more updates from Kris

(pasted from CaringBridge)

WEDNESDAY, JULY 09, 2008 01:13 PM, PDT

Paul continues to make good progress. He is frustrated that the surgery has been put off until tomorrow. We talked about his accident and what has been going on while he's been here. He wanted to know why we weren't going to Seabeck with the girls. He still doesn't really understand the extent of his injuries, so he's thinking that he'll be able to go home shortly after the facial surgery. I tried to let him know that it would be a while, but since I really don't know how long it will be, it's hard to know what to tell him. He is being moved the another floor sometime this afternoon. On the one hand, we are excited about this because it means that he no longer needs critical care. But, he will most likely have to share a room with one or more patients, and I know he will not like this. He will also share a nurse with several other patients, so it will be even more important to make sure he always has an advocate there. Thank you to Nathaniel and John D. for staying with Paul last night. And thank you Karen for taking on the task of coordinating meals and other stuff. You are amazing! Since Paul will now be out of ICU and into general surgery care, we may have to make some changes to the shifts with Paul. If you signed up for a shift, double-check the signup page before coming, as that is where we will post information about his room, etc. On that note, Gilman has put up a second page for daytime coverage next week. If you are interested, you can find it at http://www.mysignup.com/fopdaytime.

TUESDAY, JULY 08, 2008 10:09 PM, PDT

Today was a frustrating day. We were told that the surgery would happen in the mid-to-late afternoon, but they wouldn't be more definitive than that. When afternoon came and went, there was still no word. We didn't get a definitive answer until the doctors did there rounds (around 8pm). They decided to put a feeding tube down his nose so that Paul could get some nourishment (he'd been on fluids for the past 24 hours). So, now the plan is to keep him on the feeding tube for 24 hours, then take him off tomorrow night so that he can have surgery on Thursday. Very frustrating! Other than that, it was a pretty restful day. Paul did not talk as much today, partly because we tried not to pester him too much. At one point, the nurse asked him where he was and he wasn't entirely sure. When given a set of choices (hospital, school, and a few other locations), he said that he was at a school. But, he still seemed aware and remembered people. Thanks to everyone who continues to send wonderful notes via email, snail mail and the guestbook. It really warms our hearts! --Kris.

TUESDAY, JULY 08, 2008 04:52 PM, PDT

When I arrived today, Paul was resting peacefully. He continues to respond well to the neuro exams. Hal says he tried to fight them off then they wanted to put a needle in his arm. Shortly after they got there, nurse Dan, with the help of another nurse, shaved the rest of Paul's head. I don't think Paul cared, but it made Hal happy ;-) The rest of the day was pretty much spent waiting for Paul to go into surgery. The nurses and Susan and I were trying to let him rest. Unfortunately, as of this moment, he still has not gone into surgery, and we do not know whether he will... Thanks to Meg and Willie for staying with Paul last night. Thanks to Linda for bringing Chili and to Margaret for giving Hal a ride this morning. Thanks to Kathie for the strawberries, fresh from her grandmother's garden! And to Jackie Mason for the 3 (!) Shepard's pies. You have all been so generous with meals that we are set for food for the rest of the week! --Kris.

Wow, what difference a day makes!

(pasted from CaringBridge)

In the morning, Paul was able to tell the doctors his name, and respond to commands in a more definitive manner. When the doctor told Paul that Hal was on his left, he turned to look at him. And when the doctors asked if it would be okay to put an intravenous line in, he said no. At one point, he said "Out!", which is what Kayla used to say when she wanted out of the jogging stroller ;-)
When I arrived around noon, he was once again awake and the nurse was asking questions. He was able to say his name, where he was, and the year. He also was able to put up 2 fingers on each hand, wiggle toes, and squeeze the nurses hand.
When the nurse was done, I went to his side and started talking to him. He told me he couldn't hear me, so I talked louder. At one point, he asked me to kiss him, so I knew he was feeling a lot better!
Throughout the day, he continued to engage in conversation in between periods of rest. He was shocked when I told him he'd been there for 6 days, then asked me what was broken. After I listed all of his broken bones, he said something that can't be repeated in this forum ;-)
At around 3pm, I asked him if he'd like to see the girls, and he gave me an emphatic YES! I immediately called the people who had picked them up from camp, and they brought the kids to the house so that Matt could bring them to the hospital. They arrived around 4:30pm, and I showed them a picture of Paul and talked about what they would see.
The girls were shy at first, but they both talked with him a bit, and they we let him rest. While he rested, the girls filled out a "About My Family and Me" chart that the hospital gave us, and then we went to dinner.
When we came back to say goodbye, Rachel told Paul and old family joke about a duck in a bar. Paul's face lit up and he gave us a huge lopsided grin!
Thanks to everyone who stopped by, and to Rebecca and Heidi for picking up the girls, and bringing them to the house on short notice.

