Charles Lyttle Updates

"The Lord your God is in your midst, A victorious warrior. He will rejoice over you with joy, He will be quiet in His love, He will rejoice over you with shouts of joy." Zephaniah 3:17 NASB2020 Not taking tube out today Breathing on own for an hour got tired might try again later. They have music playing  ❤️🙌🏻🙌🏻🙌🏻🎉 Spontaneous breathing trial, increased in sedation likely caused him to tire out and not actually him tiring out. They will keep doing trials 🙌🏻🙌🏻🎉His swelling seems to be improving He was squeezing my hand and nodded when I asked if the music was ok. I was telling him the kids missed him and He even smiled slightly when I told him Amelia says "I wanna see Poppy" ❤️❤️ he squeezed with both hands tight while I was talking to him ❤️🥰 🙌🏻🙌🏻🙌🏻🙌🏻🥰🎉🎉I told him "pretend I'm giving you a big squeeze" and he smiled again❤️❤️❤️🥰 and then I said "we'll just wait until I won't squish you" and he smiled again 😊

🌙 Overnight Report: Great night, came down on Fentanyl 🙌🏻🙏🏻Vent setting so that he's breathing on own (vent only supports if needed),  possibly extubating today? If all #s look good, the team will start talking about it (might wait to give him some time to ensure he's ready)  Chest X-ray, labs, cultures? Labs looked good, no cultures back (no news is good news), just took X-ray (results not back yet) ❤️🙏🏻 Prayer Requests: Dad's continued and complete healing Everyone traveling on this road with us Health, protection. That any of Satan's attacks would have no hold and no power here. Christ has already overcome!! Wisdom for the medical team to know how and when to extubate and how to best care for Dad

This hope we have as an anchor of the soul, a hope both sure and reliable... Hebrews 6:19 NASB2020 ☀️Today's updates: PT Getting elbow moving. Lifting rt shoulder. Being gentle Finger stretch Giving Legs a break from the boots (back on now) Bend hip and legs Clonus- is common in Stroke and brain injury Keeping eye on it. He has Clonus on both sides- feet keeps going repetitive bouncing with feet Dilated his eyes to check retina Ointment started today Some swelling So big picture on the eye Dr conversation- they dilated both eyes today both equal & reactive to light.🙌🏻🙌🏻🎉❤️ Good sign that he can see, but they'll have to assess his vision when he wakes up and Can verbally tell them what he can see. No current nerve or eyeball damage. There was bleeding behind left eye due to injury which is causing the swelling/protruding of that eye. It should resolve with time. Potential concern would be if that blood "chokes" the nerve & causes damage, but

❤️🎉🎉Happy birthday, Dad!! 🌙Overnight Report Made some vent changes: yesterday 40-80% around noon, back down to 60% (could go back down to 40%) Setting overall much more comfortable with. 🎉🙌🏻🙌🏻🙌🏻Lighter setting overall, better supports spontaneous breaths  🙌🏻🙌🏻R arm Doppler Completed, no large DVT or anything, likely related to clavical fracture & injury there Chest x ray and labs, urine Similar to other days, antibiotic started yesterday ceftraxone (broad spectrum), cultures still pending, WBC normal, need to follow up on results of X-ray and some labs with day shift/doctors  Fevers 1 minor, controlled otherwise Overall improving, way more aware, more commands more frequently (nod and blink of understanding when charge nurse explained accident), 🎉🎉🎉❤️thumbs up on both sides 👍👍🎉🎉🙌🏻🙌🏻🙌🏻🙌🏻🙌🏻, wiggling toes, able to relax much more easily 🙏🏻❤️Prayer Requests: Keep doing what You're doing, God!!! We see Your miraculous healing hand at work and we pra

