Previous status reports on
He seems to have gotten the "honeymoon suite", not that he is yet in a position to appreciate the amenities personally. It has a kitchen, a dining room a bathroom and a "living room" where his bed sits. This is going to be a big change, like moving from 6th grade to junior high. He will spend a minimum of 3 hours per day, more like 5 hours, working at physical and occupational therapy. OT is re-learning to do normal things for himself like cooking (OK, that isn't a good example for Alan), getting around, dressing himself, etc.
The staff to patient ratio is much higher on this floor, so he will get a lot of personal attention. He will also interact with the other patients, at mealtime and in sessions. He will probably be there about 3 weeks before coming home. It promises to be a lot of hard work, but will probably be fun once he gets acclimated.
He has been disconnected from all IVs. He still has a stomach tube no longer in use that will come out next week. He will keep the awkward fixator attached to his pelvis for another month. Pain medication continues to be at a minimum, a 50mg/hour patch. He may need more for some of the therapy, though.
This is likely to be a very challenging phase of his recovery, but a satisfying one for him, I think.
Status report for 5/30, 7:00 p.m.: A great breakthrough today: Alan stood up! He sat on the side of the bed for 15 minutes, then, with much urging and encouragement, managed to get completely upright on a walker for about 5 minutes. This was so much tougher than it may sound; after 30 days in bed and with one good arm and leg, you can forget how to coordinate the various actions of the body, while avoiding pain. This, along with trying to concentrate on remaining conscious while being light-headed from the drop in blood pressure!
As soon as there is an opening in rehab, Alan will be headed there. It is still within St. Francis, so it is only an elevator away. We hear that it is much more pleasant in rehab, but hard work. Everything is geared toward getting you back into your normal life.
Alan is eating better today. When he says that a dish is "not bad", we take that to mean it is really good!
Status report for 5/28, 12:00 a.m.: Alan actually sat up on his bed for 10 minutes yesterday. As a result of doing something so active, his spirits and humor were at a new high. More is planned for later today.
He still finds it work to eat, but he complains about it more energetically than before. Thanks to John Bailey for the assurance that a Relay reunion is only a threat. This will head off excessive use of tranquilizers.
Update, 5:00 p.m.: Alan sat up again with the help of 2 physical therapists, and actually got both feet on the floor (although putting no real weight on the left leg). He maintained this for about 10 minutes before getting light-headed (as expected). Another good step forward.
He is off painkillers except the occasional Valium whenever the prospect of a Relay reunion occurs to him. The only IV he is still on is the blood thinner, which he will soon start taking orally.
Status report for 5/27, 12:00 p.m.: The orthopedist is talking about getting Alan into a chair! He had a good night...(more later)
Status report for 5/26, 9:30 a.m.: Good news! Alan got lots of sleep yesterday after the surgery. Although the pelvic adjustment was not invasive, it did involve some major hauling on the external fixator, and Alan is feeling pain at the insertion points. There is also pain in his left foot, where the screw was inserted.
He felt much less pain in the evening (as long as he didn't move much) and went for 5+ hours without medication in the wee hours.
We were sweating his first sheet change, since this involves a lot of movement. But when it was done at 4:30 a.m. (very efficiently by 4 nurses), it was anticlimactic; it didn't hurt him as badly as we had feared.
Dr. Howard stopped in this morning. He plans to "kick it up a notch" each day on physical therapy now. He want to get Alan sitting up as soon as feasible, and into a wheelchair. Alan told me that getting mobile in any fashion would be a big psychological lift for him.
The doctors will look at X-rays and a CT scan to see if further adjustments on the pelvic fixator will be needed. We hope not.
Status report for 5/25, 10:30 a.m.: Alan was just wheeled into surgery for the "tweaking" on his external fixator. This will get the pelvis into the best position for complete healing. While Alan is under general anesthetic, a screw will be put into his ankle. Both relatively minor operations. The doctor estimated less than an hour for both procedures. It will take longer to come out of the anesthetic than to do the operations.
Alan had a good night's sleep. His color is excellent, and he can move himself on the bed with more strength. He got his left leg into a near painless position yesterday with the help of one of the nurses. I also hear that he put down a potato cake and most of an Arby's sandwich. His appetite is coming back, but he says it still seems like work to eat.