Paul responding; signup sheet

(several updates pasted from CaringBridge)

SUNDAY, JULY 06, 2008 09:15 PM, CDT

Announcement: Sign-up sheet website OPEN A website at http://www1.mysignup.com/fop has been created to coordinate the efforts of those who would like to volunteer to take a shift watching Paul at night or provide an evening meal.

SUNDAY, JULY 06, 2008 09:14 PM, PDT

While I was making the previous entry, the respiratory nurse came in and checked Paul's breathing again. He was doing so well, that they switched the respirator into a mode in which it only assists Paul when his oxygen levels start to drop. Most of the time, he is breathing on his own, despite having the tube in his mouth. For tonight, at least, the breathing tube will stay in. Most of the rest of the day was uneventful. Paul is being roused approximately every hour to assess his neurological responses. Some tests are better than others. Tonight he apparently tried to pull his breathing tube out with his right hand. This is good news since the responses on his right side have been lagging those on his left. Thanks to everyone who visited today, and to whomever it was that brought the enchiladas, they were a big hit. Thanks to Leslie and Janet for volunteering to stay the night, and to Jim, Bob, Amy and John for volunteering to get Hal to the hospital in morning every day this week! The nurse did say that when we visit Paul it's okay to talk softly and soothingly to him, but she asked that we keep our side conversations to a minimum, or take them outside the room. She felt that Paul was listening to everything and that was detracting from his ability to focus internally.

SUNDAY, JULY 06, 2008 11:57 AM, PDT

Hal provided two more bit of news when I arrived this morning. The first was that Paul responded to his name when the Neurosurgeons examined him, and the second is that Paul does have a bit of pneumonia in one lung (the right, I think). Fortunately, they started the antibiotics yesterday, so hopefully, we'll nip that problem in the bud. The doctors says that all of his trends are still positive, and he's still on track to have facial surgery on Tuesday. --Kris.

Paul breathing on his own

(pasted from CaringBridge)
FRIDAY, JULY 04, 2008 03:27 PM, PDT
I am sitting in Paul's room right now. It's fairly quiet. His ICP has been low all day and his temperature is staying down. He periodically stirs and moves his arms and legs around. He also moves his head from side-to-side. These are all good signs.
Another milestone event occurred earlier today. The respiration nurse came in to check how well he could breathe on his own. He was off the breathing tube for about 30 minutes and was maintaining the same respiratory rates as he had been with the breathing tube. This means he is able to breathe on his own. However, they are leaving the breathing tube in for now so that he doesn't have spend energy breathing, and can direct that energy to healing the rest of his body.
I'm not sure if I already noted this, but he has also had his chest tube removed. He had the tube in to help make sure that the lung that had collapsed at the scene of the accident stayed inflated. It was determined that he didn't need the tube any more and it has been removed.
For the next few days, they will primarily be monitoring how his brain is healing. If he remains stable, he will have surgery on Tuesday to stabilize the broken bones in is face. It is unclear whether he will get his breathing tube out before then, since they will most likely need to put one in again after the surgery.
The girls are out enjoying the 4th with our neighbors, the Parker/Crepeau family. They are going to see the Kirkland parade, then hang out at the beach and see the fireworks.
Thanks to everyone who visited, and especially the ESR couple that brought the vegan pie for Rachel (I apologize for not remembering your name!). Also, a special thanks to Matt, Hal and Ben for staying the night and keeping me updated on the events of the night.
I hope everyone is out enjoying the fireworks. Hopefully, there will not be any here in the hospital tonight ;-)
--Kris.

more news from Kris

Here's some more news from Kris (she posted to CaringBridge, but it didn't seem to make it to the mailing list - sorry - I'll try to keep a watch and copy to here as often as I can).

Kris, you're a real trooper! Keep hanging in there.

