8/17/06 Thursday 25 Days Post Accident

            More progress and success today!  Your foley catheter (the tube in your bladder that was “peeing” for you) was removed last night and you have had no problems “peeing” on your own today.  You are asking the nurse when you need your urinal – No problems there.

            You are asking the nurse for pain medication when you hurt which is mainly your ankle you complain about with pain.

            You have been saying how hungry you are.  The Trauma team has decided it is time to downsize your trach and then have speech therapy come and do a swallow study to test whether you can take liquids with out aspirating into your lungs.  If you pass you will have two wins! 1) You will be able to take in drink through a straw and 2) they could put a valve over your trach so you can talk.

            I have started talking with Case Manager and Liaison from Stallworth In-Patient Rehabilitation hospital for transfer.  We could be transferring you as soon as tomorrow – Friday August 18th - it depends on mainly whether you need to have IV Fentanyl to change your wound vac sponge dressing or if you can use IV Morphine for the dressing change.  Stallworth does not use IV Fentanyl but does use IV Morphine.

            I just walked back to see you and when I walked in the room you “spoke” to me you said, “Hi Mom.”  WOW how beautiful that sounded.  Your trach was downsized and you put your finger over the trach so you could talk.  How great is that?!?!

            The nurse also removed your wrist restraints.  Hopefully you will behave and not pull anything out.  You do not want any set backs.  You are definitely in a forward motion, let’s keep in going!

            Physical and Occupational therapy came to work with you today.  The nurse reported that you did very well and did al the exercises as requested.  She also encouraged you to keep doing your exercises while in bed.

            The Speech Therapist just got done with you swallow study – You passed!!!  You are cleared to drink fluids through a straw.  You also have your pasv muir valve on your trach and you are talking – WHEW what a day so far.

8/17/06 Thursday’s Day End Report

            What an awesome day.  You have accomplished a great deal.  You have thrilled family and friends with your ability to talk.  Daniel and Michael were so happy when they returned to the waiting room after seeing you for about a minute.  The minute was worth it because – when they said to you, “You look tired”, you responded with “Hell ya I’m tired” – made their day!

            Dr. Tressler called tonight around 9:00 p.m.  He had just looked at the CT scan of your left leg.  He said your left tibia and fibula are externally rotated about 8 degrees off.  He said for most people 8 degrees is not bad, but with the extent of your ankle/heel injury he wants to give you every possible advantage he can and he wants to take you back to the OR to get you in perfect alignment.  He also wants to take you to the OR to change the dressing on the wound vac.  He prefers the wound vac be changed under sterile settings since it is so close to the heel bone.  This would decrease the risk of infection.

            Dr. Tressler is going to speak with Dr. Kregor in the morning to discuss the tibia/fibula issue.  If they are in agreement you could go to the OR tomorrow afternoon.  You would be an “add-on” so I am not sure what time exactly you would go to the OR.

            I have to say I have been very impressed and pleased that both Dr. Tressler and Dr. Kregor have been so detailed and vested in your broken body being  put back together as near to perfection as possible.

            I pray you sleep well tonight-it sounds like you may have another busy day tomorrow. Love you!