I'll be returning to the hospital after the operation to help Alan get his contact lens back in.
2:00 p.m. update: Alan is back in his room, and surgery went well. He is experiencing pain from the fixator adjustment, despite the double dose of morphine given him after the operation. This is something for Alan to just get through. Julie is paging the doctor to see if any other pain medication can be given to get him over the hump.
A fair amount of force was used in tightening the fixator, so it isn't surprising that there would be some pain.
The screw was placed in his ankle as planned. He is as comfortable as we can make him. He is eating some ice chips for starters. I got his contact lens back in.
I think if he can get some sleep today, he'll be in much better shape tomorrow.
Status report for 5/24, 9:30 a.m.: Alan has still had no pain medication since the last note, other than 3 doses of Valium! Pain killers will be taken orally from now on...no more IV for that. He will continue on the IV for the blood thinner.
Alan has now largely adjusted to the catheter removal. That didn't take long. The feeding tube has been removed from his stomach, so he will have to do all the work from here on out. He ate a large portion of a Jason's Deli sandwich yesterday. This was facilitated by Jim Scott's threat to use the bed as a trampoline if he didn't.
His knee is healing nicely. He reports that his leg doesn't cause him nearly so much pain now, so the healing process is well underway after the last surgery. Julie is the day nurse, so all is well.
Alan said he plans to make some calls today.
Rehab can't be far away.
Status report for 5/23, 10:30 a.m.: We learned that an ultrasound test revealed a blood clot in Alan's knee. This is not cause for undue alarm, but he is already receiving a much stronger dose of blood thinner via IV. The thinner reduces the risk of the clot travelling to the lungs. According to the doctor, new blood vessels will grow to take over the function of getting oxygen to the affected area. After the IV treatment, he will be taking the thinner in pill form for about 3 months.
The forced inactivity is a contributing factor to clot formation. Movement of the leg now should not present any danger. The doctor was a little surprised that it took so long before seeing a clot. It would have occurred after the recent surgery to the femur.
Re the pelvis, further surgery will probably not be done. The external fixator will likely be adjusted to "fine tune" the pelvis, rather than attaching a plate in the pubic bone area, as had been considered. If /when any surgery is done, a titanium filter will be placed in the major abdominal blood vessel to physically prevent the clot from going any further. The filter can be placed by threading it through the blood vessels with only a local anesthetic needed.
Not to be indelicate, but the catheter was removed yesterday. There is an adjustment period before getting back to normal function in that area. This is a good time to remove it, since Alan now has the strength (and lack of pain) to deal with it. The removal also substantially reduces the risk of infection.
Alan went 12+ hours without pain medication today! No way I would be doing that well in his situation. He is looking good.
Status report for 5/22, 10:00 a.m.: Alan got a lot of good sleep last night.
There is a new IV in his arm which threads all the way through his arm to his chest. Sounds uncomfortable, but it isn't. It works well, though it isn't as big bore as the IV he had near his collarbone. That one was only supposed to last for 2 weeks anyway, so it did its job.
As usual, Alan had to be moved this morning to change the sheets on his bed. While still painful, he reports that it is much easier today than even a day or so ago. He went 9 hours between pain shots this morning!
He is supposed to hear analysis and recommendations from the pelvis doctor today. A plastic half-glove for his left hand was constructed over the weekend. This is to keep the tendons from contracting, and to provide support for the various broken bones still mending in the hand. His leg is still in a neoprene/Velcro brace to prevent movement in the wrong directions. It is slow healing, but is doing better day by day.
He ate a little more solid food yesterday, so that is coming along, too.
We still think that he might move to rehab this week...we'll see what the doctor has to say later.
So, all good news today!
Status report for 5/21, 10:40 a.m.: Again, a note from work. Alan had a good day yesterday, but got tired in the evening. His sleep was not as good as it has been. His appetite hasn't kicked in yet, but he is downing those Boost drinks and Gatorade.
Alan is frequently asked by the nurses to wiggle his toes on the injured foot. He hit upon the idea that he would oblige only when the nurse delivers on his pain shot.
