He is very sleepy, but seems in good spirits. Once the chest tube is removed Dad will move to a rehabilitation unit with a Doctor Hilmo (occupational therapist). This will help him prepare to come home. He will be using a walker. He seem to be making a lot of progress.

Thursday, July 23, 2009 (baby steps)

Today could be summarized as very slow, but normal improvement. I suppose 'slow' is a term of relativity that is different for everybody and based upon personal expectations. Though we have been told to look at this process as long, it is hard to not still expect to see more rapid improvement.

Lots of activity again today, doctors, nurses, specialists, cleaners, and some guests. Dr. Wang came by. He is the heart doctor that is watching Dad's irregular heart beat. He says that because Dad's heart had reverted to its old habits of atrial fibrilation, he was living with a 5% chance of having a stroke at some point during the year. That seems really high to me. One of the blessings that has occurred from this fall is that dad is going on blood thinning medication (likely for a long time to come) to reduce that stroke risk. That reminds me, perhaps we should start keeping a list of blessings stemming from the accident. To finish up on the heart thing, Dr. Wang says that after dad gets out of the hospital and somewhat recovered, a decision should be made about whether to have another oblation surgery. I think Wang suggested that if Dad was not too symptomatic (dizzy, nausea, tired), maybe they wouldn't do another procedure.

Changing topics to sleep apnea. It's a condition that I have begun understanding more lately. Dad has likely had it for a while, and I am hoping to use his time in the hospital to get it officially diagnosed so that he can get a cpap machine. The quick version of this story is that when some people sleep, the muscles in their throat collapse or nearly collaps cutting off air flow. The bodies reaction is to wake up repeatedly through the night. The result is lack of restful sleep and, over time, a lot of wear and tear on your body that can result in mood disorders, high blood pressure, diabetes, heart disease, etc. etc. Science is only now waking up (yeah, I meant that) to many of the effects that sleep disorders can have on our overall health. By the way, this condition has nothing to do with the fall, but I am excited about seeing if we can get him diagnosed this week.

Now for the chest tube. The purpose of the tube as Laurie as already explained it is to drain fluid and air from between the skin and the lung. You see, when the lung was punctured, both air and fluid leaked out and began collecting in the space between the lung and skin. It was weird, gross, and sort of interesting to listen to the rice crispy crackles under the skin as dad rubbed his hand over it. I think the tube has been inserted from outside his body to in between the ribs and into that cavity. Can you see why this is the thing that is causing him the most pain right now? So, the first two days, that chest tube was sucking (as in a vacuum) out any fluid hanging around in the chest cavity, allowing space for the lung to reinflate when it heals. Today, they turned off the vacuum. The goal is to see whether the cavity fills up again with fluid or air. If it does not, it means the lung has sealed itself off. So far so good on that result today. If these results continue, it is possible that tomorrow Dad may be able to have the tube taken out. He says he plans to do a little dance when that happens.

At the moment (Thurs at 3 pm), he is doing his physical therapy which basically entails standing up and turning his hips, or doing the centanarian shuffle 2 feet one direction. It concludes with sitting back down on the edge of the bed and laying down. It is TOUGH work for him. He is a trooper to do it. As he was shuffling, he said the the therapists, "Now these are real baby steps".

Wednesday 10:45 pm

Today was a busy day. I (Laurie) arrived at the hospital about 9:30 am. Shortly after I got there the orthopedic surgeon (Dr. Barker) came in. We looked at X-rays and he explained his reasons for not thinking surgery necessary. Dad has three hairline fractures in his pelvic region. One in the sacrum, and two others, one that is near the hip joint. Dr. Barker requested physical therapists to come and help Dad stand today. He wants Dad to move around to make sure there isn't any movement where the fractures are.

Physical therapy came and helped Dad stand. He did great. He shouldn't put any weight on his left side.

Then, Dr. Peterson and another doctor came. They discussed the affibulation. Dad's heart doing that vibrating thing again. Dr. Wong who came in later in the day suggested that the fall could have caused it to return.

Dr. Wong ordered Dr. Dahl to perform a test (can't remember the name), but basically they put Dad out (no pain) and put a tube down his throat. They then did an ultrasound of his heart to see if there were any blood clots. There were not any, so they shocked his heart 5-6 times to try to get it to return to it's normal rhythm. This was unscuccessful. Dad has been put on a very low dose of an anti-coagulant (blood thinner). This is to avoid clots, but also a small enough dose to not cause internal bleeding.

After all that Dad was able to rest for a bit. When I returned this evening he had some pain in his back. This was due to the muscles still doing their job inspite of the broken ribs. With some movement and massage he was doing much better. He has had more blood work tonight to watch his white blood cell count. He has a small fever, about 100 degrees. The trauma doctor says it is most likely due to the inflamation caused by the chest tube. Dad has been given tylenol and a laxative and a stool softener. You know the reason for that. Is that too much information? Hey, I am just relaying the details.

Marilyn and Larry McLay stopped by tonight. Dad seems in good spirits and very sleepy. Bishop Beach stopped by too. Liz Wixom called and Karen Cole brought us dinner. I am exhausted, but feel a lot of hope that tomorrow will be a good day. Dad seems to be doing well and is diligent about doing what the doctors ask him to do. He is craving some good food.

12 hours post fall - things are looking up

Tonight (still 7/21/09) at Midnight the nurse provided an encouraging update. She suggested that the reason we have not had an orthopedic surgeon stop in to assess the situation is that Dad's X-rays look promising. She was quite certain he will not need surgery. Further, she suggested that his shoulder dislocation and broken ribs and chest tube are the bigger deal, not the pelvis. Her understanding is that his time in the hospital may be shortened a bit due to this prognosis, perhaps in the 4-5 day time frame.

Right now, Dad is resting comfortably, even sleeping. Let's hope he has a good night.

The Fall

Tuesday morning about 8 am Dad was helping his 90+ neighbor with her swamp cooler. With the job done he started to descend the ladder. The ladder began to slip and Dad thinks he fell about 11 or 12 feet. Fortunately, an ambulance was called and he was taken to the Utah Valley hospital. The ambulance staff called me (Laurie) enroute to let me know the situation. Fred and the kids came with me to the emergency room. When we arrived we were told of his situation:

three broken ribs
2-3 fractures in the pelvis
punctured lung (pneumothorax)

Shortly after his arrival Dad's chest cavity began to fill with the air escaping from the punctured lung. This was very painful. Fortunately Jason Blackburn and Fred were in the room with Dad as his pain was increasing. They found someone and the hospital staff quickly inserted a hose on his left side that would help the air escape. Fred and Jason were also able to give Dad a priesthood blessing. We (Andrew, Vanessa, and Laurie) are now in room 261 where Dad is resting peacefully. He keeps saying how he feels so much better. He was in a lot of pain after the fall. He needs to keep breathing deeply so that fluid doesn't fill his lungs and cause pneumonia. They have also asked that he not eat or drink anything until the orthopedic surgeon can look at the x-rays. The surgeon will determine if surgery is necessary. One of the fractures in the pelvis is near the hip and they may need to do surgery for that to heal properly. Dad has leg massagers on his legs to prevent clots. He is on pain medication as the tube to drain the air is inserted between two ribs and it isn't a small tube. But, he feels no pain. He is able to talk, but is very sleepy. So far it looks good. According to the information that we have been given it looks like he will be here (the hospital) for about 5-7 days, and will be in recovery for 3-4 months. We will update with more information as we hear it.