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From: Kris
THURSDAY, JULY 03, 2008 03:32 AM, CDT
When I left the hospital last night (around 7pm), Paul had just had another neurological exam. Basically, this consists of taking off the medication that is keeping him sedated for a while and then trying to get Paul to react to commands. Sometimes, the nurses yell (we have to speak very loudly to him because we are not sure how much fluid there is in his ears) commands such as "wiggle your toes", "raise your thumb on your right hand", etc. Paul is able to move all of his limbs, though he is less responsive with his right side (which make sense because most of the brain swelling is on the left side, and that is the side of the brain that controls the right side of his body). It is not always clear when Paul is responding to a command and when he is just moving his body because of some other stimulus (e.g., we don't know how much pain he is in, so he may just be reacting to some unknown internal pain). When the nurses want to try to get a more definitive response, they sometimes hold down one arm, pinch his ear lobe, and ask him to try to stop them with his other arm. He is responding to these tests in a limited way.
All in all, it is very encouraging that he is able to control as much movement as he is right now. And since there is still some swelling in his brain, it is premature to read too much into the results of the test, but we are cautiously optimistic about the progress he has made just in one day.
Another test that was performed measured how much his body is able to self-regulate. They hooked Paul up to some complicated machine that measured how is blood pressure, temperature, and other vitals reacted when they manipulated his body. The nurses who ran this machine were not very helpful in explaining what was going on, so I'm not really sure what all was tested. However, at one point, they had some cuffs wrapped around his legs. They looked like very large blood pressure cuffs that were wrapped around his upper leg. The nurse pumped air into the cuffs to squeeze his legs. His blood pressure initially went up, then slowly settled back down into the range it had been in before they squeezed his legs. Once is BP settled, the let the air out of the cuffs to let the blood flow back into his legs. His BP initially went down, but then stabilized again. My impression was that this is exactly what they were hoping for. The end results was that his report said that his auto-response system was somewhat impaired, but that his doing some self-regulating. Once again, this is encouraging. He still has a lot of swelling, so they weren't expecting him to pass this test 100%.
When I left the hospital, Paul was in the very capable hands of Ann and Robin (his nurses), and Matt. Matt was going to keep him company for the first half of the night, and then Saint Landy was going to drive in to stay with Paul for the rest of the night.
I know I will be thanking people for years to come around this event. I know that I will not be able to thank everyone; there are so many people doing so many wonderful things that I am not even aware of. But for today. Just in the course of the past two days, we have had such an amazing outpouring of love and help. Four people stopped by to deliver food to the hospital yesterday (Jim, Randy, May, and Trish), and two more brought food to Susan and Hal's house (Judy and Barb and Ed) and kept the girls company so that we could all be at the hospital. I have many of offers of help with kids, errands, mowing (!) and all the other minutae. Please know that I appreciate every one of your offers, even if I do not take you up on it (or even acknowledge it). I am trying to respond to as many people as I can, but I cannot keep up with all of the wonderful offers and well-wishes. My hope is that you will all follow Paul's progress through this website, as this will be my primarly mechanism for keeping everyone informed of what his happening in both Paul's life and all the wonderful people around him.
On that note, the girls are holding up well. They are attending a theatre camp this week and next. They will perform a version of Cinderella next week. I am thankful that they are engaged in an activity that they enjoy so much. It is wonderful to come home each day and hear about everything they did at camp that day.
I am holding up too. Thanks to everyone who is also trying to take care of me. This is a very awful situation, but I have so much love and support surrounding me, that my burden is considerably lighter than it might have been.
Okay, that's probably enough for one night (morning?). I'm going to try to go back to sleep now ;-)

update from Kris

At the risk of duplication, I'll send this out from Kris' CaringBridge post (which I've tried to hook up to paulkris@googlegroups.com):

WEDNESDAY, JULY 02, 2008 01:23 PM, PDT
A number of things have changed since the last update. Paul had been wearing a neck brace due to a small fracture in his 5th vertebra. The doctors have determined that there is not danger to the spinal cord, so they have allowed the nurses to take the neck brace off. This allowed them to raise and turn Paul which seems to help both with the swelling, and mobility. Paul is moving all of his limbs voluntarily and seems to be responding to specific commands.
Another bit of good news is that he is starting to respond to light shone in his left eye. This was not happening yesterday and this morning. We are hopeful that as the swelling continues to go down, he will continue to show progress in his left eye.
Thanks to everyone who has called or emailed. I cannot answer/respond to everyone, but please know that your thoughts/offers/well-wishes are greatly appreciated by myself and all of Paul's family.

--Kris.

quick update

My wife (Margaret) called Harborview, and they confirmed that he is in the hospital there. Although they can't give out the room number, they did say that he is on the Neuro/ ICU floor. Hospital: 325 Ninth Ave, Seattle WA .... 206-744-3000. Here is a link to email patients in the hospital: http://uwmedicine.washington.edu/Facilities/Harborview/ClinicsAndServices/emailGifts.htm.

A quick update from Kris (in response to our offer to help with kids) is below. The address for the CaringBridge website Kris is posting to is: http://www.caringbridge.org/visit/pauldavid.

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From: Kris

For the moment, we are in pretty good shape. We are getting a lot of support from family and friends, so I don't think it is necessary for you to come right now. However, we are going to be in this for the long haul, and I might see if you are still available in a few weeks when the immediacy dies down, but the need is still great!

Thanks also for setting up the blog. I didn't see your message before setting up the one on caringbridge.com. For now, I'm going to use that one, but if it turns out to be too clunky, I'll take a look at the one you set up.

Thanks for all your thoughts and well-wishes. Paul is making good progress, be we have a long way to go....

--Kris.