Status report for 5/20, 8:00 a.m.: I am writing this from work, so I will need to be brief. I am told that Alan rested well last night. He will be getting his breakfast momentarily. Alan is up-to-date reading the guestbook. He was amused by some of the recent comments, and appreciates them all. "Mr. Bubby" is John Bailey's cat, by the way.
Status report for 5/19, 10:00 a.m.: Another night of restful sleep for Alan. The pelvis update has been deferred until Monday...not because of any problem with Alan, just doctor and schedule issues.
Alan had a strip of bacon, one bite of (tasteless) scrambled eggs, OJ, and Boost. A Pizza Hut pizza may be in the works later today. He just does not care for the hospital food.
Today, I'll be finishing up Alan's claim for the totaled Suzuki.
Alan's color is completely back to normal. His energy is noticably up. With the shave and hair-washing he got yesterday, all he needs is a clip-on tuxedo to complete the dapper image.
The doctor OK'd moving around on the bed as much as Alan can, but no getting off the bed yet. Sheet-changing is still an energy-intensive event. He had a problem with the new IV in his arm not working yesterday, but that was fixed. He is still going an average of 5 hours between pain shots, so he doesn't seem likely to develop a dependence on the pain-killing drugs.
Re visitors: this is entirely up to Alan. While he is certainly doing very well, considering what he has been through, we want to let him make the call on when he feels up to visitation. As the doctor says, any of his many wounds and injuries would be a big deal separately, and together, they are still formidable. But we feel he has definitely rounded a corner, and recovery is going full speed ahead.
Status report for 5/18, 10:15 a.m.: Helped Alan get back to the clean-shaven look this morning. He slept very well last night. He also went 8 hours between pain shots...a new record. He is back to using the patch, which is doing a good job for him at this point.
He had a rough day yesterday, but not directly due to his injuries. He wound up spending 4 hours in X-ray...they kept having to do retakes. That was exhausting. He also had the IV removed from his collarbone area and moved to his arm to let a rash clear up. Staples were removed from the incision that had been done to drain the abdomenal lymphatic fluid build-up 2 weeks ago. So, lots of changes and irritations, but he did rest well in the evening.
The pelvis doctor is studying the X-rays to see when the external fixator can come off. We'll know more about that tomorrow.
The wound to his upper thigh continues to heal properly.
He will be talking to the doctor about his pinkie today, so hold off on the "gift idea" mentioned yesterday.
Things are still looking very good for his getting into rehab early next week!
Status report for 5/17, 10:00 a.m.: The news simply could not be any better at this stage of the game. Alan rested well last night and this morning (except for a needed change of sheets). He has gone as much as 5 hours between pain shots. He ate some Cheerios, yogurt and OJ this morning.
The doctor said that his knee looks in good shape, much better than anticipated. Although the femur had been split two ways upward from the knee, the surgery was successful in getting the knee back into a working configuration. The femur itself is now solid. He is wearing a light "boot" that closes with Velcro on his left foot. He will be able to put weight on the leg with the help of the boot in the days to come.
Alan's pelvis will be X-rayed today to check the progress of the healing. This will help determine when the external fixator can come off. It still will likely be a few weeks, but it is not that painful to Alan; it just limits his range of movement.
The doctor said that Alan may be a "bragging case" for his doctors. How about that?!
Gift idea for Alan (he actually mentioned it in jest today)
Status report for 5/16, 9:00 a.m.: The scheduled time for Alan's surgery today is 1:15 p.m., but this is not carved in stone. He did get a decent amount of sleep last night, but was troubled by the traction setup more than he has been. Possibly, the thought of getting it off his leg is making him impatient.
He has discovered Gatorade and put down a large quantity of it yesterday, right up until midnight. As of midnight, he is not to eat or drink anything until surgery. Glycerin swabs are available to keep his mouth moist. They help a lot.
We appreciate all your good thoughts. We hope that, after he recovers from the surgery, Alan will soon feel up to having some visitors! I think he will be very happy to be out of traction.
Late note, 5 p.m.: Alan is in recovery...the surgery went well. Now, we just have to get him through the next 24 hours' pain...
Later note, 7 p.m.: The surgeon is very pleased with the results. Also, his foot and hand are in better shape than anticipated. And the pain level is much more controlled than after the last surgery. Because Alan is such a big guy, the doctor approved a larger dosage of morphine, and Alan has been able to rest relatively comfortably. This is great news.