Praising God for continued progress!! ❤️🙌🏻🎉🎉🎉🙌🏻🙌🏻❤️ God, You are my God; I shall be watching for You; My soul thirsts for You, my flesh yearns for You, In a dry and exhausted land where there is no water. So have I seen You in the sanctuary, To see Your power and glory. Because Your favor is better than life, My lips will praise You. So I will bless You as long as I live; I will lift up my hands in Your name. Psalms 63:1‭-‬4 NASB2020 He moved his leg and arms. Left arm to chest. A friend said he moved left arm when he was talking Dr: Gave thumbs up  Opened eye squeezed left hand Wiggled toes and really good this am. Did a lot just now. Changed vent setting to allow more for breathing on own and he's doing well with that  Plan to reduce fentanyl and look at other meds as well (to wean off where they can) Try to take central line out today! Will likely put in PICC line instead IV temp management is off today and temps doing well. Will control temp with meds instead at th

🌙Overnight Report Good night overall Breathing better without excess fluid Blood pressure under control Vital signs look good Breathing trials happen when respiratory team goes around (could be anytime during the day) - it doesn't seem like they did this yesterday because they were working to figure out the fluid situation Still on fentanyl, will start to wean off if he keeps doing well with breathing 🙏🏻❤️Prayer Requests: Continued opportunities to pray with and show Christ's love to those around us! ❤️

We'd love to have you join us for Prayer and Worship (and a cookout!) at our house on the River this Saturday. Please RSVP to hmacpherson727@gmail.com or reach out with any questions! 

☀️❤️🎉🙌🏻Today's Recap & Praises: Discussed MRI r/t prognosis: Scattered injuries. Not to preclude recovery/ forward progress.  Unknown time frame for full following commands/walking/talking etc. 🎉🙌🏻🙌🏻🙌🏻Today Open/close eyes to command & wiggle toes did not for hands/feet. (Squeezed hand of overnight nurse at shift change though) AM Chest X-ray showed a lot of fluid. 🙌🏻🙌🏻🎉Diuretic worked well w/ lots of urine output. Ultrasound didn't show large pocket of fluid anymore to have to do the needle aspiration.  ❤️🙌🏻🙌🏻🙌🏻Good thing- following commands/wake up. Good sign. 🙌🏻🙌🏻🙌🏻❤️He's on the better end for exams at this point compared to other cases where people may not have woken up yet. For eyes- Over time swelling goes down, should get better. Ophthalmology following. Right now, Not looking at you- r/t injury & sedation  Gaze should improve with time/healing (did look towards someone talking to him tonight) 🎉 Bear hugger back on Temp up. IV

🌙Overnight Report: Similar neuro exam, stable BP stable, little high (meds to keep down) Harder time with vent/asynchronous so gave additional fentanyl, 1x midazolam (sedative)

So many praises in today's updates!! 🙌🏻 🙌🏻🙌🏻❤️🎉 thank you for your continued prayers. God cares and hears our prayers! ❤️ -CT overnight looks stable. Will continue with regular scans to monitor progress/assess for changes. It would show where blood is being reabsorbed & show swelling. -Neuro exams stable.  -Just on fentanyl drip now; off propofol (sedation). Still sedative/cause drowsiness & help with pain but as brain continues to heal should continue to see more wakefulness.  -urinalysis & sputum had shown white blood cells, but the cultures so far showed no growth. Current antibiotic- cefepime working well. If any growth today/tomorrow will adjust the antibiotic to treat the specific bug (if different than what is currently being used to treat). - the Shivering increased after propofol was weaned off. Currently seems comfortable & not shivering. -He's still maintaining a fairly high temp. -Oral Tylenol is now scheduled (& was scheduled overnight) s

From Mikayla (mom and Mikayla were in the room when this happened) So many updates I'm trying to finish writing out but just wanted to share 1st off- that dad woke up (his eyes) opened to our voices when we were talking/getting report & showing some facial expressions. He squeezed his left hand to verbal command & seemed to try on the right hand like just a flit of movement but not a squeeze). So awesome that he woke up for us. We were encouraging him after that he was doing great!! Praise the Lord for the ways He continues to work! ❤️🙌🏻🙌🏻🙌🏻🎉🎉🎉 keep going, God!!! We're still asking for a miracle of complete healing!!!! 

