Day 8-August 27: Recap/Updates

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) should help w/ shivering too. Plus water cooling through central line so temp is stable even though they can tell his body was trying to have a fever.

-Oral pain meds added on- will help when they eventually take the fentanyl drip down

-oral gabapentin continues (for pain & 2nd benefit- seizure prevention) 

-5mg Morphine q6hr scheduled (helps w/ neuro-storming even more than the fentanyl would)

- neuro-storming is common at this point in the recovery process (signs of storming are often quieted w/ sedation so may show more now that dad is on just fentanyl drip vs propofol). 

- Dad's current/normal ventilator setting- (Pcmv)- pressure control setting does a lot of the breathing work (though you can still see dad's underlying spontaneous breath attempts-pink triangles on the monitor)

-They "Spot trialed him today"- "spontaneous breathing trial"

-Dad did well for 2.5hr on minimal settings!!! He's initiating the breath, pulling in the volume of air (then vent adds a little more if needed).

-Right now he's Blowing off lot of c02, pH slightly basic, higher end tidal c02. Continuing to monitor ABGs. Respiratory therapy monitoring.

-Resp therapist thought he would tire out, so they returned to the pcmv setting

-They will now trial spontaneous breathing (lower vent setting) every morning and watch for longer tolerance. 

-When dad is consistently following verbal commands & having longer tolerance of spontaneous breathing, they will talk about getting the breathing tube out.

-When they initiated the trials this morning he still had a little propofol in system & still did as well as he did! (2.5hrs!!!) 

-On vent the indicators for his spontaneous breaths (pink triangles) may not show as many after those trials bc the trialing expectedly tires him out. He's in a reapiratory rest/recovery phase. 

-They're monitoring pleural effusions; chest xray stable & improving

[[-Explained by the nurse- the initial Rib fracture caused pneumothorax (collapsed lung) which then caused the pleural effusions (both lungs)

...the effusion is Damage to lining that surrounds the lungs. Initially, to help drain, they did the chest tube. When felt like they took enough off, they removed it. 

Pleura around entire lungs. When there is damage to the lung, the body's way of protecting is to add fluid--->thus the pleural effusions.]] It looks like they're resolving but not compeltely gone but also not warranting further intervention.

-Swelling left eye slightly worse. Have been doing eye drops in both eyes. May start a different, petroleum based, eye drop...having some trouble closing eye after opens. This different drop will keep eyes from irritating/drying out & preventing related long-term damage. 

-Both Eyes reactive to light which is a good sign neurologically, they are slightly different in sizes (could be due to optic trauma to nerves (right side is larger could be related to surgical intervention). Usually doesn't have impact on vision per-say.  She's going to ask for an ophthalmology referral for him. If at any point we see his eyes becoming more intentional in their gaze we should let her know. (More wakeful sign). 

🙌🎉🙌🎉🙌🎉Dad spontaneously woke up! His eyes opened to Amy & Mikayla's voices when we were talking/getting report from the nurse, & he was 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!! Then he went back to sleep 😴 The nurse said that was one of the best exams she had seen yet. 

Mikayla went to leave and told dad that Troy was coming in, he immediately opened his eyes at the sound of Mikayla's voice. When Troy indicated he was there,  dad was opening/blinking his eyes. Furrowing eyebrows. He continued with this for 26min, though Troy tried to let him rest. Nurse noticed some changes in vitals with this wakefulness and came in to help calm and reorient dad to events leading up to him being here (in an ATV accident/ hit his head/at the hospital/ receiving care). 

The nurse did give a bolus of fentanyl to help with the calming. 

On two different occasions he squeezed Mikayla's hand with his right hand spontaneously. Good sign to have strength in that side too.

🙏🏻❤️ Prayer requests: 

-Asking for God's peace over Charles, that surpasses all understanding. Especially as he is more wakeful and trying to process where he is and what had happened. That he would not worry and would have confidence that God is taking good care of him. That he would feel safe. 

-Helping us as friends/family visiting to know the right balance. Help us be selfless in the opportunity of talking to Charles by also giving him the chance to rest/heal without being overstimulated. It is so exciting to see the responsiveness but want to be respectful of this time of healing and allow for continued forward progress. 

-We had an opportunity to pray with nursing staff! Praying God would shine his light through us and help people come to know Jesus as their personal savior.