Status report for 5/15, 9:15 a.m.: Alan seems now to be over the upset stomach; he put away a "Boost" drink this morning. He is scheduled for surgery on his femur tomorrow morning. This should be the last major operation. He will be out of traction, which he will welcome, because he has never gotten comfortable with that contraption on his leg. The stabilizer holding his pelvis together will likely remain for several more weeks, but it is not as uncomfortable as the traction. He should be moving into the rehab area in about a week, so the end is in sight for his hospital stay!
Tomorrow's operation will likely be as painful as the last one, so we will do our best to help him manage the pain over the next few days. But everything is looking very promising.
Status report for 5/14, 9:30 a.m.: Alan is still doing fine, but continues to be troubled by an upset stomach. He is still getting nourishment via tube, so this is not a danger. We'll address it with the doctor. The hospital food is not proving very enticing to Alan.
Status report for 5/13, 10:00 a.m.: Alan is still doing well in all respects. His appetite is slowly coming back; he had a quarter of an Arby's French Dip yesterday. I understand that Alan did make some phone calls, so you know that his energy level is improving.
I will be seeing him again this afternoon.
5/13, 6 p.m. report: Pain management is still good. Alan had an upset stomach this morning when drinking an Instant Breakfast-type drink, and hasn't had much solid food today. But otherwise, he is doing well. He will have a little Schlotzsky's sandwich this evening.
Alan read all your guestbook entries this afternoon, and appreciates them very much.
Status report for 5/12, 9:00 a.m.: An excellent day for Alan. He is eating more, and last night had a Braum's hot fudge sundae to boot! The tibia surgery is looking good (not literally, but from a medical point of view). His thigh wounds are improving, too...he is scheduled for surgery on his femur Tuesday. It's great that he is building up so much strength for that; his energy level is higher and his pain level is more controlled than before the recent surgery.
He enjoyed some bacon, eggs, OJ and coffee this morning. He passed on the Cream of Wheat and biscuit and gravy, which I saved from being wasted. We hear that the hospital has Nintendo games and VCRs. Alan is suffering from the inactivity as he builds up his endurance for the next operation, so the Nintendo may be especially good for him when he feels up to it.
When I left this morning, he thought he would try to make a few phone calls today. Alan thanks you for all those sympathy cards!
Status report for 5/11, 10:00 a.m.: A pretty good night and morning for Alan. His nurses are keeping the pain manageable, and he got a lot of sleep. His tibia repair looks very good, says the doctor. I saw that he had gotten a number of nice cards...he read them and appreciates them. His concentration is short-term, due to the drugs. He is making good progress recovering from the surgery.
He originally had a good bit of internal bleeding in the pelvic area. The accumulated blood caused his lower abdomen to be somewhat distended. But his body is at work resorbing this mass, and it will eventually go away. In the first days after the accident, he also had a buildup in the upper abdomen of lymphatic fluid, which was drained some days ago. This has not recurred.
Being in traction makes him even more immobile than before, so he is back to taking the breathing treatments. They will help keep his lungs clear and minimize the chance of pneumonia.
Alan got his first real breakfast today: scrambled eggs, pancakes, real coffee, and orange juice. He didn't care for the quality of the pancakes (kind of tough), and complained that the eggs were tasteless. This fussiness sounds like the old Alan. As a kid, he insisted on sawing off the bread crust before eating a sandwich.
Alan will probably be seeing the guestbook again tonight.
Late note, 5/10, 9 p.m.: Many thanks to Gary Brown for taking care of Alan's lawn. Gary said the weeds were so big, they went "Splat!" when hit by the mower.
During that feverish Sunday night at the hospital when I was trying to call Alan's friends, Gary made it down to the emergency center. He was there in our darkest hour, and it was much appreciated. I know that many others would have been there if I had succeeded in contacting them soon enough.
A couple of days ago when Alan was at his best to date, he intended to make a number of phone calls. But he found himself worn out after only one. So we're still holding off on visitors. We're hopeful that Alan will soon exceed his previous high energy level and feel up to making more calls.
Alan got a lot of good sleep today. That is very good news.