🌙Overnight Report: Stable, neuro exam relatively the same CT Scan & X-ray in the night (we will get results today) Tolerating vent

☀️🌙End of Day Update: Working to balance Pain management/sedation: Trying to get off of propofol and totally onto fentanyl (started at 1230). Fentanyl will likely need to be increased as propofol is decreased. And they usually won't talk about extubating until lower fentanyl dose. So it's a matter of making this switch and then decreasing the fentanyl with the eventual goal of extubating. 🎉🙌🏻Praises: Neuro: about the same exam wise, consistent, really good movement/reactive movement with left arm, r brain controls left but left is good!! ❤️🙌🏻🙌🏻🙌🏻 usually with the right brain injury the left side is weaker, but the fact that his left upper extremity is so strong is really encouraging Same vent settings today, still some tan/yellow sputum but not more than yesterday so that's also encouraging.  C collar (around his neck) is off (no ligament injuries) JP drain out (from surgical site) Good MRI results (as expected based on what we knew previously-see last post for mo

Update: Chest x-ray is improved from yesterday🙌🏻🎉 MRI - findings stable🎉🎉🎉 No ligament injury/FX of spine C8 pinched nerve, not concerned Disc protrusion could be age related not necessarily injury related Not surprised by imaging findings but expected, stable Nothing has worsened Chance of improvement is good🙌🏻🙌🏻🙌🏻🙌🏻🙌🏻🙌🏻🙌🏻🙌🏻🙌🏻🙌🏻❤️🎉 (we didn't really discuss prognosis specifically) Trying to wean sedation, started consistent fentanyl (pain & sedation) next steps: wean off sedation They discontinued prophylactic keppra (only goes for 7 days)  They stopped vancomycin antibiotic since it's not MRSA He's still on Cefapim antibiotic for infection Q2h neurological checks  Lots of praises!!! ❤️🎉🎉🙌🏻

 

🌙Quick overnight update: Went for MRI & tolerated well (waiting for results) Propofol still for sedation and comfortable  No neuro changes

🌇Today's Recap: Today did a Pan culture- collected urine, sputum, blood. Takes 1-3days to grow/result. Sputum showed wbc so likely some sort of bug but need to the culture to result to know what/how to treat.  His Vitals are very affected by agitation/activity. & Hourly cooling via central line (being cold makes it hard to stay relaxed).  Continued Propofol (& intermittent small dose fentanyl IV push to control agitation/ pain).  Propofol can affect liver labs if prolonged use. 1 indicator of the liver being affected negatively would be green urine. His is clear yellow. Current dosing 25-40mcg (80-100 is max). So he's on a relatively low dose. We talked about the Presidex (a preferred ICU sedative) that they previously tried. This med has tendency to lower heart rate & w/ agitation dad's HR lowers anyway (to the 40s), so Presidex is not a safe alternative for him. So they'll continue with low dose propofol.  Also give Morphine which lowers HR too.  She said

We continue to be encouraged by the verses from the Bible that are part of our devotional time, shared by friends, prayers, and worship music that is coming into our days during this time.  We are reminded of God's goodness and faithfulness in the time and wanted to share with you all as we travel this journey of trusting in Him together.  Now to Him who is able to do far more abundantly beyond all that we ask or think, according to the power that works within us, to Him be the glory in the church and in Christ Jesus to all generations forever and ever. Amen. Ephesians 3:20‭-‬21 NASB2020 God, continue to remind us of who you are, your promises to us, and how you love us. Let us see your hand at work in each day and sing your praises for the ways you are working. Amen

🌙Overnight Report: Breathing was a little bit desynchronized with the ventilator last night so they checked ABG levels which were slightly abnormal as well. They changed the ventilator mode again to help with this and he's doing so much better!  The nurse also noted change in breath sounds so they gave some Lasix and he's doing much better with this and had great output in the night as a result of the medication.  Labs overall looked good. Some electrolytes were low (related to meds given) but they're replacing these today.  They also gave medication to help with shivering and he still has the bear hugger warmer on. No further shivering after meds.  Sedation medication is currently at a lower level again (they have to adjust these to find what he needs at the time- it's a balance) CT Scan scheduled for today. They decided to hold on MRI last night for more support/to decide the best timing. Especially considering that yesterday when they laid him flat he did have a low