Status report for 5/10, 12:30 p.m.: Surgery was successfully completed, but the doctors elected not to do the femur or knee implants. They discovered that the wounds to Alan's thigh were deeper and "dirtier" than they had thought. There are some abrasions that would put him at unacceptable risk for infection. They undoubtedly made the prudent choice.
Alan was in extreme pain following the surgery, greater than any I have seen to date. He rated it 4 or 5 on a 0-5 scale. And he had handled the previous pain very stoically. This was the worst night since the accident. We couldn't find any way to get Alan any significant relief. He became delirious and removed some of his bandages. He couldn't figure out how he could be in so much pain if things were being done correctly.
We had the orthopedic specialist check the traction that had been set up for his left leg, and it was correct. His toes protruding from the bandage are warm, so we know circulation is good. The probable source of pain is the bones within the thigh being in a changed position. We know to expect it to "hurt like hell", but the pain seemed to go far beyond that.
I am told by my mom around noon that the pain has finally been brought under relative control. Alan is now more coherent when he is awake. The next surgery will probably be in 4-7 days. Wish Alan (and us) luck!
Status report for 5/9, 2:30 p.m.: Alan just went into planned surgery for his leg. This is all orthopedic: his tibia and femur fractures will be repaired, and the knee wound will be also be dealt with. It will probably take 4 or more hours.
Alan had a difficult day yesterday. The patch worked fairly well on the pain, but he wanted to be more alert, or at least not have the unpleasant buzz that is one of the patches' side effects with him. So the patch was on, off, on, off. An anti-histamine also didn't work so well. He got some sleep with the aid of a couple of morphine shots in the 8 hours before the surgery.
He also got very frustrated with the repeated pricking of his fingertips for blood samples, having his sleep interrupted by breathing treatments, the cast on his leg, the irritating feel of the bedding (due to prolonged contact), the immobile position he has been stuck in for over a week. He also was not allowed to have water after midnight, only glycerin swabs to keep his mouth moister. Pretty rough sledding.
He got a good balance of the pain medication not too long before he went into surgery. Despite the risk associated with any major surgery, I feel pretty good about this one. It is planned and under much more controlled circumstances than the original emergency treatment.
5:00 p.m.: Alan will soon be in post-op. After his doctors found that the wounds in his thigh were deeper than previously thought, they elected to confine the scope of this operation. They repaired his tibia (shinbone) fractures, and put a pin in his ankle. There are broken bones in his left foot and hand that have not yet been addressed. The wounds in his thigh would pose a danger of infection if reconstructive surgery were attempted today. He will have the left leg in traction.
This is very disappointing, since we had hoped to get all the surgery done in one go. But he took a tremendous battering and recovery is simply going to be slower than we hoped. He is hanging in there, and that's still a great thing.
Status report for 5/8, 10:40 a.m.: The news continues to be great. Alan got some quality sleep this morning with no pain reliever except the patch. Alan joked with the nurse that it would help him quit smoking, too (I don't think she caught that). It is apparently the patch that makes him feel a bit fuzzy (although he seems OK to me). He is now trying a smaller patch.
Alan got an ultrasound exam today to check the flow in the veins in his legs. It looked good. Tomorrow, surgery is scheduled to repair the multiple fractures in his leg with the high tech niobium/titanium alloy prosthetics. I guess he can forget about waltzing through the metal detector at the airport from now on.
This is going to seem unbelievable, but he could be out of the hospital as early as next week. My guess is that once the titanium is in place, that he will soon begin exercises to put weight on the leg to encourage proper fusion of the bionic parts with new bone growth.
He is able to keep his lungs quite clear without the aid of breathing treatments. He longer requires the oxygen tube at all.
Alan had some Cream of Wheat cereal, decaf coffee and apple juice this morning. His tube diet has been changed to a formula that will give his digestive tract more work to do. Looking good!
Last Monday when Alan was in intensive care, with a breathing tube down his throat, we could tell that he was pretty coherent for being as doped up as he was, but he had no way of communicating his state of mind to us. We feared that he might be frightened about or not entirely aware of his situation and possibly even hallucinating. A number of Alan's friends were visiting in the ICU waiting room that day, and since the ICU nurses had no objections, we allowed a number of visits. The thinking was that if he were in a delirious state, that we might at least be able to populate his dreams with friendly voices and faces.
Talking with Alan this morning, that may not have been so far from the truth. He doesn't remember too much specifically about those visits, but he thinks they helped.him. In retrospect, most of his frustration stemmed from the pesky breathing tube, which isolated him by shutting off effective communication.
Once he got the breathing tube out, we learned how aware he really was about what had happened. Then he was moved into the regular hospital room. The battle facing him there was to get enough sleep, conserve his energy and manage his pain. Our goal was to do whatever necessary to help him achieve those things.
Last night, I had the opportunity to ask him again how he felt about having visitors. He said he wasn't ready yet. Once he recovers from tomorrow's surgery, he may then be ready. It is up to him. He will let us know when.
He has a recent copy of the guestbook entries. He will probably read them today. Thank you, everyone!
Quickie Status report for 5/7, 9:00 p.m.: I have been told that Alan has not needed pain medication (other than the patch) since 11 a.m. today. How about that! I am now leaving for the hospital. He is still drifting in and out, but that is due to the anti-nausea medication, which he doesn't want any more. He has eaten about 8-10 spoonfuls of soup. Hurray!
Status report for 5/7, 10:00 a.m.: Alan's pain medication didn't do a very good job yesterday evening and he wasn't able to get to sleep. But from his movements, you can see that he has more strength and he is thinking on a longer timeline now. He watches some TV to try to get his mind off the pain (favorite show: that awful auction program on channel 9).
He is more aware of his positioning on the bed, and needs occasional changes to try to be more comfortable. At 2 a.m., we tried morphine again and he got enough relief to sleep. He got another shot 3 hours later, plus a 3-day patch that should provide pain relief and is compatible with the other medications. He got some more quality sleep later in the morning. After he is relatively rested, he will get his dressings changed. Then when he has rested from that, his bedding will be changed. Thanks to Julie, the head nurse, these activities are being coordinated with the pain medication.
The orthopedic doctor stopped in this morning. Alan is scheduled for orthopedic surgery on his leg Tuesday, so he will probably have a few more days after that where we concentrate on pain control.
Despite all the pain, Alan is clearly improving. His awareness is beginning to be focused on his positioning more than generalized pain. He is able to lift his torso in a way that he would not have only a day or so ago. He can hold his own drinking cup and adjust the oxygen tube himself. He does not need the oxygen all the time, another good sign.
So, cross your fingers and keep Alan in your thoughts...he IS getting better. He should be seeing the guestbook later today, if he is feeling up to it.
Status report for 5/6, 4:00 p.m.: Alan had a rough night, morning and first part of the afternoon. But by around 3 p.m., he was doing much better.
The problem was with the pain medication. He was originally on morphine, then Demerol, then again morphine last night when the Demerol was ineffective. But the excellent nurse today tried a combination of orally-taken liquid Lortab, and crushed-up Valium, and this proved effective. Alan not only got some needed sleep, but was awake, alert and feeling less pain than he had before. Needless to say, we will stick with this combination as long as it's effective. Alan sure doesn't care for the taste of Valium.
He is able to work the controls on his bed to change positions, which is probably like a bit of physical therapy itself. His oxygen level has has been good today, too, although he still suffers from a bit of nasal congestion. He has been able to cough effectively to keep his lungs clear. He can drink cranberry juice (good for his kidneys), but was nauseated after eating a gelatin cube yesterday. So, we are going slow on food.
He continues to be jaundiced (yellow). This does not appear to be a problem. The doctor thought that some of the many blood products given may not have agreed with his system. His liver may have decided to break down the hemoglobin, producing enough bile to make him look jaundiced. It is also possible that his liver is simply working overtime to replenish his own blood factors, which were very much diluted by all the blood given to keep him alive in the first several days.
All in all, he is looking better this afternoon than I have seen since the accident. We (family members) continue to fight to give him the opportunity for uninterrupted sleep as much as is possible with all the procedures that must be carried out regularly.
On the visitation issue: Alan is very aware that his friends are concerned about him and wish to visit at the earliest posssible opportunity. He said that he feels bad that he hasn't been up to having company yet. I'm sure all his friends will understand that we must get Alan stabilized and back to an energy level where he will feel up to it. Please don't add to our stress level by insisting that you must be allowed to see Alan. Alan's well-being should be everyone's number one priority. If your interpretation of what is best includes visits from his friends, we agree, but please respect our judgment (and Alan's own wishes) by waiting until the appropriate time, when his condition is both better and more stable.