☀️Today's Recap:  Calcium was slightly low, but they're working to replace it.  Team is working to reduce shivering with medication & bear hugger warmer VS fluctuating some related to body's response to TBI (expected with TBIs and the team is helping to regulate with meds) Planning for MRI overnight 🙌🏻🎉Praises: ICP is out!!  CT Scan shows no changes, no new bleeding Labs that have come back were normal (except note above) Change in ventilator mode seems to be working better for Dad today Chest X-rays have looked stable ❤️🙏🏻Prayer Requests: Complete restoration of health for Dad and continued wins from a progress perspective!  Safety with everyone traveling. That people around us would see God's love and that God would be seen in all of this (His hand, His glory, His love). Balancing caring for Dad, work, school, kids, etc. For our friends and family who are also processing and coping with Dad's accident.  We love you all and appreciate all of your prayers a

❤️🙌🏻🙌🏻 Praise God!! They were able to remove Dad's ICP (Intracranial Pressure) Monitor (Camino). 

Overnight Report: They were able to decrease sedation last night pretty well. He's off the fentanyl completely and at a low rate of the propofol.  Planning for CT scan today. If things look good, they plan to remove the Intracranial Pressure monitor and will plan to do an MRI (they can't until the ICP monitor is out).  🙌🏻🙌🏻☀️Praises: He is getting morphine and is looking really comfortable. He had been shivering (likely nerve related but they are also regulating his temperature) and they were able to give him some meds to help decrease that.  God continues to encourage us through your prayers and words of encouragement! 🙏🏻❤️Prayer Requests: In the most recent neuro exam: His neuro responses were a little bit less than yesterday with right arm and leg. And he didn't open his eyes as wide as he had. This could be related to all of the med changes but they will monitor via CT scan today.  Also, he's had an increased respiratory rate, coughing, trying to breathe over

Updates: They've put his right arm in a sling to better support it with his fractured clavical.  Praises: His body is able to regulate his blood pressure without medication (as of yesterday)!! Continued safety while traveling. Amazing supportive family and friends. Thank you all for the continued prayers, encouragement, support and love!! Prayer Requests: Rest and strength for all of us: Charles and family. Continued healing and progress for Charles. Guidance and wisdom for the medical team as they care for Charles. Clarity, wisdom, direction, and insight for family as we navigate this season. Knowing the questions to ask, understanding the information given, juggling work, life, school, kids, etc. 

Day 1- 8/20/23:  Craniotomy, removal of subdural hematoma, sedation, intubation, chest tube, feeding tube, Camino intracranial pressure catheter, JP drain from the head, Foley catheter. Left arm & both feet movement to pain stimuli. Day 2- 8/21/23:  Swelling phase. adjusting sedation with goal to wean off, balance sedation/stimulation/ pain control. Brain pressures & scans are stable. Both arms, legs, upper chest movements, facial furrowing & opening eyes to pain stimulation. Cough reflex present. Day 3-8/22/23:  Chest tube out. Spontaneous movements x4 extremies. X1 squeezed right hand by verbal command of the nurse but was unsure if reflex or intentional. Other movements are intentional, good signs of wakefulness (attempts to grab at breathing tube & bites down with oral care). EEGs no seizure activity. Chest & abdominal X-rays are good. Day 4- 8/23/23:  Neuro exams, ICPs stable.  Spontaneous breaths! Gave thumbs up to verbal command! 

On August 20th, an ATV malfunction forced Charles into a guardrail he was passing. This caused the ATV to roll 4-5 times with Charles. Emergency help arrived and he was airlifted to Upstate in Syracuse. He arrived in time, but in critical condition. Injuries included a large blood clot on the right side of his brain, fractured clavicle, fractured ribs, punctured lung, and many other "smaller" injuries. Surgery was performed to remove part of his skull to relieve the pressure on his brain. He was sedated and intubated. He had a GCS score of 4/15 (lowest is 3). We praise God for: Life - Charles is alive because of fast-acting emergency workers, an available helicopter, incredible doctors/nurses/staff at Upstate Comfort - Charles and his family are surrounded by hundreds of friends and family that are pouring out love, support, and prayer Healing - Charles is continuing to show signs of improvement with a guarded, but optimistic prognosis God's goodness - We have seen dozens