James Postoak, one of the paramedics from Jay who helped save Alan's life, came by today. We told him about Alan's improved condition this afternoon, and thanked him effusively. He will be back to visit Alan when he is better.
Status report for 5/5, 4:00 p.m.: Alan's two main doctors checked in on him this morning. The healing is progressing satisfactorily. However, he still has a significant quantity of seepage from the areas of his body where the pelvic stabilizer is attached to to the bone. This is not abnormal, but requires attention. His entire left leg is also immobilized by a parallel rod sort of construction that is attached directly to bone. He has not required any further units of blood, despite this seepage. He continues to get an IV drip of fluid, and nourishment is delivered by tube.
Because of the seepage, his bedding must be changed on a daily basis. This is an agonizing process, because he must be moved for this to be done. The pain level created by this movement nullifies the narcotic that he is on, and it is exhausting for him.
He has had a small tube delivering oxygen through his nose. However, today, he had a problem with nasal congestion, and as a result, his oxygen level dipped. He is now on an open mask that delivers oxygen as well as humidity to help the congestion. He also needs to cough regularly to get rid of lung congestion, and thus avoid the possibility of pneumonia. This, too, is painful and exhausting.
He received a nice card signed by the Honda of Tulsa folks. I showed it to Alan and offered to read a bit, but his energy level was just too low for him to respond. I have told him about all his friends who are very concerned and wish to visit whenever possible.
He remains lucid, just very, very tired, and in pain much of the time he is awake. The scope of his conversation has been mostly limited to discussion of his condition. Immediate family is staying in Alan's room in shifts to make sure he gets attention when needed.
He is scheduled for orthopedic surgery next week to begin the process of trying to put his leg back together. His fractures are complex. A specialist from Philadelphia will be doing the surgery, and using some cutting-edge titanium technology to reconstruct the leg.
The fact that he is out of the Intensive Care Unit is deceptive. It is true that he is not in immediate danger, but the threat of infection or respiratory problems is ever present. ICU is much like a MASH unit; it must be cleared for arriving trauma patients. As you have seen, Alan is nowhere near a condition in which visiting is advisable. There is no way to know when this will change.
Our mission is to let him sleep as much as possible. That is difficult, because, unlike ICU, this unit does not have high-tech monitoring equipment, so blood pressure, samples, breathing tests, medication, etc. must all be done by nurses. Each of these events requires Alan to be awakened. When he is awake, he is usually in pain and needs pain medicine. The more solid sleep Alan can string together, the better he will do. The fewer interruptions, the better. The phone in his room has been unplugged for this reason.
So, please keep Alan in your thoughts, and when he is willing and able to receive visitors, be sure that we will let you know. I will do my best to keep this status report up to date. Alan's friends will have an important role to play when he is "further on up the road". Please write in the guestbook...he will be seeing it as soon as he is able.
(This is the first entry of the journal, made after Alan was
moved out of ICU)
He has compound fractures of the left thigh and shin bones. There is extensive soft tissue damage to his left knee. His pelvis has what is called an "open book" fracture. The pelvis was physically put back into position with a "halo"-type device three days ago. This helps stop the bleeding and let clotting and healing occur. He still receives blood, although in far lesser quantity than the 1st day or so.
He did lose his left pinkie. He is aware of the extent of his injuries, and in fact, has been lucid throughout his ordeal.
The main concern for the moment is for him to get plenty of healing rest, and to avoid infection. His leg has circulatory function, and Alan has feeling in it. As long as infection can be warded off, there is a very good chance that he will get back at least some function from the leg, albeit after numerous surgeries and much painful physical therapy.
While his survival borders on miraculous, he has a very long way to go for complete recovery. Visitation is limited to immediate family for now, and the phone has been unplugged in Alan's room to give him a chance to get the uninterrupted sleep he needs so badly.
I have told Alan about all of the calls and good wishes from his friends, and he is aware how much he is cared about by all his friends. I thought it would be nice to print the contents of the guestbook occasionally and let him read it when he is up to it. So, tell everyone to send messages to Alan this way...they will get to him!